[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3060 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 3060

To amend the Public Health Service Act, the Employee Retirement Income 
 Security Act of 1974, the Internal Revenue Code of 1986, and title 5, 
    United States Code, to require that group and individual health 
insurance coverage and group health plans and Federal employees health 
     benefit plans provide coverage of colorectal cancer screening.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 17, 2007

Mr. Boren (for himself and Mr. Hall of Texas) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
 in addition to the Committees on Ways and Means, Education and Labor, 
 and Oversight and Government Reform, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act, the Employee Retirement Income 
 Security Act of 1974, the Internal Revenue Code of 1986, and title 5, 
    United States Code, to require that group and individual health 
insurance coverage and group health plans and Federal employees health 
     benefit plans provide coverage of colorectal cancer screening.

    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 ``Colorectal Cancer Screening and 
Detection Coverage Act of 2007''.

SEC. 2. COVERAGE OF COLORECTAL CANCER SCREENING.

    (a) Group Health Plans.--
            (1) Public health service act amendments.--
                    (A) In general.--Subpart 2 of part A of title XXVII 
                of the Public Health Service Act (42 U.S.C. 300gg-4 et 
                seq.) is amended by adding at the end the following new 
                section:

``SEC. 2707. COVERAGE OF COLORECTAL CANCER SCREENING.

