Saturday, January 1, 2005
Remember the old days, when "HIPAA" signaled "health insurance portability" and (more or less) the end to group-health exclusions based upon pre-existing conditions? That 1996 statute has existed for more than 8 years without a final rule (though, to be fair, there has been an "interim final rule" since 1997). The situation changed on Dec. 30, when HHS published its final rule in the Federal Register. For a quick summary, check out the HHS news release. The final regulation becomes effective for plan years starting on or after July 1, 2005.
HHS jointly published the final rule with the Departments of Treasury and Labor. They also jointly published a new proposed rule to deal with certain features of the law and
a Request for Information about experiences with benefit-specific waiting periods imposed by group health plans and group health insurance issuers. It also seeks suggestions for devising an appropriate test for determining when a benefit-specific waiting period is a preexisting condition exclusion. Some group health plans and group health insurance issuers impose benefit-specific waiting periods on specific conditions or treatments, such as a two-year restriction on benefits for transplants. To the extent such a waiting period constitutes a preexisting condition exclusion, the waiting period is subject to HIPAA's limitations on preexisting condition exclusions.