§1. SHORT TITLE; TABLE OF CONTENTS. (42 USC 201)

Health Insurance Portability and Accountability Act of 1996

(a) Short Title.—This Act may be cited as the ‘‘Health Insurance Portability and Accountability Act of 1996’’.

(b) Table of Contents.—The table of contents of this Act is as follows:

TITLE I—HEALTH CARE ACCESS, PORTABILITY, AND RENEWABILITY

Subtitle A—Group Market Rules

Part 1—Portability, Access, and Renewability Requirements

§101. Through the Employee Retirement Income Security Act of 1974.

‘‘Part 7—Group Health Plan Portability, Access, and Renewability Requirements

‘‘§701. Increased portability through limitation on preexisting condition exclusions.

‘‘§702. Prohibiting discrimination against individual participants and beneficiaries based on health status.

‘‘§703. Guaranteed renewability in multiemployer plans and multiple employer welfare arrangements.

‘‘§704. Preemption; State flexibility; construction.

‘‘§705. Special rules relating to group health plans.

‘‘§706. Definitions.

‘‘§707. Regulations.’’

§102. Through the Public Health Service Act.

‘‘TITLE XXVII—ASSURING PORTABILITY, AVAILABILITY, AND RENEWABILITY OF HEALTH INSURANCE COVERAGE

‘‘Part A—Group Market Reforms ‘‘Subpart 1—Portability, Access, and Renewability Requirements

‘‘§2701. Increased portability through limitation on preexisting condition exclusions.

‘‘§2702. Prohibiting discrimination against individual participants and beneficiaries based on health status.

‘‘Subpart 2—Provisions Applicable Only to Health Insurance Issuers

‘‘§2711. Guaranteed availability of coverage for employers in the group market.

‘‘§2712. Guaranteed renewability of coverage for employers in the group market.

‘‘§2713. Disclosure of information.

‘‘Subpart 3—Exclusion of Plans; Enforcement; Preemption

‘‘§2721. Exclusion of certain plans.

‘‘§2722. Enforcement.

‘‘§2723. Preemption; State flexibility; construction.

‘‘Part C—Definitions; Miscellaneous Provisions

‘‘§2791. Definitions.

‘‘§2792. Regulations.’’

§103. Reference to implementation through the Internal Revenue Code of 1986.

§104. Assuring coordination.

Subtitle B—Individual Market Rules

§111. Amendment to Public Health Service Act.

‘‘Part B—Individual Market Rules

‘‘§2741. Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage.

‘‘§2742. Guaranteed renewability of individual health insurance coverage.

‘‘§2743. Certification of coverage.

‘‘§2744. State flexibility in individual market reforms.

‘‘§2745. Enforcement.

‘‘§2746. Preemption.

‘‘§2747. General exceptions.’’.

Subtitle C—General and Miscellaneous Provisions

§191. Health coverage availability studies.

§192. Report on Medicare reimbursement of telemedicine.

§193. Allowing federally-qualified HMOs to offer high deductible plans.

§194. Volunteer services provided by health professionals at free clinics.

§195. Findings; severability.

TITLE II—PREVENTING HEALTH CARE FRAUD AND ABUSE; ADMINISTRATIVE SIMPLIFICATION; MEDICAL LIABILITY REFORM

§200. References in title.

Subtitle A—Fraud and Abuse Control Program

§201. Fraud and abuse control program.

§202. Medicare integrity program.

§203. Beneficiary incentive programs.

§204. Application of certain health antifraud and abuse sanctions to fraud and abuse against Federal health care programs.

§205. Guidance regarding application of health care fraud and abuse sanctions.

Subtitle B—Revisions to Current Sanctions for Fraud and Abuse

§211. Mandatory exclusion from participation in Medicare and State health care programs.

§212. Establishment of minimum period of exclusion for certain individuals and entities subject to permissive exclusion from Medicare and State health care programs.

§213. Permissive exclusion of individuals with ownership or control interest in sanctioned entities.

§214. Sanctions against practitioners and persons for failure to comply with statutory obligations.

§215. Intermediate sanctions for Medicare health maintenance organizations.

§216. Additional exception to anti-kickback penalties for risk-sharing arrangements.

