HR 493 ENR: Genetic Information Nondiscrimination Act of 2008
U.S. House of Representatives
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Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents
(a)This Act may be cited as the Genetic Information Nondiscrimination Act of 2008
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Title I—GENETIC NONDISCRIMINATION IN HEALTH INSURANCE
Sec. 101. Amendments to Employee Retirement Income Security Act of 1974.
Sec. 102. Amendments to the Public Health Service Act.
Sec. 103. Amendments to the Internal Revenue Code of 1986.
Sec. 104. Amendments to title XVIII of the Social Security Act relating to medigap.
Sec. 105. Privacy and confidentiality.
Sec. 106. Assuring coordination.
Title II—PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF GENETIC INFORMATION
Sec. 201. Definitions.
Sec. 202. Employer practices.
Sec. 203. Employment agency practices.
Sec. 204. Labor organization practices.
Sec. 205. Training programs.
Sec. 206. Confidentiality of genetic information.
Sec. 207. Remedies and enforcement.
Sec. 208. Disparate impact.
Sec. 209. Construction.
Sec. 210. Medical information that is not genetic information.
Sec. 211. Regulations.
Sec. 212. Authorization of appropriations.
Sec. 213. Effective date.
Title III—MISCELLANEOUS PROVISIONS
Sec. 301. Severability.
Sec. 302. Child labor protections.
2.Congress makes the following findings:
(1)Deciphering the sequence of the human genome and other advances in genetics open major new opportunities for medical progress. New knowledge about the genetic basis of illness will allow for earlier detection of illnesses, often before symptoms have begun. Genetic testing can allow individuals to take steps to reduce the likelihood that they will contract a particular disorder. New knowledge about genetics may allow for the development of better therapies that are more effective against disease or have fewer side effects than current treatments. These advances give rise to the potential misuse of genetic information to discriminate in health insurance and employment.
(2)The early science of genetics became the basis of State laws that provided for the sterilization of persons having presumed genetic defects
such as mental retardation, mental disease, epilepsy, blindness, and hearing loss, among other conditions. The first sterilization law was enacted in the State of Indiana in 1907. By 1981, a majority of States adopted sterilization laws to correct
apparent genetic traits or tendencies. Many of these State laws have since been repealed, and many have been modified to include essential constitutional requirements of due process and equal protection. However, the current explosion in the science of genetics, and the history of sterilization laws by the States based on early genetic science, compels Congressional action in this area.
(3)Although genes are facially neutral markers, many genetic conditions and disorders are associated with particular racial and ethnic groups and gender. Because some genetic traits are most prevalent in particular groups, members of a particular group may be stigmatized or discriminated against as a result of that genetic information. This form of discrimination was evident in the 1970s, which saw the advent of programs to screen and identify carriers of sickle cell anemia, a disease which afflicts African-Americans. Once again, State legislatures began to enact discriminatory laws in the area, and in the early 1970s began mandating genetic screening of all African Americans for sickle cell anemia, leading to discrimination and unnecessary fear. To alleviate some of this stigma, Congress in 1972 passed the National Sickle Cell Anemia Control Act, which withholds Federal funding from States unless sickle cell testing is voluntary.
(4)Congress has been informed of examples of genetic discrimination in the workplace. These include the use of pre-employment genetic screening at Lawrence Berkeley Laboratory, which led to a court decision in favor of the employees in that case Norman-Bloodsaw v. Lawrence Berkeley Laboratory (135 F.3d 1260, 1269 (9th Cir. 1998)). Congress clearly has a compelling public interest in relieving the fear of discrimination and in prohibiting its actual practice in employment and health insurance.
(5)Federal law addressing genetic discrimination in health insurance and employment is incomplete in both the scope and depth of its protections. Moreover, while many States have enacted some type of genetic non-discrimination law, these laws vary widely with respect to their approach, application, and level of protection. Congress has collected substantial evidence that the American public and the medical community find the existing patchwork of State and Federal laws to be confusing and inadequate to protect them from discrimination. Therefore Federal legislation establishing a national and uniform basic standard is necessary to fully protect the public from discrimination and allay their concerns about the potential for discrimination, thereby allowing individuals to take advantage of genetic testing, technologies, research, and new therapies.
<enum>I</enum><header>GENETIC NONDISCRIMINATION IN HEALTH INSURANCE</header>
<section id="HA672033D82B34F3DBF003BF5407E2E9E"><enum>101.</enum><header>Amendments to <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of 1974</act-name></header>
<subsection id="H4F93BEF14E03457396893E200986A784"><enum>(a)</enum><header>No discrimination in group premiums based on genetic information</header><text>Section 702(b) of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of 1974</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/29/1182">29 U.S.C. 1182(b)</external-xref>) is amended—</text>
<paragraph id="H1A1A8DCBFF9840B9B18E712317D74514"><enum>(1)</enum><text>in paragraph (2)(A), by inserting before the semicolon the following: <quote>except as provided in paragraph (3)</quote>; and</text></paragraph>
<paragraph id="H24958C8ECD5E4C849E00F72B1E6644D8"><enum>(2)</enum><text>by adding at the end the following:</text>
<quoted-block id="HC8506AAC27084D4DAED2182E3D46E13D" style="OLC">
<paragraph commented="no" id="H5DFC9E16D24D48DD9666B1004DBBA065"><enum>(3)</enum><header>No group-based discrimination on basis of genetic information</header>
<subparagraph commented="no" id="HC152AA4DC6534F71A8FC3C352357610"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">For purposes of this section, a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information.</text></subparagraph>
<subparagraph commented="no" id="HD12C4AD26E954C7082B6E0C9002F005F"><enum>(B)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">Nothing in subparagraph (A) or in paragraphs (1) and (2) of subsection (d) shall be construed to limit the ability of a health insurance issuer offering health insurance coverage in connection with a group health plan to increase the premium for an employer based on the manifestation of a disease or disorder of an individual who is enrolled in the plan. In such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members and to further increase the premium for the employer.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H5BE4648E02514482994FC076EF7AA11"><enum>(b)</enum><header>Limitations on genetic testing; prohibition on collection of genetic information; application to all plans</header><text>Section 702 of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of 1974</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/29/1182">29 U.S.C. 1182</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Employee" id="H5DAC8B5CB724498D009FC892B9BD450" style="OLC">
