Data / Federal rules / 2024-29138
Administrative Simplification: Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard
The Health and Human Services Department published this final rule in the Federal Register on December 13, 2024. It took effect on February 11, 2025.
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What the agency says
This final rule adopts updated versions of the retail pharmacy standards for electronic transactions adopted under the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These updated versions are modifications to the currently adopted standards for the following retail pharmacy transactions: health care claims or equivalent encounter information; eligibility for a health plan; referral certification and authorization; and coordination of benefits. This final rule also adopts a modification to the standard for the Medicaid pharmacy subrogation transaction.
Key facts
- Document number
- 2024-29138
- Type
- Final rule
- Action
- Final rule
- Agency
- Health and Human Services Department
- Published
- December 13, 2024
- Takes effect
- February 11, 2025
- Dates
- Effective Date: This final rule is effective on February 11, 2025. The incorporation by reference of certain publications listed in the rule is approved by the Director of the Federal Register beginning February 11, 2025. The incorporation by reference of certain other publications listed in the rule was approved by the Director as of March 17, 2009.
- Docket
- CMS-0056-F
- Regulation ID (RIN)
- 0938-AU19
- Code of Federal Regulations
- 45 CFR 162
- Topics
- Administrative practice and procedure; Health facilities; Health insurance; Hospitals; Incorporation by reference; Medicaid; Medicare; Reporting and recordkeeping requirements
- Pages
- 27
Other documents from the Health and Human Services Department
Everything from the Health and Human Services Department · Rules on administrative practice and procedure · Rules on health facilities · Rules on health insurance · Published in December 2024
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