    ``(a) Requirement.--
            ``(1) In general.--A group health plan, and a health 
        insurance issuer offering group health insurance coverage, 
        shall provide coverage under the plan or coverage, 
        respectively, for colorectal cancer screening for any 
        participant or beneficiary who is 50 years of age or older, or 
        is an individual who is at high risk for colorectal cancer (as 
        defined in section 1861(pp)(2) of the Social Security Act (42 
        U.S.C. 1395x(pp)(2)), under terms and conditions that are no 
        less favorable than the terms and conditions applicable to 
        other screening benefits otherwise provided under the plan or 
        coverage, respectively.
            ``(2) Colorectal cancer screening defined.--For purposes of 
        this section, the term `colorectal cancer screening' means 
        procedures that--
                    ``(A) are deemed appropriate by a physician (as 
                defined in section 1861(r) of the Social Security Act 
                (42 U.S.C. 1395x(r))) treating the participant or 
                beneficiary, in consultation with the participant or 
                beneficiary;
                    ``(B) are--
                            ``(i) described in section 1861(pp)(1) of 
                        the Social Security Act (42 U.S.C. 
                        1395x(pp)(1)) or section 410.37 of title 42, 
                        Code of Federal Regulations;
                            ``(ii) specified by the Secretary for the 
                        detection of colorectal cancer, based upon the 
                        recommendations of appropriate organizations 
                        with special expertise in the field of 
                        colorectal cancer, including the American 
                        Cancer Society and the American College of 
                        Gastroenterology; or
                            ``(iii) specified by the Secretary, based 
                        upon new scientific knowledge, technological 
                        advances, or other updated medical practices 
                        with respect to detection of colorectal cancer; 
                        and
                    ``(C) are performed at a frequency not greater than 
                that--
                            ``(i) described for such method in section 
                        1834(d) of the Social Security Act (42 U.S.C. 
                        1395m(d)) or section 410.37 of title 42, Code 
                        of Federal Regulations; or
                            ``(ii) specified by the Secretary for such 
                        method, if the Secretary finds, based upon new 
                        scientific knowledge, technological advances, 
                        or other updated medical practices and 
                        consistent with the recommendations of 
                        appropriate organizations with special 
                        expertise in the field of colorectal cancer, 
                        that a different frequency would not adversely 
                        affect the effectiveness of such screening.
    ``(b) Protections.--A group health plan, and a health insurance 
issuer offering group health insurance coverage in connection with a 
group health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) provide monetary payments or rebates to individuals 
        to encourage such individuals to accept less than the minimum 
        protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided care 
        to an individual participant or beneficiary in accordance with 
        this section; or
            ``(4) provide incentives (monetary or otherwise) to an 
        attending provider to induce such provider to provide care to 
        an individual participant or beneficiary in a manner 
        inconsistent with this section.
    ``(c) Rules of Construction.--
            ``(1) Nothing in this section shall be construed to require 
        an individual who is a participant or beneficiary to undergo 
        colorectal cancer screening.
            ``(2) Nothing in this section shall be construed as 
        preventing a group health plan or issuer from imposing 
        deductibles, coinsurance, or other cost-sharing in relation to 
        colorectal cancer screening under the plan (or under health 
        insurance coverage offered in connection with a group health 
        plan), except that such coinsurance or other cost-sharing shall 
        not discriminate on any basis related to the coverage required 
        under this section.
    ``(d) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 714(d) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.
    ``(e) Disclosure Requirement.--
            ``(1) In general.--A group health plan, and health 
        insurance issuer offering group health insurance coverage 
        shall--
                    ``(A) provide to participants and beneficiaries at 
                the time of initial coverage under the plan (or the 
                effective date of this section, in the case of 
                individuals who are participants or beneficiaries as of 
                such date), and at least annually thereafter, the 
                information described in paragraph (2);
                    ``(B) provide to participants and beneficiaries, 
                within a reasonable period (as specified by the 
                appropriate Secretary) before or after the date of 
                significant changes in the information described in 
                paragraph (2), information regarding such significant 
                changes; and
                    ``(C) upon request, make available to participants 
                and beneficiaries, the applicable authority, and 
                prospective participants and beneficiaries, the 
                information described in paragraph (2).
            ``(2) Information described.--For purposes of paragraph 
        (1), the information described in this paragraph, with respect 
        to colorectal cancer screening, is the following:
                    ``(A) Benefits.--Benefits offered under the plan or 
                coverage, including--
                            ``(i) covered benefits, including benefit 
                        limits and coverage exclusions;
                            ``(ii) cost sharing, such as deductibles, 
                        coinsurance, and copayment amounts, including 
                        any liability for balance billing, any maximum 
                        limitations on out of pocket expenses, and the 
                        maximum out of pocket costs for services that 
                        are provided by nonparticipating providers or 
                        that are furnished without meeting the 
                        applicable utilization review requirements;
                            ``(iii) the extent to which benefits may be 
                        obtained from nonparticipating providers; and
                            ``(iv) the extent to which a participant, 
                        beneficiary, or enrollee may select from among 
                        participating providers and the types of 
                        providers participating in the plan or issuer 
                        network.
                    ``(B) Access.--A description of the following:
                            ``(i) The number, mix, and distribution of 
                        providers under the plan or coverage.
                            ``(ii) Out-of-network coverage (if any) 
                        provided by the plan or coverage.
                            ``(iii) Any point-of-service option 
                        (including any supplemental premium or cost-
                        sharing for such option).
                            ``(iv) The procedures for participants, 
                        beneficiaries, and enrollees to select, access, 
                        and change participating primary and specialty 
                        providers.
                            ``(v) The rights and procedures for 
                        obtaining referrals (including standing 
                        referrals) to participating and 
                        nonparticipating providers.
                            ``(vi) The name, address, and telephone 
                        number of participating health care providers 
                        and an indication of whether each such provider 
                        is available to accept new patients.
                            ``(vii) How the plan or issuer addresses 
                        the needs of participants, beneficiaries, and 
                        enrollees and others who do not speak English 
                        or who have other special communications needs 
                        in accessing providers under the plan or 
                        coverage, including the provision of 
                        information under this paragraph.''.
                    (B) Section 2723(c) of such Act (42 U.S.C. 300gg-
                23(c)) is amended by striking ``section 2704'' and 
                inserting ``sections 2704 and 2707''.
            (2) ERISA amendments.--
                    (A) Subpart B of part 7 of subtitle B of title I of 
                the Employee Retirement Income Security Act of 1974 is 
                amended by adding at the end the following new section:

``SEC. 714. COVERAGE OF COLORECTAL CANCER SCREENING.

