[Code of Federal Regulations]
[Title 45, Volume 1]
[Revised as of October 1, 2004]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR162.1202]

[Page 726-727]
 
                        TITLE 45--PUBLIC WELFARE
 
                    SUBTITLE A--DEPARTMENT OF HEALTH
                         AND HUMAN SERVICES
 
PART 162_ADMINISTRATIVE REQUIREMENTS--Table of Contents
 
                 Subpart L_Eligibility for a Health Plan
 
Sec. 162.1202  Standards for eligibility for a health plan transaction.

    The Secretary adopts the following standards for the eligibility for 
a health plan transaction:
    (a) For the period from October 16, 2002 through October 15, 2003:
    (1) Retail pharmacy drugs. The National Council for Prescription 
Drug Programs Telecommunications Standards Implementaiton Guide, Version 
5, Release 1, September 1999, and equivalent NCPDP Batch Standards Batch 
Implementation Guide, Version 1, Release 0, February 1, 1996. 
(Incorporated by reference in Sec. 162.920).
    (2) Dental, professional, and institutional health care eligibility 
benefit inquiry and response. The ASC X12N 270/271--Health Care 
Eligibility Benefit Inquiry and Response, Version 4010, May 2000, 
Washington Publishing Company,004010X092. (Incorporated by reference in 
Sec. 162.920).
    (b) For the period on and after October 16, 2003:
    (1) Retail pharmacy drugs. The National Council for Prescription 
Drug Programs Telecommunication Standard Implementation Guide, Version 
5, Release 1 (Version 5.1), September 1999, and equivalent NCPDP Batch 
Standard Batch Implementation Guide, Version 1, Release 1 (Version 1.1), 
January 2000

[[Page 727]]

supporting Telecommunications Standard Implementation Guide, Version 5, 
Release 1 (Version 5.1) for the NCPDP Data Record in the Detail Data 
Record. (Incorporated by reference in Sec. 162.920).
    (2) Dental, professional, and institutional health care eligibility 
benefit inquiry and response. The ASC X12N 270/271--Health Care 
Eligibility Benefit Inquiry and Response, Version 4010, May 2000, 
Washington Publishing Company, 004010X092 and Addenda to Health Care 
Eligibility Benefit Inquiry and Response, Version 4010, October 2002, 
Washington Publishing Company, 004010X092A1. (Incorporated by reference 
in Sec. 162.920).

[68 FR 8398, Feb. 20, 2003; 68 FR 11445, Mar. 10, 2003]