HIPAA Transaction Standards

By December 31, 2015, group health plans must complete a testing process and certify that they are able to conduct electronic transactions in accordance with uniform standards and operating rules.  Plans must also ensure that third-party administrators and other outside vendors are in compliance with the electronic transaction rules if the vendors conduct transactions on the plans’ behalf.

December 2015 might seem a long way off to group health plan sponsors and administrators focused on ACA’s shared responsibility rules.  Plan sponsors should bear in mind, though, that compliance with the certification requirements for electronic transactions can involve significant lead time.  Failure to comply carries substantial penalties.  Accordingly, group health plan sponsors that have not already addressed the electronic transaction rules might wish to develop a timetable for compliance.
Continue Reading Health Plans Must Certify Ability to Conduct Electronic Transactions