article: 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.