<subsection id="HFF654AC5CEB64163B9EA45438D42CA53"><enum>(c)</enum><header>Genetic Testing</header>
<paragraph id="H6F85F6B78B1D4AE0B09737AC64EFA17D"><enum>(1)</enum><header>Limitation on requesting or requiring genetic testing</header><text>A group health plan, and 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.</text></paragraph>
<paragraph id="H5E28493F188D4DACA4676E52004CF6B8"><enum>(2)</enum><header>Rule of construction</header><text>Paragraph (1) shall not be construed to limit the authority of a health care professional who is providing health care services to an individual to request that such individual undergo a genetic test.</text></paragraph>
<paragraph id="H14FF4E23E0E8411EA1F43B5D73A879A"><enum>(3)</enum><header>Rule of construction regarding payment</header>
<subparagraph id="HF7EAD535A7894AE2B18F91EF171F14E3"><enum>(A)</enum><header>In general</header><text>Nothing in paragraph (1) shall be construed to preclude a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, from obtaining and using the results of a genetic test in making a determination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary of Health and Human Services under part C of title XI of the <act-name parsable-cite="SSA">Social Security Act</act-name> and section 264 of the <act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability Act of 1996</act-name>, as may be revised from time to time) consistent with subsection (a).</text></subparagraph>
<subparagraph id="HFB9FC8B69711487EA49F29519FA966C7"><enum>(B)</enum><header>Limitation</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, may request only the minimum amount of information necessary to accomplish the intended purpose.</text></subparagraph></paragraph>
<paragraph commented="no" id="H4ECF1F5F6B8D414B8DE406055CDE28A9"><enum>(4)</enum><header>Research exception</header><text>Notwithstanding paragraph (1), a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, may request, but not require, that a participant or beneficiary <inline-comment display="no">an individual or a family member of such individual</inline-comment>undergo a genetic test if each of the following conditions is met:</text>
<subparagraph commented="no" id="H03FAB595A983428EB98DBD39410043D1"><enum>(A)</enum><text>The request is made, in writing, pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.</text></subparagraph>
<subparagraph commented="no" id="HE020A5887B70438E85006E97B9346FB"><enum>(B)</enum><text>The plan or issuer clearly indicates to each participant or beneficiary<inline-comment display="no">individual</inline-comment>, or in the case of a minor child, to the legal guardian of such <inline-comment display="no">child</inline-comment>beneficiary, to whom the request is made that—</text>
<clause commented="no" id="H7ECAA30F930147FE89F55CD2005B9281"><enum>(i)</enum><text>compliance with the request is voluntary; and</text></clause>
<clause commented="no" id="HF544000CD30447AEBA00189FABCD7788"><enum>(ii)</enum><text>non-compliance will have no effect on enrollment status or premium or contribution amounts.</text></clause></subparagraph>
<subparagraph commented="no" id="HEB6C5E8D59254C94BEF700A682AA0716"><enum>(C)</enum><text>No genetic information collected or acquired under this paragraph shall be used for underwriting purposes. <inline-comment display="no">Q: Aren’t these activities already generally prohibited under HIPAA after the application of the other amendments made by this Act?</inline-comment></text></subparagraph>
<subparagraph commented="no" id="HE017A8233F864BE400B023BEAFDF7D09"><enum>(D)</enum><text>The plan or issuer notifies the Secretary in writing that the plan or issuer is conducting activities pursuant to the exception provided for under this paragraph, including a description of the activities conducted.</text></subparagraph>
<subparagraph commented="no" id="H762BAB6DB7EE4826A564403C5C7C895C"><enum>(E)</enum><text>The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.</text></subparagraph></paragraph></subsection>
<subsection display-inline="no-display-inline" id="HBF071925601446158000A1DEDF1C1CE8"><enum>(d)</enum><header>Prohibition on collection of genetic information</header>
<paragraph id="HBF555A4816E84F3EB3D340B448EE8E57"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic information for underwriting purposes (as defined in section 733).</text></paragraph>
<paragraph id="H2427FF57A8A94F3795F116104263723E"><enum>(2)</enum><header>Prohibition on collection of genetic information prior to enrollment</header><text display-inline="yes-display-inline">A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic information with respect to any individual prior to such individual’s enrollment under the plan or coverage in connection with such enrollment.</text></paragraph>
<paragraph id="H416B7B24D00D4BB1B89F1E7733A2F224"><enum>(3)</enum><header>Incidental collection</header><text display-inline="yes-display-inline">If a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of paragraph (2) if such request, requirement, or purchase is not in violation of paragraph (1).</text></paragraph></subsection>
<subsection id="H76E340CEDCC343908C5002591B2CA1FE"><enum>(e)</enum><header>Application to All Plans</header><text>The provisions of subsections (a)(1)(F), (b)(3), (c), and (d), and subsection (b)(1) and section 701 with respect to genetic information, shall apply to group health plans and health insurance issuers without regard to section 732(a).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HC3F7B80301354930AF830205ED198784"><enum>(c)</enum><header>Application to genetic information of a fetus or embryo</header><text>Such section is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H0EEE5BF403D24E65A4E3064BA4831C30" style="OLC">
<subsection id="HDE0C6963BA034CB6A6C48BC3906CDC05"><enum>(f)</enum><header>Genetic information of a fetus or embryo</header><text>Any reference in this part to genetic information concerning an individual or family member of an individual shall—</text>
<paragraph id="H4ACF235C63744F0F9E770890C4586CF1"><enum>(1)</enum><text>with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and</text></paragraph>
<paragraph id="H5EDDDC8BA76F4E819FCE71CF69FBDD86"><enum>(2)</enum><text>with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HE30F98018A324AC6AEE5D308C3883B5"><enum>(d)</enum><header>Definitions</header><text>Section 733(d) of the <act-name parsable-cite="ERISA">Employee Retirement Income Security Act of 1974</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/29/1191b">29 U.S.C. 1191b(d)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Employee" id="H3A2BCB2C45D244B08D58009096FC35AA" style="OLC">
<paragraph id="HDEA72E5340AB468B9881DFC66F00B8AE"><enum>(5)</enum><header>Family member</header><text>The term <term>family member</term> means, with respect to an individual—</text>
<subparagraph commented="no" id="H9C09A33216714C8D00BD4B3CE10243C9"><enum>(A)</enum><text>a dependent (as such term is used for purposes of section 701(f)(2)) of such individual, and</text></subparagraph>
<subparagraph commented="no" id="H5BC9753A6B434D95939B009B977353C2"><enum>(B)</enum><text>any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of such individual or of an individual described in subparagraph (A).</text></subparagraph></paragraph>