§217. Criminal penalty for fraudulent disposition of assets in order to obtain medicaid benefits.

§218. Effective date.

Subtitle C—Data Collection

§221. Establishment of the health care fraud and abuse data collection program.

Subtitle D—Civil Monetary Penalties

§231. Social Security Act civil monetary penalties.

§232. Penalty for false certification for home health services.

Subtitle E—Revisions to Criminal Law

§241. Definitions relating to Federal health care offense.

§242. Health care fraud.

§243. Theft or embezzlement.

§244. False statements.

§245. Obstruction of criminal investigations of health care offenses.

§246. Laundering of monetary instruments.

§247. Injunctive relief relating to health care offenses.

§248. Authorized investigative demand procedures.

§249. Forfeitures for Federal health care offenses.

§250. Relation to ERISA authority.

Subtitle F—Administrative Simplification

§261. Purpose.

§262. Administrative simplification.

‘‘Part C—Administrative Simplification

‘‘§1171. Definitions.

‘‘§1172. General requirements for adoption of standards.

‘‘§1173. Standards for information transactions and data elements.

‘‘§1174. Timetables for adoption of standards.

‘‘§1175. Requirements.

‘‘§1176. General penalty for failure to comply with requirements and standards.

‘‘§1177. Wrongful disclosure of individually identifiable health information.

‘‘§1178. Effect on State law.

‘‘§1179. Processing payment transactions.’’

§263. Changes in membership and duties of National Committee on Vital and Health Statistics.

§264. Recommendations with respect to privacy of certain health information.

Subtitle G—Duplication and Coordination of Medicare-Related Plans

§271. Duplication and coordination of Medicare-related plans.

TITLE III—TAX-RELATED HEALTH PROVISIONS

§300. Amendment of 1986 Code.

Subtitle A—Medical Savings Accounts

§301. Medical savings accounts.

Subtitle B—Increase in Deduction for Health Insurance Costs of Self-Employed Individuals

§311. Increase in deduction for health insurance costs of self-employed individuals.

Subtitle C—Long-Term Care Services and Contracts

Part I—General Provisions

§321. Treatment of long-term care insurance.

§322. Qualified long-term care services treated as medical care.

§323. Reporting requirements.

Part II—Consumer Protection Provisions

§325. Policy requirements.

§326. Requirements for issuers of qualified long-term care insurance contracts.

§327. Effective dates.

Subtitle D—Treatment of Accelerated Death Benefits

§331. Treatment of accelerated death benefits by recipient.

§332. Tax treatment of companies issuing qualified accelerated death benefit riders.

Subtitle E—State Insurance Pools

§341. Exemption from income tax for State-sponsored organizations providing health coverage for high-risk individuals.

§342. Exemption from income tax for State-sponsored workmen's compensation reinsurance organizations.

Subtitle F—Organizations Subject to Section 833

§351. Organizations subject to section 833.

Subtitle G—IRA Distributions to the Unemployed

§361. Distributions from certain plans may be used without additional tax to pay financially devastating medical expenses.

Subtitle H—Organ and Tissue Donation Information Included With Income Tax Refund Payments

§371. Organ and tissue donation information included with income tax refund payments.

TITLE IV—APPLICATION AND ENFORCEMENT OF GROUP HEALTH PLAN REQUIREMENTS

Subtitle A—Application and Enforcement of Group Health Plan Requirements

§401. Group health plan portability, access, and renewability requirements.

§402. Penalty on failure to meet certain group health plan requirements.

Subtitle B—Clarification of Certain Continuation Coverage Requirements

§421. COBRA clarifications.

TITLE V—REVENUE OFFSETS

§500. Amendment of 1986 Code.

Subtitle A—Company-Owned Life Insurance

§501. Denial of deduction for interest on loans with respect to company-owned life insurance.

Subtitle B—Treatment of Individuals Who Lose United States Citizenship

§511. Revision of income, estate, and gift taxes on individuals who lose United States citizenship.

§512. Information on individuals losing United States citizenship.

§513. Report on tax compliance by United States citizens and residents living abroad.

Subtitle C—Repeal of Financial Institution Transition Rule to Interest Allocation Rules

§521. Repeal of financial institution transition rule to interest allocation rules.