CMS Requires Use of Electronic Claim Attachments by 2028

The Centers for Medicare and Medicaid Services (CMS) recently approved the final HIPAA* simplification rule that requires the use of electronic claims attachments and related electronic signatures by May 26, 2028.

The rule (CMS-0053-F) is intended to reduce reliance on manual processes, such as paper, fax, and mail, by standardizing electronic submission of supporting documentation used in claims adjudication. It also indicates how additional requests for information and documentation by a healthcare insurer will be conducted electronically.

Providers should begin communicating with their software vendors, internal IT teams, billing services, and clearinghouses on how to best meet the requirements of the new rule.

Highmark is currently reviewing its systems and processes to prepare for the implementation of this new rule. We will share updates and opportunities for provider education via Provider News and the Provider Resource Center.

*HIPAA is an acronym for Health Insurance Portability and Accountability Act.