[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1322 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                S. 1322

  To prohibit health insurance and employment discrimination against 
individuals and their family members on the basis of predictive genetic 
                    information or genetic services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              July 1, 1999

   Mr. Daschle (for himself, Mr. Harkin, Mr. Dodd, and Mr. Kennedy) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To prohibit health insurance and employment discrimination against 
individuals and their family members on the basis of predictive genetic 
                    information or genetic services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Genetic Nondiscrimination in Health 
Insurance and Employment Act of 1999''.

TITLE I--PROHIBITION OF HEALTH INSURANCE DISCRIMINATION ON THE BASIS OF 
                     PREDICTIVE GENETIC INFORMATION

SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 
              1974.

    (a) Prohibition of Health Insurance Discrimination on the Basis of 
Genetic Services or Predictive Genetic Information.--
            (1) No enrollment restriction for genetic services.--
        Section 702(a)(1)(F) of the Employee Retirement Income Security 
        Act of 1974 (29 U.S.C. 1182(a)(1)(F)) is amended by inserting 
        before the period ``(or information about a request for or the 
        receipt of genetic services by such individual or family member 
        of such individual)''.
            (2) No discrimination in group rate based on predictive 
        genetic information.--
                    (A) In general.--Subpart B of Part 7 of subtitle B 
                of title I of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1185 et seq.) is amended by 
                adding at the end the following:

``SEC. 714. PROHIBITING DISCRIMINATION AGAINST GROUPS ON THE BASIS OF 
              PREDICTIVE GENETIC INFORMATION.

    ``A group health plan, and a health insurance issuer offering group 
health insurance coverage in connection with a group health plan, shall 
not deny eligibility to a group or adjust premium or contribution rates 
for a group on the basis of predictive genetic information concerning 
an individual in the group (or information about a request for or the 
receipt of genetic services by such individual or family member of such 
individual).''.
                    (B) Conforming amendments.--
                            (i) Section 702(b)(2)(A) of the Employee 
                        Retirement Income Security Act of 1974 (29 
                        U.S.C. 1182(b)) is amended to read as follows:
                    ``(A) to restrict the amount that an employer may 
                be charged for coverage under a group health plan, 
                except as provided in section 714; or''.
                            (ii) Section 732(a) of the Employee 
                        Retirement Income Security Act of 1974 (29 
                        U.S.C. 1191a(a)) is amended by striking 
                        ``section 711'' and inserting ``subsections 
                        (a)(1)(F), (b) (with respect to cases relating 
                        to genetic information or information about a 
                        request or receipt of genetic services by an 
                        individual or family member of such 
                        individual), (c), (d), (e), (f), or (g) of 
                        section 702, section 711 and section 714''.
    (b) Limitations on Genetic Testing and on Collection and Disclosure 
of Predictive Genetic Information.--Section 702 of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 1182) is amended by 
adding at the end the following:
    ``(c) Genetic Testing.--
            ``(1) Limitation on requesting or requiring genetic 
        testing.--A group health plan, or a health insurance issuer 
        offering health insurance coverage in connection with a group 
        health plan, shall not request or require an individual or a 
        family member of such individual to undergo a genetic test.
            ``(2) Rule of construction.--Nothing in this title shall be 
        construed to limit the authority of a health care professional, 
        who is providing treatment with respect to an individual and 
        who is employed by a group health plan or a health insurance 
        issuer, to request that such individual or family member of 
        such individual undergo a genetic test. Such a health care 
        professional shall not require that such individual or family 
        member undergo a genetic test.
    ``(d) Collection of Predictive Genetic Information.--Except as 
provided in subsections (f) and (g), a group health plan, or a health 
insurance issuer offering health insurance coverage in connection with 
a group health plan, shall not request, require, collect, or purchase 
predictive genetic information concerning an individual (or information 
about a request for or the receipt of genetic services by such 
individual or family member of such individual).
    ``(e) Disclosure of Predictive Genetic Information.--A group health 
plan, or a health insurance issuer offering health insurance coverage 
in connection with a group health plan, shall not disclose predictive 
genetic information about an individual (or information about a request 
for or the receipt of genetic services by such individual or family 
member of such individual) to--
            ``(1) any entity that is a member of the same controlled 
        group as such issuer or plan sponsor of such group health plan;
            ``(2) any other group health plan or health insurance 
        issuer or any insurance agent, third party administrator, or 
        other person subject to regulation under State insurance laws;
            ``(3) the Medical Information Bureau or any other person 
        that collects, compiles, publishes, or otherwise disseminates 
        insurance information;
            ``(4) the individual's employer or any plan sponsor; or
            ``(5) any other person the Secretary may specify in 
        regulations.
    ``(f) Information for Payment for Genetic Services.--
            ``(1) In general.--With respect to payment for genetic 
        services conducted concerning an individual or the coordination 
        of benefits, a group health plan, or a health insurance issuer 
        offering group health insurance coverage in connection with a 
        group health plan, may request that the individual provide the 
        plan or issuer with evidence that such services were performed.
            ``(2) Rule of construction.--Nothing in paragraph (1) shall 
        be construed to--
                    ``(A) permit a group health plan or health 
                insurance issuer to request (or require) the results of 
                the services referred to in such paragraph; or
                    ``(B) require that a group health plan or health 
                insurance issuer make payment for services described in 
                such paragraph where the individual involved has 
                refused to provide evidence of the performance of such 
                services pursuant to a request by the plan or issuer in 
                accordance with such paragraph.
    ``(g) Information for Payment of Other Claims.--With respect to the 
payment of claims for benefits other than genetic services, a group 
health plan, or a health insurance issuer offering group health 
insurance coverage in connection with a group health plan, may request 
that an individual provide predictive genetic information so long as 
such information--
            ``(1) is used solely for the payment of a claim;
            ``(2) is limited to information that is directly related to 
        and necessary for the payment of such claim and the claim would 
        otherwise be denied but for the predictive genetic information; 
        and
            ``(3) is used only by an individual (or individuals) within 
        such plan or issuer who needs access to such information for 
        purposes of payment of a claim.
    ``(h) Rules of Construction.--
            ``(1) Collection or disclosure authorized by individual.--
