X12 Member Announcement: Withdrawal of Recommendations to NCVHS - Set 2
I’m reaching out today to share that X12 has formally withdrawn the recommendations it presented in 2023, commonly referenced as “recommendation set 2”. These recommendations were related to advancing the version of three already mandated transactions, which are listed below.
- 008030X329 Health Care Claim Status Request and Response (276/277)
- 008030X333 Benefit Enrollment and Maintenance (834)
- 008030X334 Payroll Deducted and Other Group Premium Payment for Insurance Products (820)
There are several reasons to support this withdrawal including the following.
- A significant period of time has passed since X12 presented the second recommendation for action. Since X12 publishes updated versions of its standards and implementation guides annually, three revision cycles with enhancements to meet new business requirements have been completed. The current version of X12’s standards and implementation guides is version 008060.
- Although stakeholder organizations previously requested that X12 recommend new versions of mandated standards individually based on specific enhancements, recent public feedback from stakeholder organizations advocates for advancing the version of the mandated transactions as a set.
- The National Standards Group (NSG) may choose to move the set of transactions forward in one rulemaking process or to move related transactions forward in separate rulemaking processes. X12 stands ready to support either option.
X12 has socialized this withdrawal among its members via presentations at several standing meetings, written notices distributed to members, and information posted on the X12 website. Additionally, X12 has discussed it broadly and publicly via presentations at healthcare industry events, such as those hosted by the Workgroup for Electronic Data Interchange (WEDI), public-facing information on the X12 website, and informal discussions with various healthcare industry associations and organizations.
X12 is in the process of publishing 008060 implementation guides in its online viewer, Glass. Once these implementation guides are published, X12 intends to modify its initial recommendation, which suggested advancing the 005010 versions of four implementation guides to the equivalent 008020 versions. The modified recommendation will suggest advancing each of the currently mandated transactions to their counterpart 008060 version. X12 will also post information on the enhancements included in the 008060 versions for each of the transactions.
As the X12 recommendations work their way through the federal processes, X12 will continue teaming with a group of its licensing partners and members to develop and implement pilot testing that proves the viability of the recommended versions and the accuracy of the cost projections X12 provides. The pilot results are posted on the X12 website and available to members, industry stakeholders, and the public.
Based on the requirement to consult with the organizations named as Designated Standard Maintenance Organizations (DSMOs) in the HIPAA regulations, X12 has informally discussed this withdrawal and the subsequent recommendation with the DSMO organizations. In addition, X12 has formally notified the organizations via letter. Updates to X12 members, other stakeholders, and the public will be provided on the X12 website and via presentations sponsored by various industry associations and organizations. Although the National Committee on Vital and Health Statistics (NCVHS) is not currently active, X12 has also sent a notice to the general NCVHS email address.
X12 looks forward to discussing this withdrawal and the planned recommendations in more detail in the coming weeks. In the meantime, if you need more information or have any questions, please contact me, Gary Beatty, the ASC Chair, or Tara Rose, the X12N Subcommittee Chair.
Sincerely,
Cathy Sheppard
X12 CEO