[Federal Register Volume 64, Number 205 (Monday, October 25, 1999)]
[Rules and Regulations]
[Pages 57520-57521]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-27646]
[[Page 57519]]
_______________________________________________________________________
Part II
Department of the Treasury
_______________________________________________________________________
Internal Revenue Service
26 CFR Part 54
_______________________________________________________________________
Department of Labor
_______________________________________________________________________
Pension and Welfare Benefits Administration
29 CFR Part 2590
_______________________________________________________________________
Department of Health and Human Services
_______________________________________________________________________
Health Care Financing Administration
45 CFR Subtitle A, Parts 144 and 146
Health Insurance Portability; Final Rule
Federal Register / Vol. 64, No. 205 / Monday, October 25, 1999 /
Rules and Regulations
[[Page 57520]]
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 54
DEPARTMENT OF LABOR
Pension and Welfare Benefits Administration
29 CFR Part 2590
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
45 CFR Subtitle A, Parts 144 and 146
Health Insurance Portability
AGENCY: Office of Tax Policy and Internal Revenue Service, Treasury;
Pension and Welfare Benefits Administration, Labor; and Health Care
Financing Administration, HHS (the Departments).
ACTION: Solicitation of comments on interim rule.
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SUMMARY: In response to interim regulations published on April 8, 1997,
the Departments 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 (HIPAA). The Departments are interested in receiving further
comments reflecting the experience that interested parties have had
with the interim regulations.
DATES: The Departments have requested that comments be submitted on or
before January 25, 2000.
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 Departments for their consideration. All comments
will be available for public inspection in their entirety. Comments
should be sent to: Health Care Financing Administration, Department of
Health and Human Services, Attention: HCFA-2056-NC, P.O. Box 9013,
Baltimore, MD 21244-9013.
If you prefer, you may deliver a signed original and 3 copies of
your written comments to one of the following addresses:
Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW.,
Washington, DC.
or
Room C5-16-03, 7500 Security Boulevard, Baltimore, Maryland.
Comments may also be submitted electronically to the following e-
mail address: HIPAAComments@hcfa.gov. E-mail comments must include the
full name and address of the sender, and must be submitted to the
referenced address in order to be considered. All comments must be
incorporated into the text of the e-mail message itself in case of any
difficulty in accessing attachments. Electronically submitted comments
will be available for public inspection at the Independence Avenue
address, below. Because of staffing and resource limitations, comments
by facsimile (FAX) transmission cannot be accepted. In commenting,
please refer to file code HCFA-2056-NC. Comments received timely will
be available for public inspection as they are received, generally
beginning approximately 3 weeks after publication of this document, in
Room 309-G of the Department of Health and Human Service's 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).
Upon receipt from HCFA, the Department of Labor will make all
comments available for public inspection and copying in their entirety.
All comments received by the Department of Labor will be available for
public inspection and copying at the Public Disclosure Room, Pension
and Welfare Benefits Administration, U.S. Department of Labor, Room N-
5638, 200 Constitution Avenue, NW, Washington, DC 20210, on Monday
through Friday of each week from 8:30 a.m. to 4:30 p.m.
FOR FURTHER INFORMATION CONTACT: Amy Turner, Department of Labor,
Pension and Welfare Benefits Administration, Health Care Task Force, at
(202) 219-7006 (not a toll-free number); Russ Weinheimer, Internal
Revenue Service, at (202) 622-4695 (not a toll-free number); or
Danielle Noll, Health Care Financing Administration, at 410-786-1565
(not a toll-free number).
SUPPLEMENTARY INFORMATION:
Customer Service Information
To assist consumers and the regulated community, the Departments
have issued questions and answers concerning HIPAA. Individuals
interested in obtaining a copy of the Department of Labor's publication
``Recent Changes in Health Care Law'' may call a toll free number, 800-
998-7542, or access the publication on-line at www.dol.gov/dol/pwba,
the Department of Labor's website. Questions and answers pertaining to
HIPAA are also available on-line at www.hcfa.gov/hipaa/hipaahm.htm
(HCFA's website). The IRS publication ``Deciding Whether to Elect COBRA
Health Care Continuation Coverage After the Enactment of HIPAA'' is
available on the IRS's website at http://www.irs.ustreas.gov/prod/news/
index.html. Copies of the interim rules under HIPAA, as well as notices
and press releases related to HIPAA and other recently enacted health
care laws, are also available at the above referenced websites.