<paragraph id="H7D96820BA14F43B18D00599FB65F126C"><enum>(6)</enum><header>Genetic information</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H42348DC30AF8412694BD69C2ED723E2E"><enum>(A)</enum><header>In general</header><text>The term <term>genetic information</term> means, with respect to any individual, information about—</text>
<clause commented="no" display-inline="no-display-inline" id="HA37655505971444CA323A28FD6DEDF89"><enum>(i)</enum><text>such individual’s genetic tests,</text></clause>
<clause commented="no" id="H0DF0BC0241DF4D75B4081300D398E52C"><enum>(ii)</enum><text>the genetic tests of family members of such individual, and</text></clause>
<clause commented="no" id="HB0A8D33316AF43C4AEDFA53091435F13"><enum>(iii)</enum><text>the manifestation of a disease or disorder in family members of such individual.</text></clause></subparagraph>
<subparagraph id="HB1BBDF251EA243EABB4255608DE176C6"><enum>(B)</enum><header>Inclusion of genetic services and participation in genetic research</header><text display-inline="yes-display-inline">Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual.</text></subparagraph>
<subparagraph commented="no" id="H4EF4146849D8452D894287789BE58000"><enum>(C)</enum><header>Exclusions</header><text>The term <term>genetic information</term> shall not include information about the sex or age of any individual.</text></subparagraph></paragraph>
<paragraph id="HCAA9EB8CAF6C4053BA95E58B54A6C5D0"><enum>(7)</enum><header>Genetic test</header>
<subparagraph id="H283BF2DB683E442DA363A300FF744D39"><enum>(A)</enum><header>In general</header><text>The term <term>genetic test</term> means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detects genotypes, mutations, or chromosomal changes.</text></subparagraph>
<subparagraph id="HE2FEB911DFCD46958B579DB50633807"><enum>(B)</enum><header>Exceptions</header><text>The term <term>genetic test</term> does not mean—</text>
<clause id="H4163E184779E4EAD9B486CB373CF66FA"><enum>(i)</enum><text>an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes; or</text></clause>
<clause id="HB6FC3012CD1944E2A9654857F776EF9F"><enum>(ii)</enum><text>an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.</text></clause></subparagraph></paragraph>
<paragraph id="H2CAF5E360A024044AFC9D22FE8382265"><enum>(8)</enum><header>Genetic services</header><text>The term <term>genetic services</term> means—</text>
<subparagraph id="H21512B0A0ED549B68E7262D7C080084"><enum>(A)</enum><text>a genetic test;</text></subparagraph>
<subparagraph id="H00D970CD8A1445D19C036E6603C99CA2"><enum>(B)</enum><text>genetic counseling (including obtaining, interpreting, or assessing genetic information); or</text></subparagraph>
<subparagraph id="HFD712EA512624E5BB1E4027CC6A390B4"><enum>(C)</enum><text>genetic education.</text></subparagraph></paragraph>
<paragraph id="HE52234BD957A422883CD5E3B7EE6F8D3"><enum>(9)</enum><header>Underwriting purposes</header><text display-inline="yes-display-inline">The term <quote>underwriting purposes</quote> means, with respect to any group health plan, or health insurance coverage offered in connection with a group health plan—</text>
<subparagraph id="H2801BD61AAF34361AFA13DB008E6C7D"><enum>(A)</enum><text>rules for, or determination of, eligibility (including enrollment and continued eligibility) for benefits under the plan or coverage;</text></subparagraph>
<subparagraph id="H5DBF443E93214616A16F2BF4F649B4E0"><enum>(B)</enum><text display-inline="yes-display-inline">the computation of premium or contribution amounts under the plan or coverage;</text></subparagraph>
<subparagraph id="H637D13E9B09C4B25BE2B0082C232AAE"><enum>(C)</enum><text display-inline="yes-display-inline">the application of any pre-existing condition exclusion under the plan or coverage; and</text></subparagraph>
<subparagraph id="H1136C4D976C84E08BDDF857524F38FEF"><enum>(D)</enum><text>other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection display-inline="no-display-inline" id="H73371B5BDEC44C0DB866FDEA4D597CB5"><enum>(e)</enum><header>ERISA enforcement</header><text>Section 502 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1132">29 U.S.C. 1132</external-xref>) is amended—</text>
<paragraph id="H2949EBF9E711482E971D59A905D96E28"><enum>(1)</enum><text>in subsection (a)(6), by striking <quote>(7), or (8)</quote> and inserting <quote>(7), (8), or (9)</quote>;</text></paragraph>
<paragraph id="H1E0F070F4373483BB8FB5FB7AE818327"><enum>(2)</enum><text>in subsection (b)(3), by striking <quote>The Secretary</quote> and inserting <quote>Except as provided in subsections (c)(9) and (a)(6) (with respect to collecting civil penalties under subsection (c)(9)), the Secretary</quote>; and</text></paragraph>
<paragraph id="H9187A8A7856A4EB18DC46F1B18085DAC"><enum>(3)</enum><text>in subsection (c), by redesignating paragraph (9) as paragraph (10), and by inserting after paragraph (8) the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HD7035D5386F847CF832B4D48BECBE267" style="OLC">
<paragraph id="H796F88FB2BE547D689373C8405DEC500"><enum>(9)</enum><header>Secretarial enforcement authority relating to use of genetic information</header>
<subparagraph id="H9C1D83711D044C19B8B100ECDE06FB4D"><enum>(A)</enum><header>General rule</header><text>The Secretary may impose a penalty against any plan sponsor of a group health plan, or any health insurance issuer offering health insurance coverage in connection with the plan, for any failure by such sponsor or issuer to meet the requirements of subsection (a)(1)(F), (b)(3), (c), or (d) of section 702 or section 701 or 702(b)(1) with respect to genetic information, in connection with the plan.</text></subparagraph>
<subparagraph id="H653F3F3D70034F65B5366B5B11E57899"><enum>(B)</enum><header>Amount</header>
<clause id="H650575DAA87949618D8EAAF5217900AD"><enum>(i)</enum><header>In general</header><text>The amount of the penalty imposed by subparagraph (A) shall be $100 for each day in the noncompliance period with respect to each participant or beneficiary to whom such failure relates.</text></clause>
<clause id="HCCAAA394E53F434EA7015E07ED641164"><enum>(ii)</enum><header>Noncompliance period</header><text>For purposes of this paragraph, the term <term>noncompliance period</term> means, with respect to any failure, the period—</text>
<subclause id="HB1884F9C91764EE5BFCBA142EE82009B"><enum>(I)</enum><text>beginning on the date such failure first occurs; and</text></subclause>
<subclause id="H3BE4E2BFC83A4A86911C86D938946C89"><enum>(II)</enum><text>ending on the date the failure is corrected.</text></subclause></clause></subparagraph>
<subparagraph id="H8CF28E825BC84CCDA033A5E99D2CF7FB"><enum>(C)</enum><header>Minimum penalties where failure discovered</header><text>Notwithstanding clauses (i) and (ii) of subparagraph (D):</text>
<clause id="H310624D6166943E4821900FBFDFCB23F"><enum>(i)</enum><header>In general</header><text>In the case of 1 or more failures with respect to a participant or beneficiary—</text>
<subclause id="HA228A98F964046EA807229F42EE7C82"><enum>(I)</enum><text>which are not corrected before the date on which the plan receives a notice from the Secretary of such violation; and</text></subclause>
<subclause id="H25E6E1D24493410CA27E06A59EEFB200"><enum>(II)</enum><text>which occurred or continued during the period involved;</text></subclause><continuation-text continuation-text-level="clause">the amount of penalty imposed by subparagraph (A) by reason of such failures with respect to such participant or beneficiary shall not be less than $2,500.</continuation-text></clause>
