Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), focusing on: (1) HCFA's progress in enforcing HIPAA and related laws in states lacking conforming statutes; (2) HCFA's role in enforcing HIPAA for state and local government health plans; and (3) the status of pending federal regulations regarding HIPAA's nondiscrimination provisions that restrict health plans from excluding employees, or varying benefits, premiums, or employer contributions, on the basis of health status.
Recommendations for Executive Action
|Health Care Financing Administration||The Administrator, HCFA, should complete the established federal process for determining whether federal enforcement will be required in additional states as quickly as possible, to include developing a consistent strategy and time period for enforcing HIPAA and the related laws' provisions in the states that lack conforming enforcement authority.|
|Department of Labor||HCFA, Labor, and Treasury should promptly complete regulations related to HIPAA's nondiscrimination provisions.|
|Department of the Treasury||HCFA, Labor, and Treasury should promptly complete regulations related to HIPAA's nondiscrimination provisions.|
|Health Care Financing Administration||HCFA, Labor, and Treasury should promptly complete regulations related to HIPAA's nondiscrimination provisions.|