Timeline of Key Statutes and Regulations From the CMS

By mferistin24

  • HIPAA, Health Insurance Portability and Accountability Act

    The law requires HHS to adopt national standards
    and code sets for electronic transactions. The
    provisions become known as Administrative
    Simplification.

  • Health Insurance Reform: Announcement of Designated Standard Maintenance Organizations

    HHS announces the organizations that the Secretary
    designates as Designated Standard Maintenance
    Organizations (DSMOs).

  • Standards and Co Sets for Electronic Transactions and DSMO Process

    HHS adopts code sets (ICD-9, CPT-4, National Drug
    Codes, Code on Dental Procedures and
    Nomenclature, and HCPCS) and standards for
    electronic transactions

  • ASCA, Administrative Simplification Compliance Act

    Congress requires electronic submission of
    Medicare claims.

  • Employer Identification Number (EIN)

    HHS adopts standard for Employer Identifier
    Standard (EIN) which becomes mandatory for use
    on July 30, 2002.

  • Transaction Standards and Code Sets

    HHS adopts modified specifications for 1)
    transaction standards, and 2) how HIPAA-covered
    entities use standards, effective Mar 24, 2003.

  • Electronic Submission of Medicare Claims

    hes regulation implementing ASCA,
    requiring electronic submission of Medicare claims,
    effective Oct 16, 2003.

  • National Provider Identifier (NPI)

    HHS publishes regulation adopting the National
    Provider Identifier (NPI) under HIPAA, effective May
    23, 2007, except for small health plans, which had
    until May 23, 2008, to comply.

  • Enforcement of Administrative Simplification

    HHS extends civil monetary penalties for privacy
    violations to apply to all Administrative
    Simplification violations, effective Mar 16, 2006

  • Version 5010/D.0 Final Rule

    HHS adopts updated versions of the standards: ASC
    X12 Version 5010, NCPCP D.0, and NCPDP 3.0 and
    requires adoption by Jan 1, 2012.

  • ICD-10 Final Rule

    HHS requires HIPAA-covered entities to transition
    from ICD-9 to ICD-10 codes for medical diagnosis
    and inpatient hospital procedures on Oct 1, 2013

  • HITECH (Health Information Technology and Economic and Clinical Health Act and Civil Penalties)

    Part of the American Reinvestment and Recovery
    Act, HITECH adjusts civil monetary penalties for
    HIPAA violations, including Administrative
    Simplification.