Background
The Health Insurance Portability and Accountability Act of 1996
(HIPAA) was enacted on August 21, 1996 (Public Law 104-191). HIPAA
amended the Internal Revenue Code of 1986 (Code), the Employee
Retirement Income Security Act of 1974 (ERISA), and the Public Health
Service Act (PHS Act) to provide for, among other things, improved
portability and continuity of health coverage including group health
plan coverage provided in connection with employment and other coverage
in the group and the individual insurance markets. Health coverage is
regulated in part by the Federal government, through the Code, ERISA,
the PHS Act and other Federal provisions, and in part by the States.
The portability, access, and renewability provisions of HIPAA are
set forth in Subtitle K of the Code, Part 7 of Subtitle B of Title I of
ERISA, and Title XXVII of the PHS Act (referred to below as the HIPAA
portability provisions). The HIPAA portability provisions are designed
to improve the availability and portability of health 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 portability
provisions also include rules that guarantee access to individual
coverage for people who lose their group coverage. These provisions
also set forth requirements imposed on health insurance issuers.
Pursuant to sections 101(g)(4), 102(c)(4), and 401(c)(4) of HIPAA, the
Departments issued interim regulations made available on April 1, 1997
(published in the Federal Register on April 8,1997) (62 FR 16894) to
carry out these provisions, and are in the process of updating those
regulations.
[[Page 57521]]
Comments
In response to the interim regulations issued in April of 1997,
comments have been received from the public on a number of issues
arising under the HIPAA portability provisions. Further comments on the
HIPAA portability provisions are welcome, including comments
concerning, for example, certificates of creditable coverage,
limitations on preexisting condition exclusion periods, special
enrollment, excepted benefits, guaranteed availability and renewability
of coverage, and individual market requirements. The Departments are
interested in comments reflecting the experience of group health plans,
health insurance issuers, States, individuals, and other interested
parties in complying with or enforcing HIPAA's statutory and regulatory
requirements, or in obtaining the protections provided by these
provisions. With respect to HIPAA's nondiscrimination provisions, the
Departments expect to publish comprehensive regulations shortly and
comments will be solicited separately in connection with that
rulemaking. In order to quantify the costs and benefits associated with
the major provisions of HIPAA and the interim rule, the Departments are
interested in comments, studies, surveys, or reports on these costs and
benefits and why and how they arise. For benefits, areas of interest
include the impact HIPAA has had on: ``job lock,'' in which the risk of
losing health care coverage discourages workers from changing jobs;
health coverage--whether it has been expanded and whether lapses in
health coverage have become less frequent and shorter in duration; and
access to health coverage, particularly in light of HIPAA's
nondiscrimination and guaranteed issue provisions. In terms of costs,
areas of interest include the impact HIPAA has had on administrative
costs, claims costs, and group and individual premiums. In addition,
comments are sought regarding other changes to group health plans
resulting from HIPAA, as well as the experience with State
implementation of alternative mechanisms in the individual health
insurance market.
In addition, a recent General Accounting Office (GAO) report
contained a recommendation that the model certificate of creditable
health plan coverage should more explicitly inform consumers of their
rights under HIPAA.1 The GAO recommended that, at a minimum,
the model certificate should inform consumers about appropriate
contacts for additional information about HIPAA, and highlight key
provisions and restrictions, including: (1) The limits on preexisting
condition exclusion periods and the guaranteed renewability of all
health coverage; (2) the reduction or elimination of preexisting
condition exclusion periods for employees changing jobs; (3) the
prohibition against excluding an individual from an employer health
plan on the basis of one or more health factors; and (4) the guarantee
of access to insurance products for certain individuals losing group
health coverage and the restrictions placed on that guarantee. In light
of the GAO's recommendation, the Departments are interested in comments
on how best to improve the model certificate of creditable coverage
under HIPAA.
\1\ Private Health Insurance: Progress and Challenges in
Implementing 1996 Federal Standards (HEHS-99-100, May 1999).
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Signed at Washington, DC this 5th day of August 1999.
J. Mark Iwry,
Benefits Tax Counsel, Department of the Treasury.
Signed at Washington, DC this 5th day of August 1999.
Nancy J. Marks,
Acting Associate Chief Counsel, Employee Benefits and Exempt
Organizations, Internal Revenue Service, Department of the Treasury.
Signed at Washington, DC this 19th day of July 1999.
Richard M. McGahey,
Assistant Secretary, Pension and Welfare Benefits Administration,
Department of Labor.
Signed at Washington, DC this 15th day of September 1999.
Michael M. Hash,
Deputy Administrator, Health Care Financing Administration, Department
of Health and Human Services.
[FR Doc. 99-27646 Filed 10-22-99; 8:45 am]
BILLING CODE 4830-01-P; 4510-29-P; 4120-01-P
