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
medicaid · Centers for Medicare and Medicaid Services · Rule · Published 2025-02-11 · Effective 2025-04-14 · 90 FR 9289
Document
Document number
2025-02511
Federal Register citation
90 FR 9289
CFR reference
45 CFR 162
Type
Rule
Action
Final rule; delay of effective date.
Category
medicaid
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2025-02-11
Effective date
2025-04-14
HHS docket
CMS-0056-F2
Abstract
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.