Overview
- The regulation takes effect May 26, 2026, with full compliance required by May 26, 2028 after a two-year transition.
- HIPAA-covered providers, insurers, and clearinghouses must submit claim attachments—such as medical records, imaging, clinical notes, lab results, and telehealth documentation—via standardized electronic transactions.
- New electronic signature standards will allow secure transmission and digital authentication of submitted documents.
- The final rule specifies X12 standards for administrative transaction data and HL7 standards for clinical data, adopting the March 2022 HL7 Attachments Implementation Guide.
- CMS excluded prior authorization attachments from this rule and says the change supports its Optimizing Care Delivery Framework to reduce fax-driven delays and lost information.