<clause id="H914B880252F641330050A1942F000846"><enum>(ii)</enum><header>Higher minimum penalty where violations are more than de minimis</header><text>To the extent violations for which any person is liable under this paragraph for any year are more than de minimis, clause (i) shall be applied by substituting <quote>$15,000</quote> for <quote>$2,500</quote> with respect to such person.</text></clause></subparagraph>
<subparagraph id="HED5234C29132444E00CD801B04A47626"><enum>(D)</enum><header>Limitations</header>
<clause id="H9BF5381915A7449DBB21AA53CAE4B5DB"><enum>(i)</enum><header>Penalty not to apply where failure not discovered exercising reasonable diligence</header><text>No penalty shall be imposed by subparagraph (A) on any failure during any period for which it is established to the satisfaction of the Secretary that the person otherwise liable for such penalty did not know, and exercising reasonable diligence would not have known, that such failure existed.</text></clause>
<clause id="HA0F1A13A6DE44DF4BCB1FE9DDD905233"><enum>(ii)</enum><header>Penalty not to apply to failures corrected within certain periods</header><text>No penalty shall be imposed by subparagraph (A) on any failure if—</text>
<subclause id="H941CA4A5ECA94483AA6FBACA3B1F755D"><enum>(I)</enum><text>such failure was due to reasonable cause and not to willful neglect; and</text></subclause>
<subclause id="HD41EF1CEDA60496CA48FDB10C0729CF6"><enum>(II)</enum><text>such failure is corrected during the 30-day period beginning on the first date the person otherwise liable for such penalty knew, or exercising reasonable diligence would have known, that such failure existed.</text></subclause></clause>
<clause id="H72C3C1FDB466469DB1D707F600288938"><enum>(iii)</enum><header>Overall limitation for unintentional failures</header><text>In the case of failures which are due to reasonable cause and not to willful neglect, the penalty imposed by subparagraph (A) for failures shall not exceed the amount equal to the lesser of—</text>
<subclause id="H7DDB72173D634BC1B98BC4004C179E79"><enum>(I)</enum><text>10 percent of the aggregate amount paid or incurred by the plan sponsor (or predecessor plan sponsor) during the preceding taxable year for group health plans; or</text></subclause>
<subclause id="H1818749E426F474BA725DBD6F8208BE7"><enum>(II)</enum><text>$500,000.</text></subclause></clause></subparagraph>
<subparagraph id="H9038D7E4587E49238C7EBF7EE1EB1DE5"><enum>(E)</enum><header>Waiver by secretary</header><text>In the case of a failure which is due to reasonable cause and not to willful neglect, the Secretary may waive part or all of the penalty imposed by subparagraph (A) to the extent that the payment of such penalty would be excessive relative to the failure involved.</text></subparagraph>
<subparagraph id="HB6406E3CB7D040CC0062DD92B26BDB83"><enum>(F)</enum><header>Definitions</header><text>Terms used in this paragraph which are defined in section 733 shall have the meanings provided such terms in such section.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H727DE229F9E947F60022B3F83DFD0630"><enum>(f)</enum><header>Regulations and Effective Date</header>
<paragraph id="HC09E1C8A93494C8BAD7B305FA57F01A1"><enum>(1)</enum><header>Regulations</header><text>The Secretary of Labor shall issue final regulations not later than 12 months after the date of enactment of this Act to carry out the amendments made by this section.</text></paragraph>
<paragraph id="HD51F405C542C4403B868D355E3AC00FD"><enum>(2)</enum><header>Effective date</header><text>The amendments made by this section shall apply with respect to group health plans for plan years beginning after the date that is 1 year after the date of enactment of this Act.</text></paragraph></subsection></section>
<section id="H7A5EB2CB39A5463E935E85FBDFD4A335"><enum>102.</enum><header>Amendments to the <act-name parsable-cite="PHSA">Public Health Service Act</act-name></header>
<subsection id="H28C4A67F46824CB49651FA6DC20D99B"><enum>(a)</enum><header>Amendments Relating to the Group Market</header>
<paragraph display-inline="no-display-inline" id="HF07EBE52039E4A60BB2D64D014C80028"><enum>(1)</enum><header>No discrimination in group premiums based on genetic information</header><text>Section 2702(b) of the <act-name parsable-cite="ERISA">Public Health Service Act </act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-1">42 U.S.C. 300gg–1(b)</external-xref>) is amended—</text>
<subparagraph id="H956AA2A0C8494B5A813E319CBFB15EED"><enum>(A)</enum><text>in paragraph (2)(A), by inserting before the semicolon the following: <quote>except as provided in paragraph (3)</quote>; and</text></subparagraph>
<subparagraph id="HECA587FCBEBE4E3ABE33785DCA8ED864"><enum>(B)</enum><text>by adding at the end the following:</text>
<quoted-block id="H8119C8DCB0604E919388013B5DE27549" style="OLC">
<paragraph commented="no" id="HF84405E6FD404E97A33DFDC775ED8FA6"><enum>(3)</enum><header>No group-based discrimination on basis of genetic information</header>
<subparagraph commented="no" id="HF25C3D6D910A4A779E69E8A648731DB"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">For purposes of this section, a group health plan, and health insurance issuer offering group health insurance coverage in connection with a group health plan, may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H4342A228768D48E589EE2FB9036ED1AB"><enum>(B)</enum><header display-inline="yes-display-inline">Rule of construction</header><text display-inline="yes-display-inline">Nothing in subparagraph (A) or in paragraphs (1) and (2) of subsection (d) shall be construed to limit the ability of a health insurance issuer offering health insurance coverage in connection with a group health plan to increase the premium for an employer based on the manifestation of a disease or disorder of an individual who is enrolled in the plan. In such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members and to further increase the premium for the employer.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H3D0984AF115245F2AA00113D95AC9916"><enum>(2)</enum><header>Limitations on genetic testing; prohibition on collection of genetic information; application to all plans</header><text>Section 2702 of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-1">42 U.S.C. 300gg–1</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="HFBDEFCAB144948C09B571F7F459FB8A6" style="OLC">
<subsection display-inline="no-display-inline" id="HB353F540C5E245DDAE096C12A2254282"><enum>(c)</enum><header>Genetic Testing</header>
<paragraph id="HF5025A616DA2455394B9551900ADE41"><enum>(1)</enum><header>Limitation on requesting or requiring genetic testing</header><text>A group health plan, and 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.</text></paragraph>
<paragraph id="H4BD2B6AEDFCF4085BCE4745608834350"><enum>(2)</enum><header>Rule of construction</header><text>Paragraph (1) shall not be construed to limit the authority of a health care professional who is providing health care services to an individual to request that such individual undergo a genetic test.</text></paragraph>
<paragraph display-inline="no-display-inline" id="HEBBE01BBB924453EA02F34C500B24EC1"><enum>(3)</enum><header>Rule of construction regarding payment</header>