        The provisions of subsections (d) (regarding collection) and 
        (e) shall not apply to an individual if the individual (or 
        legal representative of the individual) provides prior, 
        knowing, voluntary, and written authorization for the 
        collection or disclosure of predictive genetic information.
            ``(2) Disclosure for health care treatment.--Nothing in 
        this section shall be construed to limit or restrict the 
        disclosure of predictive genetic information from a health care 
        provider to another health care provider for the purpose of 
        providing health care treatment to the individual involved.
    ``(i) Definitions.--In this section:
            ``(1) Controlled group.--The term `controlled group' means 
        any group treated as a single employer under subsections (b), 
        (c), (m), or (o)of section 414 of the Internal Revenue Code of 
        1986.
            ``(2) Group health plan, health insurance issuer.--The 
        terms `group health plan' and `health insurance issuer' include 
        a third party administrator or other person acting for or on 
        behalf of such plan or issuer.''.
    (c) Enforcement.--Section 502 (29 U.S.C. 1132) is amended by adding 
at the end the following:
    ``(n) Violation of Genetic Discrimination or Genetic Disclosure 
Provisions.--In any action under this section against any administrator 
of a group health plan, or health insurance issuer offering group 
health insurance coverage in connection with a group health plan 
(including any third party administrator or other person acting for or 
on behalf of such plan or issuer) alleging a violation of subsection 
(a)(1)(F), (b) (with respect to cases relating to genetic information 
or information about a request or receipt of genetic services by an 
individual or family member of such individual), (c), (d), (e), (f), or 
(g) of section 702, or section 714, the court may award any appropriate 
legal or equitable relief. Such relief may include a requirement for 
the payment of attorney's fees and costs, including the costs of expert 
witnesses.
    ``(o) Civil Penalty.--The monetary provisions of section 
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for 
purposes of the Secretary enforcing the provisions referred to in 
subsection (n), except that any such relief awarded shall be paid only 
into the general fund of the Treasury.''.
    (d) Preemption.--Section 731 of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1191) is amended--
            (1) in subsection (a)(1), by inserting ``or (e)'' after 
        ``subsection (b)''; and
            (2) by adding at the end the following:
    ``(e) Special Rule in Case of Genetic Information.--With respect to 
group health insurance coverage offered by a health insurance issuer, 
the provisions of this part relating to genetic information (including 
information about a request for or the receipt of genetic services by 
an individual or a family member of such individual) shall not be 
construed to supersede any provision of State law which establishes, 
implements, or continues in effect a standard, requirement, or remedy 
that more completely--
            ``(1) protects the confidentiality of genetic information 
        (including information about a request for or the receipt of 
        genetic services by an individual or a family member of such 
        individual) or the privacy of an individual or a family member 
        of the individual with respect to genetic information 
        (including information about a request for or the receipt of 
        genetic services by an individual or a family member of such 
        individual) than does this part; or
            ``(2) prohibits discrimination on the basis of genetic 
        information than does this part.''.
    (e) Definitions.--Section 733(d) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1191b(d)) is amended by adding at the 
end the following:
            ``(5) Family member.--The term `family member' means with 
        respect to an individual--
                    ``(A) the spouse of the individual;
                    ``(B) a dependent child of the individual, 
                including a child who is born to or placed for adoption 
                with the individual; and
                    ``(C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
            ``(6) Genetic information.--The term `genetic information' 
        means information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a family 
        member of such individual (including information about a 
        request for or the receipt of genetic services by such 
        individual or family member of such individual).
            ``(7) Genetic services.--The term `genetic services' means 
        health services, including genetic tests, provided to obtain, 
        assess, or interpret genetic information for diagnostic and 
        therapeutic purposes, and for genetic education and counseling.
            ``(8) Genetic test.--The term `genetic test' means the 
        analysis of human DNA, RNA, chromosomes, proteins, and certain 
        metabolites in order to detect genotypes, mutations, or 
        chromosomal changes.
            ``(9) Predictive genetic information.--
                    ``(A) In general.--The term `predictive genetic 
                information' means--
                            ``(i) information about an individual's 
                        genetic tests;
                            ``(ii) information about genetic tests of 
                        family members of the individual; or
                            ``(iii) information about the occurrence of 
                        a disease or disorder in family members.
                    ``(B) Limitations.--The term `predictive genetic 
                information' shall not include--
                            ``(i) information about the sex or age of 
                        the individual;
                            ``(ii) information about chemical, blood, 
                        or urine analyses of the individual, unless 
                        these analyses are genetic tests; or
                            ``(iii) information about physical exams of 
                        the individual, and other information relevant 
                        to determining the current health status of the 
                        individual.''.
    (f) Amendment Concerning Supplemental Excepted Benefits.--Section 
732(c)(3) of the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1191a(c)(3)) is amended by inserting ``, other than the 
requirements of subsections (a)(1)(F), (b) (in cases relating to 
genetic information or information about a request for or the receipt 
of genetic services by an individual or a family member of such 
individual), (c), (d), (e), (f) and (g) of section 702 and section 
714,'' after ``The requirements of this part''.
    (g) Effective Date.--
            (1) In general.--Except as provided in this section, this 
        section and the amendments made by this section shall apply 
        with respect to group health plans for plan years beginning 
        after October 1, 2000.
            (2) Special rule for collective bargaining agreements.--In 
        the case of a group health plan maintained pursuant to one or 
        more collective bargaining agreements between employee 
        representatives and one or more employers ratified before the 
        date of the enactment of this Act, this section and the 
        amendments made by this section shall not apply to plan years 
        beginning before the later of--
                    (A) the date on which the last of the collective 
                bargaining agreements relating to the plan terminates 
                (determined without regard to any extension thereof 
                agreed to after the date of the enactment of this Act), 
                or
                    (B) October 1, 2000.
        For purposes of subparagraph (A), any plan amendment made 
        pursuant to a collective bargaining agreement relating to the 
        plan which amends the plan solely to conform to any requirement 
        of the amendments made by this section shall not be treated as 
        a termination of such collective bargaining agreement.

SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

    (a) Amendments Relating to the Group Market.--
            (1) Prohibition of health insurance discrimination on the 
        basis of predictive genetic information or genetic services.--
                    (A) No enrollment restriction for genetic 
                services.--Section 2702(a)(1)(F) of the Public Health 
                Service Act (42 U.S.C. 300gg-1(a)(1)(F)) is amended by 
                inserting before the period the following: ``(or 
                information about a request for or the receipt of 
                genetic services by an individual or a family member of 
                such individual)''.
                    (B) No discrimination in group rate based on 
                predictive genetic information.--
                            (i) In general.--Subpart 2 of part A of 
                        title XXVII of the Public Health Service (42 
                        U.S.C. 300gg-4 et seq.) is amended by adding at 
                        the end the following:

``SEC. 2707. PROHIBITING DISCRIMINATION AGAINST GROUPS ON THE BASIS OF 
              PREDICTIVE GENETIC INFORMATION.

    ``A group health plan, and a health insurance issuer offering group 
health insurance coverage in connection with a group health plan, shall 
not deny eligibility to a group or adjust premium or contribution rates 
for a group on the basis of predictive genetic information concerning 
an individual in the group (or information about a request for or the 
receipt of genetic services by such individual or family member of such 
individual).''.
                            (ii) Conforming amendments.--
                                    (I) Section 2702(b)(2)(A) of the 
                                Public Health Service Act (42 U.S.C. 
                                300gg-1(b)(2)(A)) is amended to read as 
                                follows:
                    ``(A) to restrict the amount that an employer may 
                be charged for coverage under a group health plan, 
                except as provided in section 2707; or''.
                                    (II) Section 2721(a) of the Public 
                                Health Service Act (42 U.S.C. 300gg-
                                21(a)) is amended by inserting ``(other 
                                than subsections (a)(1)(F), (b) (with 
                                respect to cases relating to genetic 
                                information or information about a 
                                request or receipt of genetic services 
                                by an individual or family member of 
                                such individual), (c), (d), (e), (f), 
                                or (g) of section 2702 and section 
                                2707)'' after ``subparts 1 and 3''.
            (2) Limitations on genetic testing and on collection and 
        disclosure of predictive genetic information.--Section 2702 of 
        the Public Health Service Act (42 U.S.C. 300gg-1) is amended by 
        adding at the end the following:
    ``(c) Genetic Testing.--
            ``(1) Limitation on requesting or requiring genetic 
        testing.--A group health plan, or a health insurance issuer 
        offering health insurance coverage in connection with a group 
        health plan, shall not request or require an individual or a 
        family member of such individual to undergo a genetic test.
            ``(2) Rule of construction.--Nothing in this title shall be 
        construed to limit the authority of a health care professional, 
        who is providing treatment with respect to an individual and 
        who is employed by a group health plan or a health insurance 
        issuer, to request that such individual or family member of 
        such individual undergo a genetic test. Such a health care 
        professional shall not require that such individual or family 
        member undergo a genetic test.
    ``(d) Collection of Predictive Genetic Information.--Except as 
provided in subsections (f) and (g), a group health plan, or a health 
insurance issuer offering health insurance coverage in connection with 
a group health plan, shall not request, require, collect, or purchase 
predictive genetic information concerning an individual (or information 
about a request for or the receipt of genetic services by such 
individual or family member of such individual).
    ``(e) Disclosure of Predictive Genetic Information.--A group health 
plan, or a health insurance issuer offering health insurance coverage 
in connection with a group health plan, shall not disclose predictive 
genetic information about an individual (or information about a request 
for or the receipt of genetic services by such individual or family 
member of such individual) to--
            ``(1) any entity that is a member of the same controlled 
        group as such issuer or plan sponsor of such group health plan;
            ``(2) any other group health plan or health insurance 
        issuer or any insurance agent, third party administrator, or 
        other person subject to regulation under State insurance laws;
            ``(3) the Medical Information Bureau or any other person 
        that collects, compiles, publishes, or otherwise disseminates 
        insurance information;
            ``(4) the individual's employer or any plan sponsor; or
            ``(5) any other person the Secretary may specify in 
        regulations.
    ``(f) Information for Payment for Genetic Services.--
            ``(1) In general.--With respect to payment for genetic 
        services conducted concerning an individual or the coordination 
        of benefits, a group health plan, or a health insurance issuer 
        offering group health insurance coverage in connection with a 
        group health plan, may request that the individual provide the 
        plan or issuer with evidence that such services were performed.
            ``(2) Rule of construction.--Nothing in paragraph (1) shall 
        be construed to--
                    ``(A) permit a group health plan or health 
                insurance issuer to request (or require) the results of 
                the services referred to in such paragraph; or
                    ``(B) require that a group health plan or health 
                insurance issuer make payment for services described in 
                such paragraph where the individual involved has 
                refused to provide evidence of the performance of such 
                services pursuant to a request by the plan or issuer in 
                accordance with such paragraph.
    ``(g) Information for Payment of Other Claims.--With respect to the 
payment of claims for benefits other than genetic services, a group 
health plan, or a health insurance issuer offering group health 
insurance coverage in connection with a group health plan, may request 
that an individual provide predictive genetic information so long as 
such information--
            ``(1) is used solely for the payment of a claim;
            ``(2) is limited to information that is directly related to 
        and necessary for the payment of such claim and the claim would 
        otherwise be denied but for the predictive genetic information; 
        and
            ``(3) is used only by an individual (or individuals) within 
        such plan or issuer who needs access to such information for 
        purposes of payment of a claim.
    ``(h) Rules of Construction.--
            ``(1) Collection or disclosure authorized by individual.--
        The provisions of subsections (d) (regarding collection) and 
        (e) shall not apply to an individual if the individual (or 
        legal representative of the individual) provides prior, 
        knowing, voluntary, and written authorization for the 
        collection or disclosure of predictive genetic information.
            ``(2) Disclosure for health care treatment.--Nothing in 
        this section shall be construed to limit or restrict the 
        disclosure of predictive genetic information from a health care 
        provider to another health care provider for the purpose of 
        providing health care treatment to the individual involved.
    ``(i) Definitions.--In this section:
            ``(1) Controlled group.--The term `controlled group' means 
        any group treated as a single employer under subsections (b), 
        (c), (m), or (o) of section 414 of the Internal Revenue Code of 
        1986.
            ``(2) Group health plan, health insurance issuer.--The 
        terms `group health plan' and `health insurance issuer' include 
        a third party administrator or other person acting for or on 
        behalf of such plan or issuer.''.
            (3) Definitions.--Section 2791(d) of the Public Health 
        Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at the 
        end the following new paragraphs:
            ``(15) Family member.--The term `family member' means with 
        respect to an individual--
                    ``(A) the spouse of the individual;
                    ``(B) a dependent child of the individual, 
                including a child who is born to or placed for adoption 
                with the individual; and
                    ``(C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
            ``(16) Genetic information.--The term `genetic information' 
        means information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a family 
        member of such individual (including information about a 
        request for or the receipt of genetic services by such 
        individual or family member of such individual).
            ``(17) Genetic services.--The term `genetic services' means 
        health services, including genetic tests, provided to obtain, 
        assess, or interpret genetic information for diagnostic and 
        therapeutic purposes, and for genetic education and 
        counselling.
            ``(18) Genetic test.--The term `genetic test' means the 
        analysis of human DNA, RNA, chromosomes, proteins, and certain 
        metabolites in order to detect genotypes, mutations, or 
        chromosomal changes.
            ``(19) Predictive genetic information.--
                    ``(A) In general.--The term `predictive genetic 
                information' means--
                            ``(i) information about an individual's 
                        genetic tests;
                            ``(ii) information about genetic tests of 
                        family members of the individual; or
                            ``(iii) information about the occurrence of 
                        a disease or disorder in family members.
                    ``(B) Limitations.--The term `predictive genetic 
                information' shall not include--
                            ``(i) information about the sex or age of 
                        the individual;
                            ``(ii) information about chemical, blood, 
                        or urine analyses of the individual, unless 
                        these analyses are genetic tests; or
                            ``(iii) information about physical exams of 
                        the individual, and other information relevant 
                        to determining the current health status of the 
                        individual.''.
    (b) Amendment Relating to the Individual Market.--The first subpart 
3 of part B of title XXVII of the Public Health Service Act (42 U.S.C. 
300gg-51 et seq.) is amended--
            (1) by redesignating such subpart as subpart 2; and
            (2) by adding at the end the following:

``SEC. 2753. PROHIBITION OF HEALTH INSURANCE DISCRIMINATION AGAINST 
              INDIVIDUALS ON THE BASIS OF PREDICTIVE GENETIC 
              INFORMATION.

    ``(a) In Eligibility To Enroll.--A health insurance issuer offering 
health insurance coverage in the individual market shall not establish 
rules for eligibility to enroll in individual health insurance coverage 
that are based on predictive genetic information concerning the 
individual (or information about a request for or the receipt of 
genetic services by such individual or family member of such 
individual).
    ``(b) In Premium Rates.--A health insurance issuer offering health 
insurance coverage in the individual market shall not adjust premium 
rates on the basis of predictive genetic information concerning an 
individual (or information about a request for or the receipt of 
genetic services by such individual or family member of such 
individual).

``SEC. 2754. LIMITATIONS ON GENETIC TESTING AND ON COLLECTION AND 
              DISCLOSURE OF PREDICTIVE GENETIC INFORMATION.

