PUBLIC LAW 104-208-SEPT. 30, 1996 110 STAT. 3009-718 (II) whose birth is registered in the United States; and (B) that (i) is a copy, issued by a State or local authorized custodian of record, of an original certificate of birth issued by such custodian of record; or (ii) was issued by a State or local authorized custodian of record and was produced from birth records maintained by such custodian of record. (b) STATE-ISSUED DRIVERS LICENSES AND COMPARABLE IDENTIFICATION DOCUMENTS — (1) STANDARDS FOR ACCEPTANCE BY FEDERAL AGENCIES.- (i) APPLICATION PROCESS.-The application process (ii) SOCIAL SECURITY NUMBER-Except as provided in subparagraph (B), the license or document shall contain a social security account number that can be read visually or by electronic means. (iii) FORM.-The license or document otherwise shall be in a form consistent with requirements set forth in regulations promulgated by the Secretary of Transportation after consultation with the American Association of Motor Vehicle Administrators. The form shall contain security features designed to limit tampering, counterfeiting, photocopying, or otherwise duplicating, the license or document for fraudulent purposes and to limit use of the license or document by impostors (B) EXCEPTION-The requirement in subparagraph (AXii) shall not apply with respect to a driver's license or other comparable identification document issued by a State, if the State (i) does not require the license or document to contain a social security account number; and (ii) requires (1) every applicant for a driver's license, or other comparable identification document, to submit the applicant's social security account number; and (II) an agency of the State to verify with the Social Security Administration that such account number is valid. (C) DEADLINE.-The Secretary of Transportation shall promulgate the regulations referred to in clauses (i) and (iii) of subparagraph (A) not later than 1 year after the date of the enactment of this Act. (2) GRANTS TO STATES.-Beginning on the date final regulations are promulgated under paragraph (1), the Secretary of 39-1390-96-24 (208) 110 STAT. 3009-719 PUBLIC LAW 104-208-SEPT. 30, 1996 Transportation shall make grants to States to assist them in issuing driver's licenses and other comparable identification documents that satisfy the requirements under such paragraph (3) EFFECTIVE DATES.— (A) IN GENERAL.-Except as otherwise provided in this paragraph, this subsection shall take effect on the date of the enactment of this Act. (B) PROHIBITION ON FEDERAL AGENCIES.-Subparagraphs (A) and (B) of paragraph (1) shall take effect beginning on October 1, 2000, but shall apply only to licenses or documents issued to an individual for the first time and to replacement or renewal licenses or documents issued according to State law. (c) REPORT.-Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit a report to the Congress on ways to reduce the fraudu. lent obtaining and the fraudulent use of birth certificates, including any such use to obtain a social security account number or a State or Federal document related to identification or immigration. (d) FEDERAL AGENCY DEFINED.-For purposes of this section, the term "Federal agency" means any of the following. (1) An Executive agency (as defined in section 105 of title 5, United States Code). (2) A military department (as defined in section 102 of such title). (3) An agency in the legislative branch of the Government of the United States. (4) An agency in the judicial branch of the Government of the United States. PUBLIC LAW 104-191–AUG. 21, 1996 110 STAT. 2025 "(1) IN GENERAL.-The Secretary shall adopt standards for transactions, and data elements for such transactions, to enable health information to be exchanged electronically, that are appropriate for— "(A) the financial and administrative transactions described in paragraph (2); and "(B) other financial and administrative transactions determined appropriate by the Secretary, consistent with the goals of improving the operation of the health care system and reducing administrative costs. "(2) TRANSACTIONS.-The transactions referred to in paragraph (1XA) are transactions with respect to the following: “(A) Health claims or equivalent encounter information. "(B) Health claims attachments. "(C) Enrollment and disenrollment in a health plan. "(E) Health care payment and remittance advice. "(F) Health plan premium payments. "(G) First report of injury. "(H) Health claim status. "(I) Referral certification and authorization. "(3) ACCOMMODATION OF SPECIFIC PROVIDERS.-The standards adopted by the Secretary under paragraph (1) shall accommodate the needs of different types of health care provid ers "(b) UNIQUE Health IdentIFIERS.