[Federal Register Volume 61, Number 251 (Monday, December 30, 1996)]
[Proposed Rules]
[Pages 68697-68698]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-33293]


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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: [email protected]. 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