<subparagraph id="HC2D385F81B4846D7A2F6E0F1CCDA0097"><enum>(A)</enum><header>In general</header><text>Nothing in paragraph (1) shall be construed to preclude a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, from obtaining and using the results of a genetic test in making a determination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary under part C of title XI of the <act-name parsable-cite="SSA">Social Security Act</act-name> and section 264 of the <act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability Act of 1996</act-name>, as may be revised from time to time) consistent with subsection (a).</text></subparagraph>
<subparagraph id="H36EAE999F01742308BB3DE63005956CD"><enum>(B)</enum><header>Limitation</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, may request only the minimum amount of information necessary to accomplish the intended purpose.</text></subparagraph></paragraph>
<paragraph commented="no" id="HC2999C8D105D41F99B04102894782260"><enum>(4)</enum><header>Research exception</header><text>Notwithstanding paragraph (1), a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, may request, but not require, that a participant or beneficiary <inline-comment display="no">an individual or a family member of such individual</inline-comment>undergo a genetic test if each of the following conditions is met:</text>
<subparagraph commented="no" id="HB47395F18EDC41BC9B383259814CE092"><enum>(A)</enum><text>The request is made pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.</text></subparagraph>
<subparagraph commented="no" id="H4ADD06C9B248471A996EFB67AF4E0026"><enum>(B)</enum><text>The plan or issuer clearly indicates to each participant or beneficiary<inline-comment display="no">individual</inline-comment>, or in the case of a minor child, to the legal guardian of such beneficiary<inline-comment display="no">child</inline-comment>, to whom the request is made that—</text>
<clause commented="no" id="HC4928FBCA7A44434A670CA00F77BAF70"><enum>(i)</enum><text>compliance with the request is voluntary; and</text></clause>
<clause commented="no" id="HED437DF145CE4D1BBFB5FE50649C22FA"><enum>(ii)</enum><text>non-compliance will have no effect on enrollment status or premium or contribution amounts.</text></clause></subparagraph>
<subparagraph commented="no" id="H1F193FF3B447430F8D810089FD26C16"><enum>(C)</enum><text>No genetic information collected or acquired under this paragraph shall be used for underwriting purposes. <inline-comment display="no">Q: Aren’t these activities already generally prohibited under HIPAA after the application of the other amendments made by this Act?</inline-comment></text></subparagraph>
<subparagraph commented="no" id="H453DDA610ACC441A0039C26FD6C5A224"><enum>(D)</enum><text>The plan or issuer notifies the Secretary in writing that the plan or issuer is conducting activities pursuant to the exception provided for under this paragraph, including a description of the activities conducted.</text></subparagraph>
<subparagraph commented="no" id="H7F773AE4E886480A9FA3994FDE7D279F"><enum>(E)</enum><text>The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.</text></subparagraph></paragraph></subsection>
<subsection display-inline="no-display-inline" id="H554B578E2B6E440D8E218D4F7302845E"><enum>(d)</enum><header>Prohibition on collection of genetic information</header>
<paragraph id="H0FC0D156CB9246B0928B240194B4846B"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic information for underwriting purposes (as defined in section 2791).</text></paragraph>
<paragraph id="HEBF5D47581B547D6A964450200716EA5"><enum>(2)</enum><header>Prohibition on collection of genetic information prior to enrollment</header><text display-inline="yes-display-inline">A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic information with respect to any individual prior to such individual’s enrollment under the plan or coverage in connection with such enrollment.</text></paragraph>
<paragraph id="HBF012EB1E7434E73BA09EE9089470781"><enum>(3)</enum><header>Incidental collection</header><text display-inline="yes-display-inline">If a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of paragraph (2) if such request, requirement, or purchase is not in violation of paragraph (1).</text></paragraph></subsection>
<subsection display-inline="no-display-inline" id="H710FE782FD8340F0BCFC687BFBCC214B"><enum>(e)</enum><header>Application to All Plans</header><text>The provisions of subsections (a)(1)(F), (b)(3), (c) , and (d) and subsection (b)(1) and section 2701 with respect to genetic information, shall apply to group health plans and health insurance issuers without regard to section 2721(a).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H4558FD98120C4C3EA600B1999E4030E7"><enum>(3)</enum><header>Application to genetic information of a fetus or embryo</header><text>Such section is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H882D331A2C2F4DFF82DFEC516F4569C3" style="OLC">
<subsection id="HCC0E44A846D748BD83C39E378C03BDB8"><enum>(f)</enum><header>Genetic information of a fetus or embryo</header><text>Any reference in this part to genetic information concerning an individual or family member of an individual shall—</text>
<paragraph id="HD1ABC6250F2B4941A19BEBC2958CF466"><enum>(1)</enum><text>with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and</text></paragraph>
<paragraph id="H97D082D6D62340A08BB8478FE8AE5B7F"><enum>(2)</enum><text>with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H50F341D0ED264596A1B4AE2422FA8E8B"><enum>(4)</enum><header>Definitions</header><text>Section 2791(d) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-91">42 U.S.C. 300gg–91(d)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="HF345AB5813324A99B9684DA3D27B1C84" style="OLC">
<paragraph id="H8F34AF8318984635B3002EF04357FCAB"><enum>(15)</enum><header>Family member</header><text display-inline="yes-display-inline">The term <quote>family member</quote> means, with respect to any individual—</text>
<subparagraph id="H045B83694A0F40799E83DFA9CEF0092"><enum>(A)</enum><text>a dependent (as such term is used for purposes of section 2701(f)(2)) of such individual; and</text></subparagraph>
<subparagraph id="HA0DBB05D73F94B96BB0006C79FD2C35"><enum>(B)</enum><text>any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of such individual or of an individual described in subparagraph (A).</text></subparagraph></paragraph>
<paragraph display-inline="no-display-inline" id="H25ABFD35766442B09984116BA900D572"><enum>(16)</enum><header>Genetic information</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H8F2050530497456BA026F4E5B16EE9C"><enum>(A)</enum><header>In general</header><text>The term <term>genetic information</term> means, with respect to any individual, information about—</text>
<clause commented="no" display-inline="no-display-inline" id="H9DB351F1F28841F59300B14E00E1436C"><enum>(i)</enum><text>such individual’s genetic tests,</text></clause>
<clause commented="no" id="HA4F9B316D0484A84A49727D2A5B38E"><enum>(ii)</enum><text>the genetic tests of family members of such individual, and</text></clause>
<clause commented="no" id="HFBEAAE00C727423C00F7CA690011BE52"><enum>(iii)</enum><text>the manifestation of a disease or disorder in family members of such individual.</text></clause></subparagraph>
<subparagraph id="HA3E5F83D3D4F4B8ABE5378D386905DBC"><enum>(B)</enum><header>Inclusion of genetic services and participation in genetic research</header><text display-inline="yes-display-inline">Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual.</text></subparagraph>
