New CMS final rule adopts national standards for electronic claims attachments

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has announced a final rule that it says will save the health care industry about $781 million annually by establishing national standards for the electronic exchange of clinical documentation used to support health claims.

The “Administrative Simplification; Adoption of Standards for Health Care Claims Attachment Transactions and Electronic Signatures Final Rule” also adopts standards for electronic signatures to ensure secure, authenticated transmission of this information.

“The 1980s called, and they want their fax machines back,” said CMS Administrator Dr. Mehmet Oz. “The futuristic medical breakthroughs we’ve achieved, like augmented reality glasses that give surgeons X-ray vision, shouldn’t have to coexist with administrative systems that often lag decades behind. This new rule will modernize American health care by standardizing electronic claims attachments and enabling secure electronic signatures. Because every minute providers save on paperwork is another minute they can spend caring for patients.”

CMS says the rule is effective on May 26, 2026 (60 days after publication in the Federal Register), and covered entities must comply by May 26, 2028 (24 months after the effective date).

The agency says the standards adopted in the rule apply to Health Insurance Portability and Accountability Act (HIPAA)-covered entities, including health plans, healthcare clearinghouses, and healthcare providers that conduct electronic transactions.

Historically, CMS says providers have relied on outdated manual methods to submit additional claims-related documentation requested by health plans, including medical records, X-rays, clinical notes, telemedicine visit documentation and laboratory results – all of which cause delays and unnecessary costs. It says the new standards establish a consistent, easy-to-use electronic framework for transmitting this documentation, improving efficiency across the entire health care system.

• To view the final rule fact sheet, visit: https://www.cms.gov/newsroom/fact-sheets/administrative-simplification-adoption-standards-health-care-claims-attachments-transactions.
• For more information, visit: https://www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/hipaa/events-latest-news.
• To view the final rule, visit https://www.federalregister.gov/.