    ``(a) Requirement.--
            ``(1) In general.--A group health plan, and a health 
        insurance issuer offering group health insurance coverage, 
        shall provide coverage under the plan or coverage, 
        respectively, for colorectal cancer screening for any 
        participant or beneficiary who is 50 years of age or older, or 
        is an individual who is at high risk for colorectal cancer (as 
        defined in section 1861(pp)(2) of the Social Security Act (42 
        U.S.C. 1395x(pp)(2)), under terms and conditions that are no 
        less favorable than the terms and conditions applicable to 
        other screening benefits otherwise provided under the plan or 
        coverage, respectively.
            ``(2) Colorectal cancer screening defined.--For purposes of 
        this section, the term `colorectal cancer screening' means 
        procedures that--
                    ``(A) are deemed appropriate by a physician (as 
                defined in section 1861(r) of the Social Security Act 
                (42 U.S.C. 1395x(r))) treating the participant or 
                beneficiary, in consultation with the participant or 
                beneficiary;
                    ``(B) are--
                            ``(i) described in section 1861(pp)(1) of 
                        the Social Security Act (42 U.S.C. 
                        1395x(pp)(1)) or section 410.37 of title 42, 
                        Code of Federal Regulations;
                            ``(ii) specified by the Secretary for the 
                        detection of colorectal cancer, based upon the 
                        recommendations of appropriate organizations 
                        with special expertise in the field of 
                        colorectal cancer, including the American 
                        Cancer Society and the American College of 
                        Gastroenterology; or
                            ``(iii) specified by the Secretary, based 
                        upon new scientific knowledge, technological 
                        advances, or other updated medical practices 
                        with respect to detection of colorectal cancer; 
                        and
                    ``(C) are performed at a frequency not greater than 
                that--
                            ``(i) described for such method in section 
                        1834(d) of the Social Security Act (42 U.S.C. 
                        1395m(d)) or section 410.37 of title 42, Code 
                        of Federal Regulations; or
                            ``(ii) specified by the Secretary for such 
                        method, if the Secretary finds, based upon new 
                        scientific knowledge, technological advances, 
                        or other updated medical practices and 
                        consistent with the recommendations of 
                        appropriate organizations with special 
                        expertise in the field of colorectal cancer, 
                        that a different frequency would not adversely 
                        affect the effectiveness of such screening.
    ``(b) Protections.--A group health plan, and a health insurance 
issuer offering group health insurance coverage in connection with a 
group health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) provide monetary payments or rebates to individuals 
        to encourage such individuals to accept less than the minimum 
        protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided care 
        to an individual participant or beneficiary in accordance with 
        this section; or
            ``(4) provide incentives (monetary or otherwise) to an 
        attending provider to induce such provider to provide care to 
        an individual participant or beneficiary in a manner 
        inconsistent with this section.
    ``(c) Rules of Construction.--
            ``(1) Nothing in this section shall be construed to require 
        an individual who is a participant or beneficiary to undergo 
        colorectal cancer screening.
            ``(2) Nothing in this section shall be construed as 
        preventing a group health plan or issuer from imposing 
        deductibles, coinsurance, or other cost-sharing in relation to 
        colorectal cancer screening under the plan (or under health 
        insurance coverage offered in connection with a group health 
        plan), except that such coinsurance or other cost-sharing shall 
        not discriminate on any basis related to the coverage required 
        under this section.
    ``(d) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a), for 
purposes of assuring notice of such requirements under the plan; except 
that the summary description required to be provided under the fourth 
sentence of section 104(b)(1) with respect to such modification shall 
be provided by not later than 60 days after the first day of the first 
