When the HIPAA electronic transaction standards went into effect in October 2003, they were expected to simplify administrative transactions in healthcare. But instead, they merely clogged up the works (Medical Economics, "Not getting paid? Blame HIPAA," June 4, 2004). The key problem was that the payers hadn't reprogrammed their information systems to accept standard transactions. Instead, they issued hundreds of "companion guides" that tweaked the standards to fit each of their systems.