By: HUB’s EB Compliance Team

The Health Plan Identifier Rule is finally dead (at least for now).  This rule would have required self-funded health plans and carriers to apply for, and use, unique health plan ID (“HPID”) or other entity ID (“OEID”) numbers to identify themselves in transactions, such as paying doctors and other providers.

It may seem barely a memory at this point, but back in 2012, the U.S. Department of Health and Human Services (“HHS”) finalized a rule that required all health plans to adopt a unique identifier.  This was supposed to help streamline health plan administration and payments. 

However, due to what HHS called “overwhelming industry input” that the requirement was not needed and was unnecessarily complicated, as well as similar comments from their own advisory body, HHS decided to suspend this requirement in 2014.  The industry has moved to using other identifiers to streamline health plan payments and so this identifier was not necessary.  As a result, last year HHS proposed to remove the requirement altogether.  Now, on October 28, HHS has finally and fully removed this requirement.

Given that the requirement was suspended in 2014, the full removal will have little to no impact on most employers.  However, that is not the end of the story.

What to Do Now

The good news is that plans and carriers that didn’t get an ID do not need to apply for one now.

For plans and carriers that already have one, they can continue to use them in transactions if they want, but that is not required.  HHS will deactivate all the IDs in its system automatically and will no longer regulate the use of these IDs.

Gone, but Not Forgotten

While the HPID/OEID requirement is gone for now, HHS has a problem.  HHS is still required by law to create some kind of unique health plan identifier.  This was added to the law in 1996 and was reaffirmed by Congress as part of the Affordable Care Act.  As a result, HHS is looking for input from the industry on how best to meet this requirement.  Therefore, HHS may end up proposing new rules along these lines in the future.

The other possibility is that Congress quietly amends the law to remove this requirement.  This issue is probably not significant enough to warrant legislation on its own.  Therefore, if it is removed, it would likely happen as part of a larger bill making other changes. 

HUB will keep an eye on these developments and provide updates if there are any changes.  If you have any questions, please contact your HUB Advisor. View more compliance articles in our Compliance Directory. 

NOTICE OF DISCLAIMER 

The information herein is intended to be educational only and is based on information that is generally available. HUB International makes no representation or warranty as to its accuracy and is not obligated to update the information should it change in the future. The information is not intended to be legal or tax advice. Consult your attorney and/or professional advisor as to your organization’s specific circumstances and legal, tax or other requirements.