plan year in which such requirements apply.
    ``(e) Disclosure Requirement.--
            ``(1) In general.--A group health plan, and health 
        insurance issuer offering group health insurance coverage 
        shall--
                    ``(A) provide to participants and beneficiaries at 
                the time of initial coverage under the plan (or the 
                effective date of this section, in the case of 
                individuals who are participants or beneficiaries as of 
                such date), and at least annually thereafter, the 
                information described in paragraph (2);
                    ``(B) provide to participants and beneficiaries, 
                within a reasonable period (as specified by the 
                appropriate Secretary) before or after the date of 
                significant changes in the information described in 
                paragraph (2), information regarding such significant 
                changes; and
                    ``(C) upon request, make available to participants 
                and beneficiaries, the applicable authority, and 
                prospective participants and beneficiaries, the 
                information described in paragraph (2).
            ``(2) Information described.--For purposes of paragraph 
        (1), the information described in this paragraph, with respect 
        to colorectal cancer screening, is the following:
                    ``(A) Benefits.--Benefits offered under the plan or 
                coverage, including--
                            ``(i) covered benefits, including benefit 
                        limits and coverage exclusions;
                            ``(ii) cost sharing, such as deductibles, 
                        coinsurance, and copayment amounts, including 
                        any liability for balance billing, any maximum 
                        limitations on out of pocket expenses, and the 
                        maximum out of pocket costs for services that 
                        are provided by nonparticipating providers or 
                        that are furnished without meeting the 
                        applicable utilization review requirements;
                            ``(iii) the extent to which benefits may be 
                        obtained from nonparticipating providers; and
                            ``(iv) the extent to which a participant, 
                        beneficiary, or enrollee may select from among 
                        participating providers and the types of 
                        providers participating in the plan or issuer 
                        network.
                    ``(B) Access.--A description of the following:
                            ``(i) The number, mix, and distribution of 
                        providers under the plan or coverage.
                            ``(ii) Out-of-network coverage (if any) 
                        provided by the plan or coverage.
                            ``(iii) Any point-of-service option 
                        (including any supplemental premium or cost-
                        sharing for such option).
                            ``(iv) The procedures for participants, 
                        beneficiaries, and enrollees to select, access, 
                        and change participating primary and specialty 
                        providers.
                            ``(v) The rights and procedures for 
                        obtaining referrals (including standing 
                        referrals) to participating and 
                        nonparticipating providers.
                            ``(vi) The name, address, and telephone 
                        number of participating health care providers 
                        and an indication of whether each such provider 
                        is available to accept new patients.
                            ``(vii) How the plan or issuer addresses 
                        the needs of participants, beneficiaries, and 
                        enrollees and others who do not speak English 
                        or who have other special communications needs 
                        in accessing providers under the plan or 
                        coverage, including the provision of 
                        information under this paragraph.''.
                    (B) Section 731(c) of such Act (29 U.S.C. 1191(c)) 
                is amended by striking ``section 711'' and inserting 
                ``sections 711 and 714''.
                    (C) Section 732(a) of such Act (29 U.S.C. 1191a(a)) 
                is amended by striking ``section 711'' and inserting 
                ``sections 711 and 714''.
                    (D) The table of contents in section 1 of such Act 
                is amended by inserting after the item relating to 
                section 713 the following new item:

