[Congressional Record Volume 147, Number 61 (Monday, May 7, 2001)]
[Senate]
[Pages S4417-S4418]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CRAIG (for himself, Mr. Dorgan, and Mr. Crapo):
  S. 836. A bill to amend part C of title XI of the Social Security Act 
to provide for coordination of implementation of administrative 
simplification standards for health care information; to the Committee 
on Finance.
  Mr. CRAIG. Mr. President, I rise today to introduce a bill to amend 
the Administrative Simplification provisions of the Health Insurance 
Portability and Accountability Act. I am pleased that Senator Byron 
Dorgan and Senator Mike Crapo are joining with me in this effort today.
  I understand the benefits of administration simplification and 
support the goal of getting healthcare providers to use uniform codes 
to reduce overall costs through increased efficiencies. However, it was 
originally intended for the entire package of administrative 
simplification regulations to be released at one time. This would have 
allowed for system changes to be included in a comprehensive upgrade. 
These final provisions are now expected to be released over time, which 
will drive up the cost substantially for providers and health plans as 
they will be forced to adapt their systems with every new regulation. 
For example, identifiers for providers, plans and employers have yet to 
be finalized, making it impossible to incorporate this information into 
new computer systems.
  In addition to the costs of repeatedly updating systems to be 
incurred by providers, the overall cost of compliance with the Health 
Insurance Portability and Accountability Act is expected to exceed the 
costs of Y2K readiness. Small providers, like those in my state of 
Idaho, cannot afford the high cost in such a short time frame. A longer 
timeframe will allow these small providers to pay incrementally for 
systems upgrades.
  In addition, if health plans and providers hurry implementation of 
these provisions, there is the serious possibility that service 
problems will arise for consumers, including inaccurate payments and 
customer service issues. A longer implementation timeframe will also 
allow providers and plans to address any unanticipated consequences as 
they arise.
  For these reasons, with my colleagues Senators Dorgan and Crapo, I am 
introducing this legislation to delay implementation of the 
administrative provisions until the later date of either October 16, 
2004 or two years after the final adoption of all regulations. The 
regulations that would be impacted by this legislation include 
electronic transactions, code sets, security standards for the 
electronic standards, and identifiers for health plans and providers. 
To avoid confusion, let me be clear that this legislation does not 
affect implementation of the Health Insurance Portability and 
Accountability Act medical privacy issues and does not deal with unique 
health identifiers for individuals.
  To ensure that providers, plans and the Department of Health and 
Human Services are working towards compliance to these provisions, this 
legislation calls for the General Accounting Office to evaluate the 
progress of implementation no later than October 31, 2003.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

[[Page S4418]]

                                 S. 836

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. COORDINATION OF IMPLEMENTATION OF ADMINISTRATIVE 
                   SIMPLIFICATION STANDARDS FOR HEALTH CARE 
                   INFORMATION.

       (a) In General.--Section 1175(b)(1) of the Social Security 
     Act (42 U.S.C. 1320d-4(b)(1)) is amended to read as follows:
       ``(1) In General.--Each person to whom an initial standard 
     or implementation specification is adopted or established 
     under sections 1172 and 1173 applies shall comply with the 
     standard or specification by the later of--
       ``(A) 24 months after the date on which the Secretary 
     determines that--
       ``(i) regulations with respect to all of the standards and 
     specifications required by such sections (other than 
     standards for unique health identifiers for individuals under 
     section 1173(b)(1)) have been adopted in final form;
       ``(ii) regulations implementing section 1176 have been 
     issued in final form; and
       ``(iii) reliable national unique health identifiers for 
     health plans and health care providers are ready and 
     available; or
       ``(B) October 16, 2004.''.
       (b) Rule of Construction.--For purposes of section 
     1175(b)(1) of the Social Security Act (42 U.S.C. 1320d-
     4(b)(1)), as amended by subsection (a)--
       (1) the requirements of such section (relating to issuance 
     of a regulation ``in final form'') shall be considered to be 
     met with respect to a standard, specification, or section if 
     a regulation implementing such standard, specification, or 
     section is issued and becomes effective in accordance with 
     section 553 of title 5, United States Code;
       (2) nothing in such section 1175(b)(1) shall be construed 
     as requiring the Secretary of Health and Human Services to 
     take into account subsequent modifications made to such 
     regulation pursuant to section 1174(b) of the Social Security 
     Act (42 U.S.C. 1 320d-3(b)) in making the determination that 
     a regulation has been issued ``in final form'' with respect 
     to a standard, specification, or section; and
       (3) nothing in such section 1175(b)(1) shall be construed 
     as limiting or affecting the authority of the Secretary of 
     Health and Human Services to issue or implement the final 
     regulations establishing standards for privacy of 
     individually identifiable health information published in the 
     Federal Register by the Secretary on December 28, 2000 (65 
     Fed. Reg. 82462), including the requirements of section 
     164.530 of title 45 of the Code of Federal Regulations.
       (c) Study of Compliance with Health Insurance Portability 
     and Accountability Act of 1996.--
       (1) In general.--The Comptroller General of the United 
     States shall conduct a study to examine the effect of the 
     enactment of section 262 of the Health Insurance Portability 
     and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 
     2021), and regulations issued thereunder, on health plans, 
     health care providers, the medicare and medicaid programs, 
     and the Department of Health and Human Services, including 
     the progress of such entities or programs in complying with 
     the amendments made by such section.
       (2) Report.--Not later than October 31, 2003, the 
     Comptroller General shall submit to the appropriate 
     committees of Congress a report on the study conducted under 
     paragraph (1).
       (d) Effective Date.--The amendment made by subsection (a) 
     shall take effect as if included in the enactment of section 
     262 of the Health Insurance Portability and Accountability 
     Act of 1996 (Public Law 104-191; 110 Stat. 2021).
                                 ______