<subparagraph commented="no" id="H883614887C2D4F5BAB4B80EFBC7869F"><enum>(C)</enum><header>Exclusions</header><text>The term <term>genetic information</term> shall not include information about the sex or age of any individual.</text></subparagraph></paragraph>
<paragraph id="H62BD1A8E2D514199B3E7FA3F1605497E"><enum>(17)</enum><header>Genetic test</header>
<subparagraph id="H525B20B99E7A4A3E85BEDD2271484404"><enum>(A)</enum><header>In general</header><text>The term <term>genetic test</term> means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detects genotypes, mutations, or chromosomal changes.</text></subparagraph>
<subparagraph id="HB3C22765056744DD87981D7029C94D82"><enum>(B)</enum><header>Exceptions</header><text>The term <term>genetic test</term> does not mean—</text>
<clause id="H8EF9E764F23442C28587327EC1042C97"><enum>(i)</enum><text>an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes; or</text></clause>
<clause id="H04537C2B10C745CC8194113B2FB85F00"><enum>(ii)</enum><text>an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.</text></clause></subparagraph></paragraph>
<paragraph id="H7A6F99D45A6940DF8F41F5BA8B540FB"><enum>(18)</enum><header>Genetic services</header><text>The term <term>genetic services</term> means—</text>
<subparagraph id="HBAAD55B322FE49C1935191E2F0E44C73"><enum>(A)</enum><text>a genetic test;</text></subparagraph>
<subparagraph id="H983725AFBAE44D20BB8D374354938C00"><enum>(B)</enum><text>genetic counseling (including obtaining, interpreting, or assessing genetic information); or</text></subparagraph>
<subparagraph id="HD50EC075D1644CCE8837764768087047"><enum>(C)</enum><text>genetic education.</text></subparagraph></paragraph>
<paragraph id="H0803CDEDAC394D528889E2CEA5EC41C"><enum>(19)</enum><header>Underwriting purposes</header><text display-inline="yes-display-inline">The term <quote>underwriting purposes</quote> means, with respect to any group health plan, or health insurance coverage offered in connection with a group health plan—</text>
<subparagraph id="HDFEB3107EAE6468085DB8BC8FF4F25E"><enum>(A)</enum><text>rules for, or determination of, eligibility (including enrollment and continued eligibility) for benefits under the plan or coverage;</text></subparagraph>
<subparagraph id="HBDE6308F86D84B2E8B48586EC1455BF"><enum>(B)</enum><text display-inline="yes-display-inline">the computation of premium or contribution amounts under the plan or coverage;</text></subparagraph>
<subparagraph id="HDC5BEC155B744E3885F8414707D7EEEB"><enum>(C)</enum><text display-inline="yes-display-inline">the application of any pre-existing condition exclusion under the plan or coverage; and</text></subparagraph>
<subparagraph id="HFBD8C548E3814F068C8570A4BF15F9B7"><enum>(D)</enum><text>other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H9056FD16419B46C0884CA235FD87B863"><enum>(5)</enum><header>Remedies and enforcement</header><text>Section 2722(b) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-22">42 U.S.C. 300gg–22(b)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H27C0F60BC3A7421A8B5F8E90F6C49400" style="OLC">
<paragraph id="H7F8AC6F340364993816CAFB42ECC032"><enum>(3)</enum><header>Enforcement authority relating to genetic discrimination</header>
<subparagraph id="H78F7FF8571FF45D8A9BC41D946747932"><enum>(A)</enum><header>General rule</header><text display-inline="yes-display-inline">In the cases described in paragraph (1), notwithstanding the provisions of paragraph (2)(C), the succeeding subparagraphs of this paragraph shall apply with respect to an action under this subsection by the Secretary with respect to any failure of a health insurance issuer in connection with a group health plan, to meet the requirements of subsection (a)(1)(F), (b)(3), (c), or (d) of section 2702 or section 2701 or 2702(b)(1) with respect to genetic information in connection with the plan.</text></subparagraph>
<subparagraph id="HFF6B7A4BBC2F487386E16B4C99346EDA"><enum>(B)</enum><header>Amount</header>
<clause id="H49718CC43D21431784576F25352D2374"><enum>(i)</enum><header>In general</header><text>The amount of the penalty imposed under this paragraph shall be $100 for each day in the noncompliance period with respect to each participant or beneficiary to whom such failure relates.</text></clause>
<clause id="HC5BCA8917C5A4CBF9402009E20E8F1E0"><enum>(ii)</enum><header>Noncompliance period</header><text>For purposes of this paragraph, the term <term>noncompliance period</term> means, with respect to any failure, the period—</text>
<subclause id="H061F7475147E4E1AA15659E55503C8B4"><enum>(I)</enum><text>beginning on the date such failure first occurs; and</text></subclause>
<subclause id="H88823C8C4C3D46CDBAA2254F8432D554"><enum>(II)</enum><text>ending on the date the failure is corrected.</text></subclause></clause></subparagraph>
<subparagraph id="H1C4EDBC059F44BD1B6863F2576D95992"><enum>(C)</enum><header>Minimum penalties where failure discovered</header><text>Notwithstanding clauses (i) and (ii) of subparagraph (D):</text>
<clause id="H343321D703D94C139DCBDC82EE3E00D9"><enum>(i)</enum><header>In general</header><text>In the case of 1 or more failures with respect to an individual—</text>
<subclause id="H08B0DAE68E1C4C3A9DED7EE23439723C"><enum>(I)</enum><text>which are not corrected before the date on which the plan receives a notice from the Secretary of such violation; and</text></subclause>
<subclause id="HD3B4C1B563564C309C5442BDFE39700"><enum>(II)</enum><text>which occurred or continued during the period involved;</text></subclause><continuation-text continuation-text-level="clause">the amount of penalty imposed by subparagraph (A) by reason of such failures with respect to such individual shall not be less than $2,500.</continuation-text></clause>
<clause id="H92A92B0F51C74DD295BD848EBFE621D4"><enum>(ii)</enum><header>Higher minimum penalty where violations are more than de minimis</header><text>To the extent violations for which any person is liable under this paragraph for any year are more than de minimis, clause (i) shall be applied by substituting <quote>$15,000</quote> for <quote>$2,500</quote> with respect to such person.</text></clause></subparagraph>
<subparagraph id="H2899A1A57E65440DA603B3BE3CC1842E"><enum>(D)</enum><header>Limitations</header>
<clause id="H43198A1EDD5B4E9BBA35A0B1921E3D38"><enum>(i)</enum><header>Penalty not to apply where failure not discovered exercising reasonable diligence</header><text>No penalty shall be imposed by subparagraph (A) on any failure during any period for which it is established to the satisfaction of the Secretary that the person otherwise liable for such penalty did not know, and exercising reasonable diligence would not have known, that such failure existed.</text></clause>
<clause id="H8ECAF3A836E3462ABC3796BEAA9EFB1B"><enum>(ii)</enum><header>Penalty not to apply to failures corrected within certain periods</header><text>No penalty shall be imposed by subparagraph (A) on any failure if—</text>
<subclause id="H6567B6DD8771467AB3D4B8BBDB12B7FB"><enum>(I)</enum><text>such failure was due to reasonable cause and not to willful neglect; and</text></subclause>
<subclause id="HC61605E1EF55421600FAAF7511B839F5"><enum>(II)</enum><text>such failure is corrected during the 30-day period beginning on the first date the person otherwise liable for such penalty knew, or exercising reasonable diligence would have known, that such failure existed.</text></subclause></clause>
