Page:United States Statutes at Large Volume 124.djvu/174

 124 STAT. 148 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(A) The entity focuses its mission on administrative simplification. ‘‘(B) The entity demonstrates a multi-stakeholder and consensus-based process for development of operating rules, including representation by or participation from health plans, health care providers, vendors, relevant Federal agencies, and other standard development organizations. ‘‘(C) The entity has a public set of guiding principles that ensure the operating rules and process are open and transparent, and supports nondiscrimination and conflict of interest policies that demonstrate a commitment to open, fair, and nondiscriminatory practices. ‘‘(D) The entity builds on the transaction standards issued under Health Insurance Portability and Account- ability Act of 1996. ‘‘(E) The entity allows for public review and updates of the operating rules. ‘‘(3) REVIEW AND RECOMMENDATIONS.—The National Com- mittee on Vital and Health Statistics shall— ‘‘(A) advise the Secretary as to whether a nonprofit entity meets the requirements under paragraph (2); ‘‘(B) review the operating rules developed and rec- ommended by such nonprofit entity; ‘‘(C) determine whether such operating rules represent a consensus view of the health care stakeholders and are consistent with and do not conflict with other existing standards; ‘‘(D) evaluate whether such operating rules are con- sistent with electronic standards adopted for health information technology; and ‘‘(E) submit to the Secretary a recommendation as to whether the Secretary should adopt such operating rules. ‘‘(4) IMPLEMENTATION.— ‘‘(A) IN GENERAL.—The Secretary shall adopt operating rules under this subsection, by regulation in accordance with subparagraph (C), following consideration of the oper- ating rules developed by the non-profit entity described in paragraph (2) and the recommendation submitted by the National Committee on Vital and Health Statistics under paragraph (3)(E) and having ensured consultation with providers. ‘‘(B) ADOPTION REQUIREMENTS; EFFECTIVE DATES.— ‘‘(i) ELIGIBILITY FOR A HEALTH PLAN AND HEALTH CLAIM STATUS.—The set of operating rules for eligibility for a health plan and health claim status transactions shall be adopted not later than July 1, 2011, in a manner ensuring that such operating rules are effective not later than January 1, 2013, and may allow for the use of a machine readable identification card. ‘‘(ii) ELECTRONIC FUNDS TRANSFERS AND HEALTH CARE PAYMENT AND REMITTANCE ADVICE.—The set of operating rules for electronic funds transfers and health care payment and remittance advice trans- actions shall— ‘‘(I) allow for automated reconciliation of the electronic payment with the remittance advice; and Deadlines. Regulations.