    ``(a) Genetic Testing.--
            ``(1) Limitation on requesting or requiring genetic 
        testing.--A health insurance issuer offering health insurance 
        coverage in the individual market shall not request or require 
        an individual or a family member of such individual to undergo 
        a genetic test.
            ``(2) Rule of construction.--Nothing in this title shall be 
        construed to limit the authority of a health care professional, 
        who is providing treatment with respect to an individual and 
        who is employed by a group health plan or a health insurance 
        issuer, to request that such individual or family member of 
        such individual undergo a genetic test. Such a health care 
        professional shall not require that such individual or family 
        member undergo a genetic test.
    ``(b) Collection of Predictive Genetic Information.--Except as 
provided in subsections (d) and (e), a health insurance issuer offering 
health insurance coverage in the individual market shall not request, 
require, collect, or purchase predictive genetic information concerning 
an individual (or information about a request for or the receipt of 
genetic services by such individual or family member of such 
individual).
    ``(c) Disclosure of Predictive Genetic Information.--A health 
insurance issuer offering health insurance coverage in the individual 
market shall not disclose predictive genetic information about an 
individual (or information about a request for or the receipt of 
genetic services by such individual or family member of such 
individual) to--
            ``(1) any entity that is a member of the same controlled 
        group as such issuer or plan sponsor of such group health plan;
            ``(2) any other group health plan or health insurance 
        issuer or any insurance agent, third party administrator, or 
other person subject to regulation under State insurance laws;
            ``(3) the Medical Information Bureau or any other person 
        that collects, compiles, publishes, or otherwise disseminates 
        insurance information;
            ``(4) the individual's employer or any plan sponsor; or
            ``(5) any other person the Secretary may specify in 
        regulations.
    ``(d) Information for Payment for Genetic Services.--
            ``(1) In general.--With respect to payment for genetic 
        services conducted concerning an individual or the coordination 
        of benefits, a health insurance issuer offering health 
        insurance coverage in the individual market may request that 
        the individual provide the plan or issuer with evidence that 
        such services were performed.
            ``(2) Rule of construction.--Nothing in paragraph (1) shall 
        be construed to--
                    ``(A) permit a health insurance issuer to request 
                (or require) the results of the services referred to in 
                such paragraph; or
                    ``(B) require that a health insurance issuer make 
                payment for services described in such paragraph where 
                the individual involved has refused to provide evidence 
                of the performance of such services pursuant to a 
                request by the plan or issuer in accordance with such 
                paragraph.
    ``(e) Information for Payment of Other Claims.--With respect to the 
payment of claims for benefits other than genetic services, a health 
insurance issuer offering health insurance coverage in the individual 
market may request that an individual provide predictive genetic 
information so long as such information--
            ``(1) is used solely for the payment of a claim;
            ``(2) is limited to information that is directly related to 
        and necessary for the payment of such claim and the claim would 
        otherwise be denied but for the predictive genetic information; 
        and
            ``(3) is used only by an individual (or individuals) within 
        such plan or issuer who needs access to such information for 
        purposes of payment of a claim.
    ``(f) Rules of Construction.--
            ``(1) Collection or disclosure authorized by individual.--
        The provisions of subsections (c) (regarding collection) and 
        (d) shall not apply to an individual if the individual (or 
        legal representative of the individual) provides prior, 
        knowing, voluntary, and written authorization for the 
        collection or disclosure of predictive genetic information.
            ``(2) Disclosure for health care treatment.--Nothing in 
        this section shall be construed to limit or restrict the 
        disclosure of predictive genetic information from a health care 
        provider to another health care provider for the purpose of 
        providing health care treatment to the individual involved.
    ``(g) Definitions.--In this section:
            ``(1) Controlled group.--The term `controlled group' means 
        any group treated as a single employer under subsections (b), 
        (c), (m), or (o) of section 414 of the Internal Revenue Code of 
        1986.
            ``(2) Group health plan, health insurance issuer.--The 
        terms `group health plan' and `health insurance issuer' include 
        a third party administrator or other person acting for or on 
        behalf of such plan or issuer.''.
    (c) Enforcement.--
            (1) Group plans.--Section 2722 of the Public Health Service 
        Act (42 U.S.C. 300gg-22) is amended by adding at the end the 
        following:
    ``(c) Violation of Genetic Discrimination or Genetic Disclosure 
Provisions.--In any action under this section against any administrator 
of a group health plan, or health insurance issuer offering group 
health insurance coverage in connection with a group health plan 
(including any third party administrator or other person acting for or 
on behalf of such plan or issuer) alleging a violation of subsections 
(a)(1)(F), (b) (with respect to cases relating to genetic information 
or information about a request or receipt of genetic services by an 
individual or family member of such individual), (c), (d), (e), (f), or 
(g) of section 2702 and section 2707 the court may award any 
appropriate legal or equitable relief. Such relief may include a 
requirement for the payment of attorney's fees and costs, including the 
costs of expert witnesses.
    ``(d) Civil Penalty.--The monetary provisions of section 
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for 
purposes of the Secretary enforcing the provisions referred to in 
subsection (c), except that any such relief awarded shall be paid only 
into the general fund of the Treasury.''.
            (2) Individual plans.--Section 2761 of the Public Health 
        Service Act (42 U.S.C. 300gg-45) is amended by adding at the 
        end the following:
    ``(c) Violation of Genetic Discrimination or Genetic Disclosure 
Provisions.--In any action under this section against any health 
insurance issuer offering health insurance coverage in the individual 
market (including any other person acting for or on behalf of such 
issuer) alleging a violation of section 2753 and 2754 the court in 
which the action is commenced may award any appropriate legal or 
equitable relief. Such relief may include a requirement for the payment 
of attorney's fees and costs, including the costs of expert witnesses.
    ``(d) Civil Penalty.--The monetary provisions of section 
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for 
purposes of the Secretary enforcing the provisions referred to in 
subsection (c), except that any such relief awarded shall be paid only 
into the general fund of the Treasury.''.
    (d) Preemption.--
            (1) Group market.--Section 2723 of the Public Health 
        Service Act (42 U.S.C. 300gg-23) is amended--
                    (A) in subsection (a)(1), by inserting ``or (e)'' 
                after ``subsection (b)''; and
                    (B) by adding at the end the following:
    ``(e) Special Rule in Case of Genetic Information.--With respect to 
group health insurance coverage offered by a health insurance issuer, 
the provisions of this part relating to genetic information (including 
information about a request for or the receipt of genetic services by 
an individual or a family member of such individual) shall not be 
construed to supersede any provision of State law which establishes, 
implements, or continues in effect a standard, requirement, or remedy 
that more completely--
            ``(1) protects the confidentiality of genetic information 
        (including information about a request for or the receipt of 
        genetic services by an individual or a family member of such 
        individual) or the privacy of an individual or a family member 
        of the individual with respect to genetic information 
        (including information about a request for or the receipt of 
        genetic services by an individual or a family member of such 
        individual); or
            ``(2) prohibits discrimination on the basis of genetic 
        information than does this part.''.
            (2) Individual market.--Section 2762 of the Public Health 
        Service Act (42 U.S.C. 300gg-46) is amended--
                    (A) in subsection (a), by inserting ``and except as 
                provided in subsection (c),'' after ``Subject to 
                subsection (b),''; and
                    (B) by adding at the end the following:
    ``(c) Special Rule in Case of Genetic Information.--With respect to 
individual health insurance coverage offered by a health insurance 
issuer, the provisions of this part (or part C insofar as it applies to 
this part) relating to genetic information (including information about 
a request for or the receipt of genetic services by an individual or a 
family member of such individual) shall not be construed to supersede 
any provision of State law (as defined in section 2723(d)) which 
establishes, implements, or continues in effect a standard, 
requirement, or remedy that more completely--
            ``(1) protects the confidentiality of genetic information 
        (including information about a request for or the receipt of 
        genetic services of an individual or a family member of such 
        individual) or the privacy of an individual or a family member 
        of the individual with respect to genetic information 
        (including information about a request for or the receipt of 
        genetic services by an individual or a family member of such 
        individual) than does this part (or part C insofar as it 
        applies to this part); or
            ``(2) prohibits discrimination on the basis of genetic 
        information than does this part (or part C insofar as it 
        applies to this part).''.
    (e) Elimination of Option of Non-Federal Governmental Plans To Be 
Excepted From Requirements Concerning Genetic Information.--Section 
2721(b)(2) of the Public Health Service Act (42 U.S. C. 300gg-21(b)(2)) 
is amended--
            (1) in subparagraph (A), by striking ``If the plan 
        sponsor'' and inserting ``Except as provided in subparagraph 
        (D), if the plan sponsor''; and
            (2) by adding at the end the following:
                    ``(D) Election not applicable to requirements 
                concerning genetic information.--The election described 
                in subparagraph (A) shall not be available with respect 
                to the provisions of subsections (a)(1)(F), (c), (d), 
                (e), (f), and (g) of section 2702 and section 2707, and 
                the provisions of section 2702(b) to the extent that 
                they apply to genetic information (or information about 
                a request for or the receipt of genetic services by an 
                individual or a family member of such individual).''.
    (f) Amendment Concerning Supplemental Excepted Benefits.--
            (1) Group market.--Section 2721(d)(3) of the Public Health 
        Service Act (42 U.S.C. 300gg-23(d)(3)) is amended by inserting 
        ``, other than the requirements of subsections (a)(1)(F), (b) 
        (in cases relating to genetic information or information about 
        a request for or the receipt of genetic services by an 
        individual or a family member of such individual)), (c), (d), 
        (e), (f) and (g) of section 2702 and section 2707,'' after 
        ``The requirements of this part''.
            (2) Individual market.--Section 2763(b) of the Public 
        Health Service Act (42 U.S.C. 300gg-47(b)) is amended--
                    (A) by striking ``The requirements of this part'' 
                and inserting the following:
            ``(1) In general.--Except as provided in paragraph (2), the 
        requirements of this part''; and
                    (B) by adding at the end the following:
            ``(2) Limitation.--The requirements of sections 2753 and 
        2754 shall apply to excepted benefits described in section 
        2791(c)(4).''.
    (g) Effective Date.--
            (1) In general.--The amendments made by this section shall 
        apply with respect to--
                    (A) group health plans, and health insurance 
                coverage offered in connection with group health plans, 
                for plan years beginning; and
                    (B) health insurance coverage offered, sold, 
                issued, renewed, in effect, or operated in the 
                individual market, after;
        October 1, 2000.
            (2) Special rule for collective bargaining agreements.--In 
        the case of a group health plan maintained pursuant to one or 
        more collective bargaining agreements between employee 
        representatives and one or more employers ratified before the 
        date of the enactment of this Act, the amendments made by this 
        section shall not apply to plan years beginning before the 
        later of--
                    (A) the date on which the last of the collective 
                bargaining agreements relating to the plan terminates 
                (determined without regard to any extension thereof 
                agreed to after the date of the enactment of this Act); 
                or
                    (B) October 1, 2000.
        For purposes of subparagraph (A), any plan amendment made 
        pursuant to a collective bargaining agreement relating to the 
        plan which amends the plan solely to conform to any requirement 
        of the amendments made by this section shall not be treated as 
        a termination of such collective bargaining agreement.