<clause id="H4052170C4BD7427993E7242DEE7775B4"><enum>(iii)</enum><header>Overall limitation for unintentional failures</header><text>In the case of failures which are due to reasonable cause and not to willful neglect, the penalty imposed by subparagraph (A) for failures shall not exceed the amount equal to the lesser of—</text>
<subclause id="HB813E0D7380149AF87D43827F38092F1"><enum>(I)</enum><text>10 percent of the aggregate amount paid or incurred by the employer (or predecessor employer) during the preceding taxable year for group health plans; or</text></subclause>
<subclause id="H404252FA347D441B9E104D7FF488FB36"><enum>(II)</enum><text>$500,000.</text></subclause></clause></subparagraph>
<subparagraph id="H4560606067A444E18025CAFB252A95F"><enum>(E)</enum><header>Waiver by secretary</header><text>In the case of a failure which is due to reasonable cause and not to willful neglect, the Secretary may waive part or all of the penalty imposed by subparagraph (A) to the extent that the payment of such penalty would be excessive relative to the failure involved.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HCA88EE3C6A5741F3AFBE3894F2D734E"><enum>(b)</enum><header>Amendment Relating to the Individual Market</header>
<paragraph id="HAE01E88196B84F67901300B0002D361B"><enum>(1)</enum><header>In general</header><text>The first subpart 3 of part B of title XXVII of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-51">42 U.S.C. 300gg–51 et seq.</external-xref>) (relating to other requirements) is amended—</text>
<subparagraph id="H31EC3CB388784186B8DCA891324D5854"><enum>(A)</enum><text>by redesignating such subpart as subpart 2; and</text></subparagraph>
<subparagraph id="H78DA0F94913142119CDC013CD1FBA369"><enum>(B)</enum><text>by adding at the end the following:</text>
<quoted-block id="HE8423B1D099D43E0BEF302DBF7F32C99" style="OLC">
<section id="H111F0984D96F499E9C00DDA0FD61EB1"><enum>2753.</enum><header>Prohibition of health discrimination on the basis of genetic information</header>
<subsection id="H20B284B0C7B845F08097A078C6001CF1"><enum>(a)</enum><header>Prohibition on Genetic Information as a Condition of Eligibility</header>
<paragraph id="HD8E5AC9BE0724682ABF3B354E7D1195"><enum>(1)</enum><header>In general</header><text>A health insurance issuer offering health insurance coverage in the individual market may not establish rules for the eligibility (including continued eligibility) of any individual to enroll in individual health insurance coverage based on genetic information.</text></paragraph>
<paragraph commented="no" id="H54B7FF9E6D734EF7B41F91B2C900F699"><enum>(2)</enum><header>Rule of construction</header><text>Nothing in paragraph (1) or in paragraphs (1) and (2) of subsection (e) shall be construed to preclude a health insurance issuer from establishing rules for eligibility for an individual to enroll in individual health insurance coverage based on the manifestation of a disease or disorder in that individual, or in a family member of such individual where such family member is covered under the policy that covers such individual.</text></paragraph></subsection>
<subsection id="HE41D69484EFB4B7595BC9BA5D910064"><enum>(b)</enum><header>Prohibition on Genetic Information in Setting Premium Rates</header>
<paragraph id="H4CF696E6D9DB43E69B4BD5CEA8A703B8"><enum>(1)</enum><header>In general</header><text>A health insurance issuer offering health insurance coverage in the individual market shall not adjust premium or contribution amounts for an individual on the basis of genetic information concerning the individual or a family member of the individual.</text></paragraph>
<paragraph commented="no" id="HD3DF7B89B12049BA8188DC007344E0DA"><enum>(2)</enum><header>Rule of construction</header><text>Nothing in paragraph (1) or in paragraphs (1) and (2) of subsection (e) shall be construed to preclude a health insurance issuer from adjusting premium or contribution amounts for an individual on the basis of a manifestation of a disease or disorder in that individual, or in a family member of such individual where such family member is covered under the policy that covers such individual. In such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other individuals covered under the policy issued to such individual and to further increase premiums or contribution amounts.</text></paragraph></subsection>
<subsection display-inline="no-display-inline" id="H5439584282D44F35BBA71EC77B127273"><enum>(c)</enum><header>Prohibition on genetic information as preexisting condition</header>
<paragraph display-inline="no-display-inline" id="H06E7E2C5225B481F863E00C28000BA81"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">A health insurance issuer offering health insurance coverage in the individual market may not, on the basis of genetic information, impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A)) with respect to such coverage.</text></paragraph>
<paragraph commented="no" id="HCD380CDED9264CD6B7354B2CAB1800BB"><enum>(2)</enum><header>Rule of construction</header><text>Nothing in paragraph (1) or in paragraphs (1) and (2) of subsection (e) shall be construed to preclude a health insurance issuer from imposing any preexisting condition exclusion for an individual with respect to health insurance coverage on the basis of a manifestation of a disease or disorder in that individual.</text></paragraph></subsection>
<subsection id="H20DC60D4699142E5A489AD697EF2D52F"><enum>(d)</enum><header>Genetic Testing</header>
<paragraph id="HA4ED94B12CA24BD787E458E5F4464416"><enum>(1)</enum><header>Limitation on requesting or requiring genetic testing</header><text>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.</text></paragraph>
<paragraph display-inline="no-display-inline" id="HD5A063FFD65B4BACB4FD89AD18F2CB90"><enum>(2)</enum><header>Rule of construction</header><text>Paragraph (1) shall not be construed to limit the authority of a health care professional who is providing health care services to an individual to request that such individual undergo a genetic test.</text></paragraph>
<paragraph display-inline="no-display-inline" id="H67BABB16BAB24210BC70F8F7261395F6"><enum>(3)</enum><header>Rule of construction regarding payment</header>
<subparagraph id="H555CE864856C45618C118400FCDC72FC"><enum>(A)</enum><header>In general</header><text>Nothing in paragraph (1) shall be construed to preclude a health insurance issuer offering health insurance coverage in the individual market from obtaining and using the results of a genetic test in making a determination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary under part C of title XI of the <act-name parsable-cite="SSA">Social Security Act</act-name> and section 264 of the <act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability Act of 1996</act-name>, as may be revised from time to time) consistent with subsection (a) and (c).</text></subparagraph>
<subparagraph id="H604A9F3529984BB7BA0006C2F6DF711F"><enum>(B)</enum><header>Limitation</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), a health insurance issuer offering health insurance coverage in the individual market may request only the minimum amount of information necessary to accomplish the intended purpose.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H7F99FE6EF7DF4569926E686F599FF935"><enum>(4)</enum><header>Research exception</header><text>Notwithstanding paragraph (1), a health insurance issuer offering health insurance coverage in the individual market may request, but not require, that an individual or a family member of such individual undergo a genetic test if each of the following conditions is met:</text>
