Data / Federal rules / 2025-02511
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; Delay of Effective Date
The Health and Human Services Department published this final rule in the Federal Register on February 11, 2025. It took effect on April 14, 2025.
SpecStream is the live web data engine for teams and agents. It reads every rule and proposed rule in the Federal Register each morning, and this page is that reading. Name your industry once and new rules, comment deadlines and effective dates arrive in your sheet, CRM, Slack or agent as they are published.
What the agency says
In accordance with the Presidential memorandum of January 20, 2025, titled "Regulatory Freeze Pending Review," the effective date of the final rule titled "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" is delayed until April 14, 2025. That final rule adopted updated versions of the retail pharmacy standards for electronic transactions adopted under the Administrative Simplification subtitle of HIPAA, which constitute modifications to the 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. It also adopted a modification to the standard for the Medicaid pharmacy subrogation transaction.
Key facts
- Document number
- 2025-02511
- Type
- Final rule
- Action
- Final rule; delay of effective date
- Agency
- Health and Human Services Department
- Published
- February 11, 2025
- Takes effect
- April 14, 2025
- Dates
- Effective date: The final rule titled "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," which appeared in the December 13, 2024, Federal Register (89 FR 100763) is delayed to April 14, 2025. The incorporation by reference of certain publications adopted in the rule and approved by the Director of the Federal Register is also delayed to April 14, 2025.
- Docket
- CMS-0056-F2
- Regulation ID (RIN)
- 0938-AU19
- Code of Federal Regulations
- 45 CFR 162
- Pages
- 2
Other documents from the Health and Human Services Department
Everything from the Health and Human Services Department · Published in February 2025
Read from the Federal Register API, last updated 2026-10-23. The document on federalregister.gov is the official record; dates and dockets can change through later corrections. Free to reuse with credit to SpecStream under CC BY 4.0.