A bill to provide a 1-year extension of the date for compliance by certain covered entities with the administrative simplification standards for electronic transactions and code sets issued in accordance with the Health Insurance Portability and Accountability Act of 1996.

SECTION 1. 1-YEAR EXTENSION OF DATE FOR COMPLIANCE BY CERTAIN COVERED 
              ENTITIES WITH ADMINISTRATIVE SIMPLIFICATION STANDARDS FOR 
              ELECTRONIC TRANSACTIONS AND CODE SETS.

    (a) In General.--Notwithstanding section 1175(b)(1)(A) of the 
Social Security Act (42 U.S.C. 1320d-4(b)(1)(A)) and section 162.900 of 
title 45 of the Code of Federal Regulations--
            (1) a health care provider shall not be considered to be in 
        noncompliance with the applicable requirements of subparts I 
        through N of part 162 of title 45 of the Code of Federal 
        Regulations before October 16, 2003; and
            (2) a health plan (other than a small health plan) or a 
        health care clearinghouse shall not be considered to be in 
        noncompliance with the applicable requirements of subparts I 
        through R of part 162 of title 45 of the Code of Federal 
        Regulations before October 16, 2003.
    (b) Special Rules.--
            (1) Rules of construction.--Nothing in this section shall 
        be construed--
                    (A) as modifying the October 16, 2003, date for 
                compliance of small health plans with subparts I 
                through R of part 162 of title 45 of the Code of 
                Federal Regulations; or
                    (B) as modifying--
                            (i) the April 14, 2003, date for compliance 
                        of a health care provider, a health plan (other 
                        than a small health plan), or a health care 
                        clearinghouse with subpart E of part 164 of 
                        title 45 of the Code of Federal Regulations; or
                            (ii) the April 14, 2004, date for 
                        compliance of a small health plan with subpart 
                        E of part 164 of title 45 of the Code of 
                        Federal Regulations.
            (2) Applicability of privacy requirements to certain 
        transactions prior to standards compliance date.--
                    (A) In general.--Notwithstanding any other 
                provision of law, during the period that begins on 
                April 14, 2003, and ends on October 16, 2003, a health 
                care provider or, subject to subparagraph (C), a health 
                care clearinghouse, that transmits any health 
                information in electronic form in connection with a 
                transaction described in subparagraph (B) shall comply 
                with the then applicable requirements of subpart E of 
                part 164 of title 45 of the Code of Federal Regulations 
                without regard to section 164.106 of subpart A of such 
                part or to whether the transmission meets any standard 
                formats required by part 162 of title 45 of the Code of 
                Federal Regulations.
                    (B) Transactions described.--The transactions 
                described in this subparagraph are the following:
                            (i) A health care claims or equivalent 
                        encounter information transaction.
                            (ii) A health care payment and remittance 
                        advice transaction.
                            (iii) A coordination of benefits 
                        transaction.
                            (iv) A health care claim status 
                        transaction.
                            (v) An enrollment and disenrollment in a 
                        health plan transaction.
                            (vi) An eligibility for a health plan 
                        transaction.
                            (vii) A health plan premium payments 
                        transaction.
                            (viii) A referral certification and 
                        authorization transaction.
                            (ix) A transaction with respect to a first 
                        report of injury.
                            (x) A transaction with respect to health 
                        claims attachments.
                    (C) Application to health care clearinghouses.--For 
                purposes of this paragraph, during the period described 
                in subparagraph (A), an entity that would otherwise 
                meet the definition of health care clearinghouse that 
                processes or facilitates the processing of information 
                in connection with a transaction described in 
                subparagraph (B) shall be deemed to be a health care 
                clearinghouse notwithstanding that the entity does not 
                process or facilitate the processing of such 
                information into any standard formats required by part 
                162 of title 45 of the Code of Federal Regulations.
    (c) Definitions.--In this section--
            (1) the terms ``health care provider'', ``health plan'', 
        and ``health care clearinghouse'' have the meaning given those 
        terms in section 1171 of the Social Security Act (42 U.S.C. 
        1320d) and section 160.103 of part 160 of title 45 of the Code 
        of Federal Regulations;
            (2) the terms ``small health plan'' and ``transaction'' 
        have the meaning given those terms in section 160.103 of part 
        160 of title 45 of the Code of Federal Regulations; and
            (3) the terms ``health care claims or equivalent encounter 
        information transaction'', ``health care payment and remittance 
        advice transaction'', ``coordination of benefits transaction'', 
        ``health care claim status transaction'', ``enrollment and 
        disenrollment in a health plan transaction'', ``eligibility for 
        a health plan transaction'', ``health plan premium payments 
        transaction'', and ``referral certification and authorization 
        transaction'' have the meanings given those terms in sections 
        162.1101, 162.1601, 162.1801, 162.1401, 162.1501, 162.1201, 
        162.1701, and 162.1301 of part 162 of title 45 of the Code of 
        Federal Regulations, respectively.

Summary: Provides a one year extension for providers, State health programs, health plans, and others to implement the administrative simplification standards for electronic transactions and code sets required by the Health Insurance Portability and Accountability Act (HIPAA). Differentiates these electronic transaction and code set requirements from the medical privacy regulations under HIPAA which remain unaffected.