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HIPAA Update

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ACA Operating Rules Status

2011 - 2016

 

Operating Rules

Adoption Date

Effective Date

Eligibility (270/271)

July 1, 2011

January 1, 2013*

Claims Status (276)

July 1, 2011

January 1, 2013*

EFT

July 1, 2012

January 1, 2014*

Payment and Remittance Advice (835)

July 1, 2012

January 1, 2014*

Health Plan Identifier

Not Specified

October 1, 2012

Health Claims or Equivalent Encounter Information

January 1, 2014

January 1, 2016**

Enrollment and Disenrollment in a Health Plan

January 1, 2014

January 1, 2016**

Health Plan Premium Payment

January 1, 2014

January 1, 2016**

Referral Certification and Authorization

January 1, 2014

January 1, 2016**

Health Care Claims Attachments (standard)

January 1, 2014

January 1, 2016**

*Health plans certification of compliance with operating rules and standards by December 31, 2013

**Health plan certification of compliance with operating rules and standards by December 31, 2015

***Recommendations are to be made and posted by January 1, 2011

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