Health Insurance Portability [12/30/1996]
Volume 61, Number 251, Page
68697-68698=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
42 CFR Chapter IV
DEPARTMENT OF LABOR
Pension and Welfare Benefits Administration
29 CFR Chapter XXV
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Chapter I
Health Insurance Portability
AGENCY: Department of Health and Human Services, Health Care Financing
Administration; Department of Labor, Pension and Welfare Benefits
Administration; and Department of the Treasury, Office of Tax Policy
and Internal Revenue Service (the Agencies).
ACTION: Solicitation of comments.
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SUMMARY: The Agencies have received comments from the public on a
number of issues arising under the portability, access, and
renewability provisions of the Health Insurance Portability and
Accountability Act of 1996. Further comments from the public are
welcome.
DATES: The Agencies have requested that comments be submitted on or
before February 3, 1997.
ADDRESSES: For convenience, written comments should be submitted with a
signed original and 3 copies to the Health Care Financing
Administration (HCFA) at the address specified below. HCFA will provide
copies to each of the Agencies for their consideration. All comments
will be available for public inspection and copying in their entirety.
Health Care Financing Administration, Department of Health and Human
Services, Attention: BPD-886-N, P.O. Box 26688, Baltimore, Maryland
21207
If you prefer, you may deliver your written comments (1 original
and 3 copies) to one of the following addresses:
Room 309-G, Hubert Humphrey Building, 200 Independence Avenue, SW.,
Washington, D.C. 20201, or
Room C5-09-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850
Alternatively, comments may be submitted electronically via the
HCFA e-mail address at: iritf@fhcfa.gov. Because of staffing and
resource limitations, we cannot accept comments by facsimile (FAX)
transmission. In commenting, please refer to file code BPD-886-N.
Comments received timely will be available for public inspection as
they are received, generally beginning approximately 3 weeks after
publication of a document, in Room 309-G of the Department of Health
and Human Services offices at 200 Independence Avenue, SW., Washington,
DC, on Monday through Friday of each week from 8:30 a.m. to 5 p.m.
(phone (202) 690-7890).
FOR FURTHER INFORMATION CONTACT: Suzanne Long, Health Care Financing
Administration, at 410-786-0970 (not a toll-free number); Diane
Pedulla, Department of Labor, Office of the Solicitor, Plan Benefits
Security Division, at 202-219-4597 (not a toll-free number); or Russ
Weinheimer, Internal Revenue Service, at 202-622-4695 (not a toll-free
number).
SUPPLEMENTARY INFORMATION:
Background
The Health Insurance Portability and Accountability Act of 1996
(HIPAA) was enacted on August 21, 1996 (Public Law 104-191). HIPAA
amended the Public Health Service Act (PHSA), the Employee Retirement
Income Security Act of 1974 (ERISA), and the Internal Revenue Code of
1986 (Code) to provide for, among other things, improved portability
and continuity of health insurance coverage in the group and the
individual insurance markets, including group health plan coverage
provided in connection with employment. Health coverage is regulated in
part by the Federal government, under the PHSA, ERISA, the Code, and
other Federal provisions, and in part by the States.
The portability, access, and renewability provisions of HIPAA are
set forth in Title XXVII of the PHSA, Part 7 of Subtitle B of Title I
of ERISA, and Subtitle K of the Code (referred to below as the HIPAA
portability provisions). The HIPAA portability provisions are designed
to improve the availability and portability of health insurance
coverage by limiting exclusions for preexisting conditions and
providing credit for prior coverage, guaranteeing availability of
health coverage for small employers, prohibiting discrimination against
employees and dependents based on health status, and guaranteeing
renewability of health coverage for employers and individuals. The
HIPAA
[[Page 68698]]
portability provisions also include rules for the group and individual
insurance markets that guarantee access to individual coverage for
people who lose their group coverage. These provisions also set forth
requirements imposed on health insurance issuers.
Sections 101(g)(4), 102(c)(4), and 401(c)(4) of HIPAA provide that
the Secretaries of Health and Human Services, Labor, and Treasury shall
each issue, not later than April 1, 1997, such regulations as may be
necessary to carry out these provisions. The Agencies have been working
actively to develop these regulations.
Comments
Comments have been received from the public on a number of issues
arising under the HIPAA portability provisions. The purpose of this
announcement is to advise the public that further comments on all
issues under the HIPAA portability provisions are welcome in order that
comments may be taken into account, to the extent practicable, before
April 1, 1997.
In particular, in response to questions already received, the
Agencies are considering whether to include in the regulations a model
certification that generally could be used to certify an individual's
period of creditable coverage. Under sections 2701(e)(1) and 2743 of
the PHSA, section 701(e)(1) of ERISA, and section 9801(e)(1) of the
Code, a certification of creditable coverage is required to be provided
on certain occasions, such as when an individual loses coverage. The
model certification might include information identifying the parties
involved, whether the individual has at least 18 months of coverage
under the plan without a 63-day break, and, if not, the start and end
dates of coverage periods (and any related waiting period), but not
information about the particular benefits provided under the plan.
(Under this approach, information about the particular benefits
provided under a plan would have to be furnished only in the event that
another plan or issuer, after receiving the model certification,
requests additional information under section 2701(e)(2) of the PHSA,
section 701(e)(2) of ERISA, and section 9801(e)(2) of the Code.)
Comments are invited on whether a model certification of an
individual's period of creditable coverage would be helpful.
Signed at Washington, DC this 24th day of December 1996.
Bruce Vladeck,
Administrator, Health Care Financing Administration, Department of
Health and Human Services.
Robert J. Doyle,
Director, Office of Regulations and Interpretations, Pension and
Welfare Benefits Administration, Department of Labor.
J. Mark Iwry,
Associate Chief Counsel, Office of Tax Policy, Department of the
Treasury.
Sarah Hall Ingram,
Associate Chief Counsel, (Employee Benefits and Exempt Organizations),
Internal Revenue Service, Department of the Treasury.
[FR Doc. 96-33293 Filed 12-27-96; 8:45 am]
BILLING CODE 4120-01-M; 4830-01-M; 4510-29-M
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