``Sec. 714. Coverage of colorectal cancer screening.''.
            (3) Internal revenue code amendments.--
                    (A) Subchapter B of chapter 100 of the Internal 
                Revenue Code of 1986 is amended by inserting after 
                section 9812 the following new section:

``SEC. 9813. COVERAGE OF COLORECTAL CANCER SCREENING.

    ``(a) Requirement.--
            ``(1) In general.--A group health plan shall provide 
        coverage under the plan for colorectal cancer screening for any 
        participant or beneficiary who is 50 years of age or older, or 
        is an individual who is at high risk for colorectal cancer (as 
        defined in section 1861(pp)(2) of the Social Security Act (42 
        U.S.C. 1395x(pp)(2)), under terms and conditions that are no 
        less favorable than the terms and conditions applicable to 
        other screening benefits otherwise provided under the plan.
            ``(2) Colorectal cancer screening defined.--For purposes of 
        this section, the term `colorectal cancer screening' means 
        procedures that--
                    ``(A) are deemed appropriate by a physician (as 
                defined in section 1861(r) of the Social Security Act 
                (42 U.S.C. 1395x(r))) treating the participant or 
                beneficiary, in consultation with the participant or 
                beneficiary;
                    ``(B) are--
                            ``(i) described in section 1861(pp)(1) of 
                        the Social Security Act (42 U.S.C. 
                        1395x(pp)(1)) or section 410.37 of title 42, 
                        Code of Federal Regulations;
                            ``(ii) specified by the Secretary of Health 
                        and Human Services for the detection of 
                        colorectal cancer, based upon the 
                        recommendations of appropriate organizations 
                        with special expertise in the field of 
                        colorectal cancer, including the American 
                        Cancer Society and the American College of 
                        Gastroenterology; or
                            ``(iii) specified by the Secretary of 
                        Health and Human Services, based upon new 
                        scientific knowledge, technological advances, 
                        or other updated medical practices with respect 
                        to detection of colorectal cancer; and
                    ``(C) are performed at a frequency not greater than 
                that--
                            ``(i) described for such method in section 
                        1834(d) of the Social Security Act (42 U.S.C. 
                        1395m(d)) or section 410.37 of title 42, Code 
                        of Federal Regulations; or
                            ``(ii) specified by the Secretary of Health 
                        and Human Services for such method, if such 
                        Secretary finds, based upon new scientific 
                        knowledge, technological advances, or other 
                        updated medical practices and consistent with 
                        the recommendations of appropriate 
                        organizations with special expertise in the 
                        field of colorectal cancer, that a different 
                        frequency would not adversely affect the 
                        effectiveness of such screening.
    ``(b) Protections.--A group health plan may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) provide monetary payments or rebates to individuals 
        to encourage such individuals to accept less than the minimum 
        protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided care 
        to an individual participant or beneficiary in accordance with 
        this section; or
            ``(4) provide incentives (monetary or otherwise) to an 
        attending provider to induce such provider to provide care to 
        an individual participant or beneficiary in a manner 
        inconsistent with this section.
    ``(c) Rules of Construction.--
            ``(1) Nothing in this section shall be construed to require 
        an individual who is a participant or beneficiary to undergo 
        colorectal cancer screening.
            ``(2) Nothing in this section shall be construed as 
        preventing a group health plan from imposing deductibles, 
        coinsurance, or other cost-sharing in relation to colorectal 
        cancer screening under the plan, except that such coinsurance 
        or other cost-sharing shall not discriminate on any basis 
        related to the coverage required under this section.
    ``(d) Disclosure Requirement.--
            ``(1) In general.--A group health plan shall--
                    ``(A) provide to participants and beneficiaries at 
                the time of initial coverage under the plan (or the 
                effective date of this section, in the case of 
                individuals who are participants or beneficiaries as of 
                such date), and at least annually thereafter, the 
                information described in paragraph (2);
                    ``(B) provide to participants and beneficiaries, 
                within a reasonable period (as specified by the 
                appropriate Secretary) before or after the date of 
                significant changes in the information described in 
                paragraph (2), information regarding such significant 
                changes; and
                    ``(C) upon request, make available to participants 
                and beneficiaries, the applicable authority, and 
                prospective participants and beneficiaries, the 
                information described in paragraph (2).
            ``(2) Information described.--For purposes of paragraph 
        (1), the information described in this paragraph, with respect 
        to colorectal cancer screening, is the following:
                    ``(A) Benefits.--Benefits offered under the plan, 
                including--
                            ``(i) covered benefits, including benefit 
                        limits and coverage exclusions;
                            ``(ii) cost sharing, such as deductibles, 
                        coinsurance, and copayment amounts, including 
                        any liability for balance billing, any maximum 
                        limitations on out of pocket expenses, and the 
                        maximum out of pocket costs for services that 
                        are provided by nonparticipating providers or 
                        that are furnished without meeting the 
                        applicable utilization review requirements;
                            ``(iii) the extent to which benefits may be 
                        obtained from nonparticipating providers; and
                            ``(iv) the extent to which a participant, 
                        beneficiary, or enrollee may select from among 
                        participating providers and the types of 
                        providers participating in the plan or issuer 
                        network.
                    ``(B) Access.--A description of the following:
                            ``(i) The number, mix, and distribution of 
                        providers under the plan.
                            ``(ii) Out-of-network coverage (if any) 
                        provided by the plan.
                            ``(iii) Any point-of-service option 
                        (including any supplemental premium or cost-
                        sharing for such option).
                            ``(iv) The procedures for participants, 
                        beneficiaries, and enrollees to select, access, 
                        and change participating primary and specialty 
                        providers.
                            ``(v) The rights and procedures for 
                        obtaining referrals (including standing 
                        referrals) to participating and 
                        nonparticipating providers.
                            ``(vi) The name, address, and telephone 
                        number of participating health care providers 
                        and an indication of whether each such provider 
                        is available to accept new patients.
                            ``(vii) How the plan or issuer addresses 
                        the needs of participants, beneficiaries, and 
                        enrollees and others who do not speak English 
                        or who have other special communications needs 
                        in accessing providers under the plan, 
                        including the provision of information under 
                        this paragraph.''.
                    (B) The table of sections of such subchapter of 
                such Code is amended by inserting after the item 
                relating to section 9812 the following new item:

``Sec. 9813. Coverage of colorectal cancer screening.''.
                    (C) Section 4980D(d)(1) of such Code is amended by 
                striking ``section 9811'' and inserting ``sections 9811 
                and 9813''.
    (b) Individual Health Insurance.--
            (1) In general.--Part B of title XXVII of the Public Health 
        Service Act is amended by inserting after section 2752 the 
        following new section:

``SEC. 2753. COVERAGE OF COLORECTAL CANCER SCREENING.

    ``(a) In General.--The provisions of section 2707 (other than 
subsection (d)) shall apply to health insurance coverage offered by a 
health insurance issuer in the individual market in the same manner as 
it applies to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small or large 
group market.
    ``(b) Notice.--A health insurance issuer under this part shall 
comply with the notice requirement under section 714(d) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
referred to in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.''.
            (2) Conforming amendment.--Section 2762(b)(2) of such Act 
        (42 U.S.C. 300gg-63(b)(2)) is amended by striking ``section 
        2751'' and inserting ``sections 2751 and 2753''.
    (c) Application Under Federal Employees Health Benefits Program 
(FEHBP).--Section 8902 of title 5, United States Code, is amended by 
adding at the end the following new subsection:
    ``(p) A contract may not be made or a plan approved which does not 
comply with the requirements of section 2707 of the Public Health 
Service Act.''.
    (d) Effective Dates.--
            (1) Group health plans and health benefit plans.--The 
        amendments made by subsections (a) and (c) shall apply with 
        respect to group health plans (and health insurance coverage 
        offered in connection with group health plans) and health 
        benefit plans, respectively, for plan years beginning on or 
        after January 1, 2008.
            (2) Individual health insurance.--The amendments made by 
        subsection (b) shall apply with respect to health insurance 
        coverage offered, sold, issued, or renewed in the individual 
        market on or after January 1, 2008.
    (e) Coordination of Administration.--The Secretary of Health and 
Human Services, the Secretary of Labor, and the Secretary of the 
Treasury shall ensure, through the execution of an interagency 
memorandum of understanding among such Secretaries, that--
            (1) regulations, rulings, and interpretations issued by 
        such Secretaries relating to the same matter over which two or 
        more such Secretaries have responsibility under the provisions 
        of this section (and the amendments made thereby) are 
        administered so as to have the same effect at all times; and
            (2) coordination of policies relating to enforcing the same 
        requirements through such Secretaries in order to have a 
        coordinated enforcement strategy that avoids duplication of 
        enforcement efforts and assigns priorities in enforcement.
                                 <all>