— (1) IN GENERAL.-The Secretary shall adopt standards providing for a standard unique health identifier for each individual employer, health plan, and health care provider for use in the health care system. In carrying out the preceding sentence for each health plan and health care provider, the Secretary shall take into account multiple uses for identifiers and multiple locations and specialty classifications for health care providers. (2) USE OF IDENTIFIERS.-The standards adopted under paragraph (1) shall specify the purposes for which a unique health identifier may be used. (c) CODE SETS.— “(1) IN GENERAL.-The Secretary shall adopt standards that "(A) select code sets for appropriate data elements for the transactions referred to in subsection (aX1) from among the code sets that have been developed by private and public entities; or (B) establish code sets for such data elements if no code sets for the data elements have been developed. “(2) DistributION.-The Secretary shall establish efficient and low-cost procedures for distribution (including electronic distribution) of code sets and modifications made to such code sets under section 1174(b). "(d) SECURITY STANDARDS FOR HEALTH INFORMATION.- "(A) take into account "(i) the technical capabilities of record systems used to maintain health information; 110 STAT. 2026 42 USC 1320d-3. PUBLIC LAW 104-191-AUG. 21, 1996 "(ii) the costs of security measures; "(iii) the need for training persons who have access to health information; "(iv) the value of audit trails in computerized record systems; and "(v) the needs and capabilities of small health care providers and rural health care providers (as such providers are defined by the Secretary); and (B) ensure that a health care clearinghouse, if it is part of a larger organization, has policies and security procedures which isolate the activities of the health care clearinghouse with respect to processing information in a manner that prevents unauthorized access to such information by such larger organization. "(2) SAFEGUARDS.-Each person described in section 1172(a) who maintains or transmits health information shall maintain reasonable and appropriate administrative, technical, and physical safeguards "(A) to ensure the integrity and confidentiality of the information; "(B) to protect against any reasonably anticipated"(i) threats or hazards to the security or integrity of the information; and "(ii) unauthorized uses or disclosures of the information; and "(C) otherwise to ensure compliance with this part by the officers and employees of such person. "(e) ELECTRONIC SIGNATURE. "(1) STANDARDS.-The Secretary, in coordination with the Secretary of Commerce, shall adopt standards specifying procedures for the electronic transmission and authentication of signatures with respect to the transactions referred to in subsection (a)(1). "(2) EFFECT OF COMPLIANCE. Compliance with the standards adopted under paragraph (1) shall be deemed to satisfy Federal and State statutory requirements for written signatures with respect to the transactions referred to in subsection (a)(1). "(f) TRANSFER OF INFORMATION AMONG HEALTH PLANS.-The Secretary shall adopt standards for transferring among health plans appropriate standard data elements needed for the coordination of benefits, the sequential processing of claims, and other data elements for individuals who have more than one health plan. "TIMETABLES FOR ADOPTION OF STANDARDS “SEC. 1174. (a) Initial StandARDS.-The Secretary shall carry out section 1173 not later than 18 months after the date of the enactment of the Health Insurance Portability and Accountability Act of 1996, except that standards relating to claims attachments shall be adopted not later than 30 months after such date. “(b) ADDITIONs and Modifications to Standards.— (1) IN GENERAL.-Except as provided in paragraph (2), the Secretary shall review the standards adopted under section 1173, and shall adopt modifications to the standards (including additions to the standards), as determined appropriate, but not more frequently than once every 12 months. Any addition or modification to a standard shall be completed in a manner which minimizes the disruption and cost of compliance. DEPARTMENT OF HEALTH & HUMAN SERVICES Statement for the Record by William R. Braithwaite, M.D., Ph.D. Senior Advisor on Health Information Policy Office of the Assistant Secretary for Planning and Evaluation for the Subcommittee on National Economic Growth, Natural Resources, and Regulatory Affairs House Committee on Government Reform and Oversight September 17, 1998 |