In December 2024, the Department of Health and Human Services released a Federal Register final rule changing the Retail Pharmacy Standards of the National Council for Prescription Drug Programs (NCPDP) as well as the Medicaid Pharmacy Subrogation Standard. Those modifications were set to be effective on February 11, 2025, but the HHS changed the effective date to April 14, 2025.
The HIPAA final rule acquired revised versions of the retail pharmacy standards for electronic transactions for healthcare claims or similar encounter data; referral certification and consent; qualification for a health plan; coordination of benefits, and the usage of a changed standard for the Medicaid pharmacy subrogation transaction.
The changes to the effective and compliance dates are because of President Trump’s January 20, 2025, Presidential memorandum, “Regulatory Freeze Pending Review.” Acting Secretary Dorothy A. Fink of the Department of Health and Human Services mentioned that the 60-day delay of the effective date was to allow the assessment of any questions of fact, law, and policy.
Fink stated that starting the notice and comment processes for the final rule is not needed and is opposite to the public’s interest. The HHS has a good reason to postpone the notice and comment procedures and delay the effective date for 30 days. The rule is effective instantaneously upon being published in the Federal Register.
Postponing the effective date will of course postpone the compliance date. With the February 11, 2025 effective date, full compliance with the revised standards would start February 11, 2028, having a transition time starting 8 months before the full compliance date. There was a mistake in the calculation of the beginning of the transition time, which was wrongly set for August 11, 2027. It should have been June 11, 2027. A technical rectification consequently should be made and posted in the Federal Register, and the postponement will give the HHS extra time to implement the required corrections.