SEC. 103. AMENDMENTS TO INTERNAL REVENUE CODE OF 1986.

    (a) Prohibition of Health Insurance Discrimination on the Basis of 
Genetic Services or Predictive Genetic Information.--
            (1) No enrollment restriction for genetic services.--
        Section 9802(a)(1)(F) of the Internal Revenue Code of 1986 is 
        amended by inserting before the period ``(or information about 
        a request for or the receipt of genetic services by such 
        individual or family member of such individual)''.
            (2) No discrimination in group rate based on predictive 
        genetic information.--
                    (A) In general.--Subchapter B of chapter 100 of the 
                Internal Revenue Code of 1986 is amended by adding at 
                the end the following:

``SEC. 9813. PROHIBITING DISCRIMINATION AGAINST GROUPS ON THE BASIS OF 
              PREDICTIVE GENETIC INFORMATION.

    ``A group health plan shall not deny eligibility to a group or 
adjust premium or contribution rates for a group on the basis of 
predictive genetic information concerning an individual in the group 
(or information about a request for or the receipt of genetic services 
by such individual or family member of such individual).''.
                    (B) Conforming amendments.--
                            (i) Section 9802(b)(2)(A) of the Internal 
                        Revenue Code of 1986 is amended to read as 
                        follows:
                    ``(A) to restrict the amount that an employer may 
                be charged for coverage under a group health plan, 
                except as provided in section 9813; or''.
                            (ii) Section 9831(a) of the Internal 
                        Revenue Code of 1986 is amended by inserting 
                        ``(other than subsections (a)(1)(F), (b) (with 
                        respect to cases relating to genetic 
                        information or information about a request for 
                        or receipt of genetic services by an individual 
                        or family member of such individual), (d) (e), 
                        (f), (g) or (h) of section 9802 or section 
                        9813) after ``chapter''.
    (b) Limitations on Genetic Testing and on Collection and Disclosure 
of Predictive Genetic Information.--Section 9802 of the Internal 
Revenue Code of 1986 is amended by adding at the end the following:
    ``(d) Genetic Testing.--
            ``(1) Limitation on requesting or requiring genetic 
        testing.--A group health plan shall not request or require an 
        individual or a family member of such individual to undergo a 
        genetic test.
            ``(2) Rule of construction.--Nothing in this title shall be 
        construed to limit the authority of a health care professional, 
        who is providing treatment with respect to an individual and 
        who is employed by a group health plan, to request that such 
        individual or family member of such individual undergo a 
        genetic test. Such a health care professional shall not require 
        that such individual or family member undergo a genetic test.
    ``(e) Collection of Predictive Genetic Information.--Except as 
provided in subsections (g) and (h), a group health plan shall not 
request, require, collect, or purchase predictive genetic information 
concerning an individual (or information about a request for or the 
receipt of genetic services by such individual or family member of such 
individual).
    ``(f) Disclosure of Predictive Genetic Information.--A group health 
plan shall not disclose predictive genetic information about an 
individual (or information about a request for or the receipt of 
genetic services by such individual or family member of such 
individual) to--
            ``(1) any entity that is a member of the same controlled 
        group as such issuer or plan sponsor of such group health plan;
            ``(2) any other group health plan or health insurance 
        issuer or any insurance agent, third party administrator, or 
        other person subject to regulation under State insurance laws;
            ``(3) the Medical Information Bureau or any other person 
        that collects, compiles, publishes, or otherwise disseminates 
        insurance information;
            ``(4) the individual's employer or any plan sponsor; or
            ``(5) any other person the Secretary may specify in 
        regulations.
    ``(g) Information for Payment for Genetic Services.--
            ``(1) In general.--With respect to payment for genetic 
        services conducted concerning an individual or the coordination 
        of benefits, a group health plan may request that the 
        individual provide the plan with evidence that such services 
        were performed.
            ``(2) Rule of construction.--Nothing in paragraph (1) shall 
        be construed to--
                    ``(A) permit a group health plan to request (or 
                require) the results of the services referred to in 
                such paragraph; or
                    ``(B) require that a group health plan make payment 
                for services described in such paragraph where the 
                individual involved has refused to provide evidence of 
                the performance of such services pursuant to a request 
                by the plan in accordance with such paragraph.
    ``(h) Information for Payment of Other Claims.--With respect to the 
payment of claims for benefits other than genetic services, a group 
health plan may request that an individual provide predictive genetic 
information so long as such information--
            ``(1) is used solely for the payment of a claim;
            ``(2) is limited to information that is directly related to 
        and necessary for the payment of such claim and the claim would 
        otherwise be denied but for the predictive genetic information; 
        and
            ``(3) is used only by an individual (or individuals) within 
        such plan or issuer who needs access to such information for 
        purposes of payment of a claim.
    ``(i) Rules of Construction.--
            ``(1) Collection or disclosure authorized by individual.--
        The provisions of subsections (e) (regarding collection) and 
        (f) shall not apply to an individual if the individual (or 
        legal representative of the individual) provides prior, 
        knowing, voluntary, and written authorization for the 
        collection or disclosure of predictive genetic information.
            ``(2) Disclosure for health care treatment.--Nothing in 
        this section shall be construed to limit or restrict the 
        disclosure of predictive genetic information from a health care 
        provider to another health care provider for the purpose of 
        providing health care treatment to the individual involved.
    ``(j) Definitions.--In this section:
            ``(1) Controlled group.--The term `controlled group' means 
        any group treated as a single employer under subsections (b), 
        (c), (m), or (o) of section 414.
            ``(2) Group health plan, health insurance issuer.--The 
        terms `group health plan' and `health insurance issuer' include 
        a third party administrator or other person acting for or on 
        behalf of such plan or issuer.
    ``(k) Violation of Genetic Discrimination or Genetic Disclosure 
Provisions.--In any action under this section against any administrator 
of a group health plan (including any third party administrator or 
other person acting for or on behalf of such plan) alleging a violation 
of subsection (a)(1)(F), (b) (with respect to cases relating to genetic 
information or information about a request or receipt of genetic 
services by an individual or family member of such individual), (d), 
(e), (f), (g) or (h) of this section or section 9813, the court may 
award any appropriate legal or equitable relief. Such relief may 
include a requirement for the payment of attorney's fees and costs, 
including the costs of expert witnesses.
    ``(l) Civil Penalty.--The monetary provisions of section 
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for 
purposes of the Secretary enforcing the provisions referred to in 
subsection (k), except that any such relief awarded shall be paid only 
into the general fund of the Treasury.''.
    (c) Definitions.--Section 9832(d) of the Internal Revenue Code of 
1986 is amended by adding at the end the following:
            ``(6) Family member.--The term `family member' means with 
        respect to an individual--
                    ``(A) the spouse of the individual;
                    ``(B) a dependent child of the individual, 
                including a child who is born to or placed for adoption 
                with the individual; and
                    ``(C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
            ``(7) Genetic information.--The term `genetic information' 
        means information about genes, gene products, or inherited 
        characteristics that may derive from an individual or a family 
        member of such individual (including information about a 
        request for or the receipt of genetic services by such 
        individual or family member of such individual).
            ``(8) Genetic services.--The term `genetic services' means 
        health services, including genetic tests, provided to obtain, 
        assess, or interpret genetic information for diagnostic and 
        therapeutic purposes, and for genetic education and counseling.
            ``(9) Genetic test.--The term `genetic test' means the 
        analysis of human DNA, RNA, chromosomes, proteins, and certain 
        metabolites in order to detect genotypes, mutations, or 
        chromosomal changes.
            ``(10) Predictive genetic information.--
                    ``(A) In general.--The term `predictive genetic 
                information' means--
                            ``(i) information about an individual's 
                        genetic tests;
                            ``(ii) information about genetic tests of 
                        family members of the individual; or
                            ``(iii) information about the occurrence of 
                        a disease or disorder in family members.
                    ``(B) Limitations.--The term `predictive genetic 
                information' shall not include--
                            ``(i) information about the sex or age of 
                        the individual;
                            ``(ii) information about chemical, blood, 
                        or urine analyses of the individual, unless 
                        these analyses are genetic tests; or
                            ``(iii) information about physical exams of 
                        the individual, and other information relevant 
                        to determining the current health status of the 
                        individual.''.
    (d) Effective Date.--
            (1) In general.--Except as provided in this section, this 
        section and the amendments made by this section shall apply 
        with respect to group health plans for plan years beginning 
        after October 1, 2000.
            (2) Special rule for collective bargaining agreements.--In 
        the case of a group health plan maintained pursuant to one or 
        more collective bargaining agreements between employee 
        representatives and one or more employers ratified before the 
        date of the enactment of this Act, this section and the 
        amendments made by this section shall not apply to plan years 
        beginning before the later of--
                    (A) the date on which the last of the collective 
                bargaining agreements relating to the plan terminates 
                (determined without regard to any extension thereof 
                agreed to after the date of the enactment of this Act), 
                or
                    (B) October 1, 2000.
        For purposes of subparagraph (A), any plan amendment made 
        pursuant to a collective bargaining agreement relating to the 
        plan which amends the plan solely to conform to any requirement 
        of the amendments made by this section shall not be treated as 
        a termination of such collective bargaining agreement.

SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY ACT RELATING 
              TO MEDIGAP.

    (a) Nondiscrimination.--
            (1) In general.--Section 1882(s)(2) of the Social Security 
        Act (42 U.S.C. 1395ss(s)(2)) is amended by adding at the end 
        the following:
                    ``(E)(i) An issuer of a medicare supplemental 
                policy shall not deny or condition the issuance or 
                effectiveness of the policy, and shall not discriminate 
                in the pricing of the policy (including the adjustment 
                of premium rates) of an eligible individual on the 
                basis of predictive genetic information concerning the 
                individual (or information about a request for, or the 
                receipt of, genetic services by such individual or 
                family member of such individual).
                    ``(ii) For purposes of clause (i), the terms 
                `family member', `genetic services', and `predictive 
                genetic information' shall have the meanings given such 
                terms in subsection (v).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply with respect to a policy for policy years beginning 
        after October 1, 2000.
    (b) Limitations on Genetic Testing and on Collection and Disclosure 
of Predictive Genetic Information.--
            (1) In general.--Section 1882 of the Social Security Act 
        (42 U.S.C. 1395ss) is amended by adding at the end the 
        following:
    ``(v) Limitations on Genetic Testing and on Collection and 
Disclosure of Predictive Genetic Information.--
            ``(1) Genetic testing.--
                    ``(A) Limitation on requesting or requiring genetic 
                testing.--An issuer of a medicare supplemental policy 
                shall not request or require an individual or a family 
                member of such individual to undergo a genetic test.
                    ``(B) Rule of construction.--Nothing in this title 
                shall be construed to limit the authority of a health 
                care professional, who is providing treatment with 
                respect to an individual and who is employed by an 
                issuer of a medicare supplemental policy, to request 
                that such individual or family member of such 
                individual undergo a genetic test. Such a health care 
                professional shall not require that such individual or 
                family member undergo a genetic test.
            ``(2) Collection of predictive genetic information.--Except 
        as provided in paragraphs (4) and (5), an issuer of a medicare 
        supplemental policy shall not request, require, collect, or 
        purchase predictive genetic information concerning an 
        individual (or information about a request for or the receipt 
        of genetic services by such individual or family member of such 
        individual).
            ``(3) Disclosure of predictive genetic information.--An 
        issuer of a medicare supplemental policy shall not disclose 
        predictive genetic information about an individual (or 
        information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual) to--
                    ``(A) any entity that is a member of the same 
                controlled group as such issuer;
                    ``(B) any issuer of a medicare supplemental policy, 
                group health plan or health insurance issuer, or any 
                insurance agent, third party administrator, or other 
                person subject to regulation under State insurance 
                laws;
                    ``(C) the Medical Information Bureau or any other 
                person that collects, compiles, publishes, or otherwise 
                disseminates insurance information;
                    ``(D) the individual's employer or any plan 
                sponsor; or
                    ``(E) any other person the Secretary may specify in 
                regulations.
            ``(4) Information for payment for genetic services.--
                    ``(A) In general.--With respect to payment for 
                genetic services conducted concerning an individual or 
                the coordination of benefits, an issuer of a medicare 
                supplemental policy may request that the individual 
                provide the issuer with evidence that such services 
                were performed.
                    ``(B) Rule of construction.--Nothing in 
                subparagraph (A) shall be construed to--
                            ``(i) permit an issuer to request (or 
                        require) the results of the services referred 
                        to in such subparagraph; or
                            ``(ii) require that an issuer make payment 
                        for services described in such subparagraph 
                        where the individual involved has refused to 
                        provide evidence of the performance of such 
                        services pursuant to a request by the issuer in 
                        accordance with such subparagraph.
            ``(5) Information for payment of other claims.--With 
        respect to the payment of claims for benefits other than 
        genetic services, an issuer of a medicare supplemental policy 
        may request that an individual provide predictive genetic 
        information so long as such information--
                    ``(A) is used solely for the payment of a claim;
                    ``(B) is limited to information that is directly 
                related to and necessary for the payment of such claim 
                and the claim would otherwise be denied but for the 
predictive genetic information; and
                    ``(C) is used only by an individual (or 
                individuals) within such issuer who needs access to 
                such information for purposes of payment of a claim.
            ``(6) Rules of construction.--
                    ``(A) Collection or disclosure authorized by 
                individual.--The provisions of paragraphs (2) 
                (regarding collection) and (3) shall not apply to an 
                individual if the individual (or legal representative 
                of the individual) provides prior, knowing, voluntary, 
                and written authorization for the collection or 
                disclosure of predictive genetic information.
                    ``(B) Disclosure for health care treatment.--
                Nothing in this section shall be construed to limit or 
                restrict the disclosure of predictive genetic 
                information from a health care provider to another 
                health care provider for the purpose of providing 
                health care treatment to the individual involved.
            ``(7) Violation of genetic discrimination or genetic 
        disclosure provisions.--In any action under this subsection 
        against any administrator of a medicare supplemental policy 
        (including any third party administrator or other person acting 
        for or on behalf of such policy) alleging a violation of this 
        subsection, the court may award any appropriate legal or 
        equitable relief. Such relief may include a requirement for the 
        payment of attorney's fees and costs, including the costs of 
        expert witnesses.
            ``(8) Civil penalty.--The monetary provisions of section 
        308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall 
        apply for purposes of the Secretary enforcing the provisions of 
        this subsection, except that any such relief awarded shall be 
        paid only into the general fund of the Treasury.
            ``(9) Special rule in case of genetic information.--This 
        subsection (relating to genetic information or information 
        about a request for, or the receipt of, genetic services by an 
        individual or a family member of such individual) shall not be 
        construed to supersede any provision of State law which 
        establishes, implements, or continues in effect a standard, 
        requirement, or remedy that more completely--
                    ``(A) protects the confidentiality of genetic 
                information (including information about a request for, 
                or the receipt of, genetic services by an individual or 
                a family member of such individual) or the privacy of 
                an individual or a family member of the individual with 
                respect to genetic information (including information 
                about a request for, or the receipt of, genetic 
                services by an individual or a family member of such 
                individual) than does this subsection; or
                    ``(B) prohibits discrimination on the basis of 
                genetic information than does this subsection.
            ``(10) Definitions.--In this subsection:
                    ``(A) Controlled group.--The term `controlled 
                group' means any group treated as a single employer 
                under subsection (b), (c), (m), or (o) of section 414 
                of the Internal Revenue Code of 1986.
                    ``(B) Family member.--The term `family member' 
                means with respect to an individual--
                            ``(i) the spouse of the individual;
                            ``(ii) a dependent child of the individual, 
                        including a child who is born to or placed for 
                        adoption with the individual; and
                            ``(iii) all other individuals related by 
                        blood to the individual or the spouse or child 
                        described in clause (i) or (ii).
                    ``(C) Genetic information.--The term `genetic 
                information' means information about genes, gene 
                products, or inherited characteristics that may derive 
                from an individual or a family member of such 
                individual (including information about a request for, 
                or the receipt of, genetic services by such individual 
                or family member of such individual).
                    ``(D) Genetic services.--The term `genetic 
                services' means health services, including genetic 
                tests, provided to obtain, assess, or interpret genetic 
                information for diagnostic and therapeutic purposes, 
                and for genetic education and counseling.
                    ``(E) Genetic test.--The term `genetic test' means 
                the analysis of human DNA, RNA, chromosomes, proteins, 
                and certain metabolites in order to detect genotypes, 
                mutations, or chromosomal changes.
                    ``(F) Issuer of a medicare supplemental policy.--
                The term `issuer of a medicare supplemental policy' 
                includes a third-party administrator or other person 
acting for or on behalf of such issuer.
                    ``(G) Predictive genetic information.--
                            ``(i) In general.--The term `predictive 
                        genetic information' means--
                                    ``(I) information about an 
                                individual's genetic tests;
                                    ``(II) information about genetic 
                                tests of family members of the 
                                individual; or
                                    ``(III) information about the 
                                occurrence of a disease or disorder in 
                                family members.
                            ``(ii) Limitations.--The term `predictive 
                        genetic information' shall not include--
                                    ``(I) information about the sex or 
                                age of the individual;
                                    ``(II) information about chemical, 
                                blood, or urine analyses of the 
                                individual, unless these analyses are 
                                genetic tests; or
                                    ``(III) information about physical 
                                exams of the individual, and other 
                                information relevant to determining the 
                                current health status of the 
                                individual.''.
            (2) Conforming amendment.--Section 1882(o) of the Social 
        Security Act (42 U.S.C. 1395ss(o)) is amended by adding at the 
        end the following:
            ``(4) The issuer of the medicare supplemental policy 
        complies with subsection (s)(2)(E) and subsection (v).''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply with respect to an issuer of a medicare 
        supplemental policy for policy years beginning after October 1, 
        2000.
    (c) Transition Provisions.--
            (1) In general.--If the Secretary of Health and Human 
        Services identifies a State as requiring a change to its 
        statutes or regulations to conform its regulatory program to 
        the changes made by this section, the State regulatory program 
        shall not be considered to be out of compliance with the 
        requirements of section 1882 of the Social Security Act due 
        solely to failure to make such change until the date specified 
        in paragraph (4).
            (2) NAIC standards.--If, not later than June 30, 2000, the 
        National Association of Insurance Commissioners (in this 
        subsection referred to as the ``NAIC'') modifies its NAIC Model 
        Regulation relating to section 1882 of the Social Security Act 
        (referred to in such section as the 1991 NAIC Model Regulation, 
        as subsequently modified) to conform to the amendments made by 
        this section, such revised regulation incorporating the 
        modifications shall be considered to be the applicable NAIC 
        model regulation (including the revised NAIC model regulation 
        and the 1991 NAIC Model Regulation) for the purposes of such 
        section.
            (3) Secretary standards.--If the NAIC does not make the 
        modifications described in paragraph (2) within the period 
        specified in such paragraph, the Secretary of Health and Human 
        Services shall, not later than October 1, 2000, make the 
        modifications described in such paragraph and such revised 
        regulation incorporating the modifications shall be considered 
        to be the appropriate regulation for the purposes of such 
        section.
            (4) Date specified.--
                    (A) In general.--Subject to subparagraph (B), the 
                date specified in this paragraph for a State is the 
                earlier of--
                            (i) the date the State changes its statutes 
                        or regulations to conform its regulatory 
                        program to the changes made by this section, or
                            (ii) October 1, 2000.
                    (B) Additional legislative action required.--In the 
                case of a State which the Secretary identifies as--
                            (i) requiring State legislation (other than 
                        legislation appropriating funds) to conform its 
                        regulatory program to the changes made in this 
                        section, but
                            (ii) having a legislature which is not 
                        scheduled to meet in 2000 in a legislative 
                        session in which such legislation may be 
                        considered,
                the date specified in this paragraph is the first day 
                of the first calendar quarter beginning after the close 
                of the first legislative session of the State 
                legislature that begins on or after July 1, 2000. For 
                purposes of the previous sentence, in the case of a 
                State that has a 2-year legislative session, each year 
                of such session shall be deemed to be a separate 
                regular session of the State legislature.

