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HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT Major provisions of the final rule include: Repealing the National Drug Code (NDC) as the standard medical data code set for reporting drugs and biologics in all non-retail pharmacy transactions. Adopting the proposed Addenda to the implementation guides with some technical revisions based upon comments received and consultation with the For retail pharmacy transactions: · Adopting the National Council for Prescription Drug Programs (NCPDP) Batch Version 1.1 to support the Telecommunications Version 5.1. · Adopting the Accredited Standards Committee (ASC) X12N 835 as the standard for payment and remittance advice and the NCPDP Telecommunications Version 5.1 and NCPDP Batch Version 1.1. Implementation Guides as the standard for the referral certification and authorization transaction. · Continuing the use of the NDC code set for the reporting of drugs and biologics. The rule also adopts modified standards for two transactions that were not included in the proposed rules -- premium payments, and coordination of benefits. The modifications were approved by the DMSOs and merely provide explanatory guidance. CMS is responsible for implementing and enforcing the security standards, the transactions standards and other HIPAA administrative simplification provisions, except for the privacy standards. HHS' Office for Civil Rights is responsible for implementing and enforcing the privacy rule. NEWS AND INFORMATION |
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