0938-AV43 202410 The Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions 0938 Centers for Medicare & Medicaid Services CMS 0900 Department of Health and Human Services HHS Administrative Simplification: Modifications to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Electronic Transaction Standards Version 8020 (CMS-0061)

This proposed rule seeks to adopt the updated versions of the standards for the electronic exchange of health information under the Administrative Simplification subtitle of HIPAA.  Specifically, this rule would propose to replace the X12 Technical Reports Type 3, Version 5010 with the X12 Technical Reports Type 3, Version 8020 for health care claims or equivalent encounter information transactions (Institutional, Professional, and Dental) and electronic remittance advice transactions. These updated versions of the X12 standards would promote interoperability and ease the administrative burden on providers and health plans.  We are developing this rule, in part, based on the number of stakeholders who have conveyed that the agency should adopt the updated version of X12 transaction standards.

]]> Other Significant Previously Published in The Unified Agenda Proposed Rule Stage Undetermined No 45 CFR 162 Social Security Act, sec. 1173 Pub. L. 104-191 (HIPAA) Pub L.111-148 (ACA), sec. 1104 No NPRM 08/00/2025 Undetermined Federal Local State Tribal No No No Geanelle Herring Technical Advisor 0938 Centers for Medicare & Medicaid Services CMS 410 786-4466 geanelle.herring@cms.hhs.gov Office of Healthcare Experience and Interoperability, 7500 Security Boulevard, Baltimore MD 21244