  TITLE II--PROHIBITION OF EMPLOYMENT DISCRIMINATION ON THE BASIS OF 
                     PREDICTIVE GENETIC INFORMATION

SEC. 201. DEFINITIONS.

    In this title:
            (1) Employee; employer; employment agency; labor 
        organization; member.--The terms ``employee'', ``employer'', 
        ``employment agency'', and ``labor organization'' have the 
        meanings given such terms in section 701 of the Civil Rights 
        Act of 1964 (42 U.S.C. 2000e), except that the terms 
        ``employee'' and ``employer'' shall also include the meanings 
        given such terms in section 717 of the Civil Rights Act of 1964 
        (42 U.S.C. 2000e-16). The terms ``employee'' and ``member'' 
        include an applicant for employment and an applicant for 
        membership in a labor organization, respectively.
            (2) Family member.--The term ``family member'' means with 
        respect to an individual--
                    (A) the spouse of the individual;
                    (B) a dependent child of the individual, including 
                a child who is born to or placed for adoption with the 
                individual; and
                    (C) all other individuals related by blood to the 
                individual or the spouse or child described in 
                subparagraph (A) or (B).
            (3) Genetic monitoring.--The term ``genetic monitoring'' 
        means the periodic examination of employees to evaluate 
        acquired modifications to their genetic material, such as 
        chromosomal damage or evidence of increased occurrence of 
        mutations, that may have developed in the course of employment 
        due to exposure to toxic substances in the workplace, in order 
        to identify, evaluate, and respond to the effects of or control 
        adverse environmental exposures in the workplace.
            (4) Genetic services.--The term ``genetic services'' means 
        health services, including genetic tests, provided to obtain, 
        assess, or interpret genetic information for diagnostic and 
        therapeutic purposes, and for genetic education and counseling.
            (5) Genetic test.--The term ``genetic test'' means the 
        analysis of human DNA, RNA, chromosomes, proteins, and certain 
        metabolites in order to detect genotypes, mutations, or 
        chromosomal changes.
            (6) Predictive genetic information.--
                    (A) In general.--The term ``predictive genetic 
                information'' means--
                            (i) information about an individual's 
                        genetic tests;
                            (ii) information about genetic tests of 
                        family members of the individual; or
                            (iii) information about the occurrence of a 
                        disease or disorder in family members.
                    (B) Limitations.--The term ``predictive genetic 
                information'' shall not include--
                            (i) information about the sex or age of the 
                        individual;
                            (ii) information about chemical, blood, or 
                        urine analyses of the individual, unless these 
                        analyses are genetic tests; or
                            (iii) information about physical exams of 
                        the individual, and other information relevant 
                        to determining the current health status of the 
                        individual.

SEC. 202. EMPLOYER PRACTICES.

