CMS Adopts Final Rule Phasing Out Fax and Mail for Health Care Claims Attachments

The Centers for Medicare & Medicaid Services (CMS) issued a final rule on national standards for electronic claims attachments and signatures, including for laboratory results, effectively phasing out fax and mail for claims documentation. The rule is effective May 26.

The Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures final rule (CMS-0053-F) includes the adoption of X12 standards for administrative transaction data; Health Level 7 standards for clinical data integration; and electronic signature requirements to authenticate transactions and ensure compliance, according to a March 20 CMS fact sheet.

The final rule is limited in scope to health care claims attachments. The decision to exclude prior authorization attachments comes in response to stakeholder concerns about potential misalignment with existing X12 standards for prior authorization, as well as potential conflicts with the CMS Advancing Interoperability and Improving Prior Authorization Processes final rule (89 FR 8758). While prior authorization attachment standards were not finalized at this time, the U.S. Department of Health and Human Services will continue to evaluate alternative standards.

The rule is projected to save the health care industry roughly $781 million annually, according to CMS. The change also promises to reduce administrative burdens, accelerate claims processing, enhance security, and streamline workflows.

Source:

https://www.cms.gov/newsroom/fact-sheets/administrative-simplification-adoption-standards-health-care-claims-attachments-transactions