CMS has adopted the standard for a national unique Health Plan Identifier (HPID) and 

established requirements for the implementation of the HPID. In addition, they are 

implementing a data element that will serve as an Other Entity Identifier (OEID), or an identifier 

for entities that are not health plans, health care providers, or individuals, but that need to be 

identified in standard transactions. In addition, the final rule also specifies the circumstances 

under which an organization covered health care provider must require certain non-covered 

individual health care providers who are prescribers to obtain and disclose a National Provider 

Identifier. 
 

Finally, this final rule confirms the Oct. 1, 2014 compliance date for the International 

Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). 

These regulations are effective on Nov. 5, 2012. Health plans with the exception of small health 

plans must obtain an HPID by Nov. 5, 2014. Small health plans must obtain an HPID by Nov. 5, 

2015. Covered entities must use HPIDs in the standard transactions on or after Nov. 7, 2016. An 

organization covered health care provider must comply with the implementation specifications 

by May 6, 2013.
 

For more details, please refer to the CMS Health Plan Identifier website.
 

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827