    (a) In General.--It shall be an unlawful employment practice for an 
employer--
            (1) to fail or refuse to hire or to discharge any 
        individual, or otherwise to discriminate against any individual 
        with respect to the compensation, terms, conditions, or 
        privileges of employment of the individual, because of 
        predictive genetic information with respect to the individual 
        (or information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual;
            (2) to limit, segregate, or classify the employees of the 
        employer in any way that would deprive or tend to deprive any 
        individual of employment opportunities or otherwise adversely 
        affect the status of the individual as an employee, because of 
        predictive genetic information with respect to the individual, 
        or information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual; or
            (3) to request, require, collect or purchase predictive 
        genetic information with respect to an individual or a family 
        member of the individual except--
                    (A) where used for genetic monitoring of biological 
                effects of toxic substances in the workplace, but only 
                if--
                            (i) the employee has provided prior, 
                        knowing, voluntary, and written authorization;
                            (ii) the employee is informed of individual 
                        monitoring results;
                            (iii) the monitoring conforms to any 
                        genetic monitoring regulations that may be 
                        promulgated by the Secretary of Labor pursuant 
                        to the Occupational Safety and Health Act of 
                        1970 (29 U.S.C. 651 et seq.) or the Federal 
                        Mine Safety and Health Act of 1977 (30 U.S.C. 
                        801 et seq.); and
                            (iv) the employer, excluding any licensed 
                        health care professional that is involved in 
                        the genetic monitoring program, receives the 
                        results of the monitoring only in aggregate 
                        terms that do not disclose the identity of 
                        specific employees; or
                    (B) where genetic services are offered by the 
                employer and the employee provides prior, knowing, 
                voluntary, and written authorization, and only the 
                employee or family member of such employee receives the 
                results of such services.
    (b) Limitation.--In the case of predictive genetic information to 
which subparagraph (A) or (B) of subsection (a)(3) applies, such 
information may not be used in violation of paragraph (1) or (2) of 
subsection (a).

SEC. 203. EMPLOYMENT AGENCY PRACTICES.

    It shall be an unlawful employment practice for an employment 
agency--
            (1) to fail or refuse to refer for employment, or otherwise 
        to discriminate against, any individual because of predictive 
        genetic information with respect to the individual (or 
        information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual);
            (2) to limit, segregate, or classify individuals or fail or 
        refuse to refer for employment any individual in any way that 
        would deprive or tend to deprive any individual of employment 
        opportunities or would limit the employment opportunities or 
        otherwise adversely affect the status of the individual as an 
        employee, because of predictive genetic information with 
        respect to the individual (or information about a request for 
        or the receipt of genetic services by such individual or family 
        member of such individual);
            (3) to request, require, collect or purchase predictive 
        genetic information with respect to an individual (or 
        information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual); or
            (4) to cause or attempt to cause an employer to 
        discriminate against an individual in violation of this title.

SEC. 204. LABOR ORGANIZATION PRACTICES.

    It shall be an unlawful employment practice for a labor 
organization--
            (1) to exclude or to expel from the membership of the 
        organization, or otherwise to discriminate against, any 
        individual because of predictive genetic information with 
        respect to the individual (or information about a request for 
        or the receipt of genetic services by such individual or family 
        member of such individual);
            (2) to limit, segregate, or classify the members of the 
        organization, or fail or refuse to refer for employment any 
        individual, in any way that would deprive or tend to deprive 
        any individual of employment opportunities, or would limit the 
        employment opportunities or otherwise adversely affect the 
        status of the individual as an employee, because of predictive 
        genetic information with respect to the individual (or 
        information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual);
            (3) to request, require, collect or purchase predictive 
        genetic information with respect to an individual (or 
        information about a request for or the receipt of genetic 
        services by such individual or family member of such 
        individual); or
            (4) to cause or attempt to cause an employer to 
        discriminate against an individual in violation of this title.

SEC. 205. TRAINING PROGRAMS.

    It shall be an unlawful employment practice for any employer, labor 
organization, or joint labor-management committee controlling 
apprenticeship or other training or retraining, including on-the-job 
training programs--
            (1) to discriminate against any individual because of 
        predictive genetic information with respect to the individual 
        (or information about a request for or the receipt of genetic 
        services by such individual), in admission to, or employment 
        in, any program established to provide apprenticeship or other 
        training or retraining;
            (2) to limit, segregate, or classify the members of the 
        organization, or fail or refuse to refer for employment any 
        individual, in any way that would deprive or tend to deprive 
        any individual of employment opportunities, or would limit the 
        employment opportunities or otherwise adversely affect the 
        status of the individual as an employee, because of predictive 
        genetic information with respect to the individual (or 
        information about a request for or receipt of genetic services 
        by such individual or family member of such individual);
            (3) to request, require, collect or purchase predictive 
        genetic information with respect to an individual (or 
        information about a request for or receipt of genetic services 
        by such individual or family member of such individual); or
            (4) to cause or attempt to cause an employer to 
        discriminate against an individual in violation of this title.

SEC. 206. MAINTENANCE AND DISCLOSURE OF PREDICTIVE GENETIC INFORMATION.

    (a) Maintenance of Predictive Genetic Information.--If an employer 
possesses predictive genetic information about an employee (or 
information about a request for or receipt of genetic services by such 
employee or family member of such employee), such information shall be 
treated or maintained as part of the employee's confidential medical 
records.
    (b) Disclosure of Predictive Genetic Information.--An employer 
shall not disclose predictive genetic information (or information about 
a request for or receipt of genetic services by such employee or family 
member of such employee) except--
            (1) to the employee who is the subject of the information 
        at the request of the employee;
            (2) to an occupational or other health researcher if the 
        research is conducted in compliance with the regulations and 
        protections provided for under part 46 of title 45, Code of 
        Federal Regulations;
            (3) under legal compulsion of a Federal court order, except 
        that if the court order was secured without the knowledge of 
        the individual to whom the information refers, the employer 
        shall provide the individual with adequate notice to challenge 
        the court order unless the court order also imposes 
        confidentiality requirements; and
            (4) to government officials who are investigating 
        compliance with this Act if the information is relevant to the 
        investigation.

SEC. 207. CIVIL ACTION.

    (a) In General.--One or more employees, members of a labor 
organization, or participants in training programs may bring an action 
in a Federal or State court of competent jurisdiction against an 
employer, employment agency, labor organization, or joint labor-
management committee or training program who commits a violation of 
this title.
    (b) Enforcement by the Equal Employment Opportunity Commission.--
            (1) In general.--The powers, remedies, and procedures set 
        forth in sections 705, 706, 707, 709, 710, and 717 of the Civil 
        Rights Act of 1964 (42 U.S.C. 2000e-4, 2000e-5, 2000e-6, 2000e-
        8, 2000e-9, and 2000e-16) shall be the powers, remedies, and 
        procedures provided to the Equal Employment Opportunity 
        Commission to enforce this title. The Commission may promulgate 
        regulations to implement these powers, remedies, and 
        procedures.
            (2) Exhaustion of remedies.--Nothing in this subsection 
        shall be construed to require that an individual exhaust the 
        administrative remedies available through the Equal Employment 
        Opportunity Commission prior to commencing a civil action under 
        this section, except that if an individual files a charge of 
        discrimination with the Commission that alleges a violation of 
        this title, the individual shall exhaust the administrative 
        remedies available through the Commission prior to commencing a 
        civil action under this section.
    (c) Remedy.--A Federal or State court may award any appropriate 
legal or equitable relief under this section. Such relief may include a 
requirement for the payment of attorney's fees and costs, including the 
costs of experts.

SEC. 208. CONSTRUCTION.

    Nothing in this title shall be construed to--
            (1) limit the rights or protections of an individual under 
        the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et 
        seq.), including coverage afforded to individuals under section 
        102 of such Act;
            (2) limit the rights or protections of an individual under 
        the Rehabilitation Act of 1973 (29 U.S.C. 701 et seq.);
            (3) limit the rights or protections of an individual under 
        any other Federal or State statute that provides equal or 
        greater protection to an individual than the rights accorded 
        under this Act;
            (4) apply to the Armed Forces Repository of Specimen 
        Samples for the Identification of Remains; or
            (5) limit the statutory or regulatory authority of the 
        Occupational Safety and Health Administration or the Mine 
        Safety and Health Administration to promulgate or enforce 
        workplace safety and health laws and regulations.

SEC. 209. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated such sums as may be 
necessary to carry out this title.

SEC. 210. EFFECTIVE DATE.

    This title shall become effective on October 1, 2000.
                                 <all>