<subparagraph commented="no" id="HB6D524114459495AA2E569B790F349E"><enum>(A)</enum><text>The request is made pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.</text></subparagraph>
<subparagraph commented="no" id="H703DDE7CBFD6412EA4F7B92F1737581C"><enum>(B)</enum><text>The issuer clearly indicates to each individual, or in the case of a minor child, to the legal guardian of such child, to whom the request is made that—</text>
<clause commented="no" id="HB5D93CBB827543CC9C0836AD3C74B904"><enum>(i)</enum><text>compliance with the request is voluntary; and</text></clause>
<clause commented="no" id="H4B16A6F1659342FEB578C9235DC7DAAF"><enum>(ii)</enum><text>non-compliance will have no effect on enrollment status or premium or contribution amounts.</text></clause></subparagraph>
<subparagraph commented="no" id="H3C8D119DD1AD43C49699BC08A4583DAA"><enum>(C)</enum><text>No genetic information collected or acquired under this paragraph shall be used for underwriting purposes. <inline-comment display="no">Q: Aren’t these activities already generally prohibited under HIPAA after the application of the other amendments made by this Act?</inline-comment></text></subparagraph>
<subparagraph commented="no" id="HAEF1A07CD10C4E9800184653629014B7"><enum>(D)</enum><text>The issuer notifies the Secretary in writing that the issuer is conducting activities pursuant to the exception provided for under this paragraph, including a description of the activities conducted.</text></subparagraph>
<subparagraph commented="no" id="HF11E2FF616A049C8B3EA5CC7B1087851"><enum>(E)</enum><text>The issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.</text></subparagraph></paragraph></subsection>
<subsection id="H59244B554F3B448997A2F8EA1C1D007C"><enum>(e)</enum><header>Prohibition on collection of genetic information</header>
<paragraph id="HA2898A0CDD01401290D5977FC012BB56"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">A health insurance issuer offering health insurance coverage in the individual market shall not request, require, or purchase genetic information for underwriting purposes (as defined in section 2791).</text></paragraph>
<paragraph id="H2CEB51D5252E46468B32DF4B2E4C4000"><enum>(2)</enum><header>Prohibition on collection of genetic information prior to enrollment</header><text display-inline="yes-display-inline">A health insurance issuer offering health insurance coverage in the individual market shall not request, require, or purchase genetic information with respect to any individual prior to such individual’s enrollment under the plan in connection with such enrollment.</text></paragraph>
<paragraph id="H0852AF89B6204AFFB1166655207E41D4"><enum>(3)</enum><header>Incidental collection</header><text display-inline="yes-display-inline">If a health insurance issuer offering health insurance coverage in the individual market obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of paragraph (2) if such request, requirement, or purchase is not in violation of paragraph (1).</text></paragraph></subsection>
<subsection display-inline="no-display-inline" id="H813309CEB18E4A42B0D023DCE8685119"><enum>(f)</enum><header>Genetic information of a fetus or embryo</header><text>Any reference in this part to genetic information concerning an individual or family member of an individual shall—</text>
<paragraph id="H06D7A5E09952459AA652F83114AAE77"><enum>(1)</enum><text>with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and</text></paragraph>
<paragraph id="H33F66B036BCA448C95715024FDA90074"><enum>(2)</enum><text>with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HF4EF06D049F44447B1DF1193E6D4B0C"><enum>(2)</enum><header>Remedies and enforcement</header><text>Section 2761(b) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-61">42 U.S.C. 300gg–61(b)</external-xref>) is amended to read as follows:</text>
<quoted-block act-name="Public Health Service Act" id="H273BF837A906462D83ECDCC4EF006701" style="OLC">
<subsection id="H38120A99B9E643089E011E92D7FC5394"><enum>(b)</enum><header>Secretarial Enforcement Authority</header><text>The Secretary shall have the same authority in relation to enforcement of the provisions of this part with respect to issuers of health insurance coverage in the individual market in a State as the Secretary has under section 2722(b)(2), and section 2722(b)(3) with respect to violations of genetic nondiscrimination provisions, in relation to the enforcement of the provisions of part A with respect to issuers of health insurance coverage in the small group market in the State.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HAF98C4F6512140D7B29140ECD6D2DAF6"><enum>(c)</enum><header>Elimination of Option of Non-Federal Governmental Plans To Be Excepted From Requirements Concerning Genetic Information</header><text>Section 2721(b)(2) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-21">42 U.S.C. 300gg–21(b)(2)</external-xref>) is amended—</text>
<paragraph id="H5CF4228217B74C4E9624C536B0C0074"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>If the plan sponsor</quote> and inserting <quote>Except as provided in subparagraph (D), if the plan sponsor</quote>; and</text></paragraph>
<paragraph id="HF733DED93F114434B63201140046393C"><enum>(2)</enum><text>by adding at the end the following:</text>
<quoted-block id="H0646DC7100BB49AC811BCF48C3752438" style="OLC">
<subparagraph id="H5C68F9024BCD4AF599CBF060B8F58114"><enum>(D)</enum><header>Election not applicable to requirements concerning genetic information</header><text>The election described in subparagraph (A) shall not be available with respect to the provisions of subsections (a)(1)(F), (b)(3), (c), and (d) of section 2702 and the provisions of sections 2701 and 2702(b) to the extent that such provisions apply to genetic information.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H100DB7D206914DAB98AF403243A7A57E"><enum>(d)</enum><header>Regulations and Effective Date</header>
<paragraph id="H3F2B6762CAD0490E998BD9991BEADD1B"><enum>(1)</enum><header>Regulations</header><text>Not later than 12 months after the date of enactment of this Act, the Secretary of Health and Human Services shall issue final regulations to carry out the amendments made by this section.</text></paragraph>
<paragraph id="HE07C0F28C44D4AC38447DEA3BBDD8555"><enum>(2)</enum><header>Effective date</header><text>The amendments made by this section shall apply—</text>
<subparagraph id="H6C1DBE03D18D466BB32E4306A9F3BFC"><enum>(A)</enum><text>with respect to group health plans, and health insurance coverage offered in connection with group health plans, for plan years beginning after the date that is 1 year after the date of enactment of this Act; and</text></subparagraph>
<subparagraph id="HC0351BE1973847F19FC0638F9BA86458"><enum>(B)</enum><text>with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market after the date that is 1 year after the date of enactment of this Act.</text></subparagraph></paragraph></subsection></section>
<section commented="no" display-inline="no-display-inline" id="H697DC4A1A89F4ECDB9F033244FE398DB" section-type="subsequent-section"><enum>103.</enum><header>Amendments to <act-name parsable-cite="ERISA">the Internal Revenue Code of 1986</act-name></header>
<subsection commented="no" id="H9479536B218441708EED0994A470DA3B"><enum>(a)</enum><header>No discrimination in group premiums based on genetic information</header><text>Subsection (b) of <external-xref legal-doc="usc" parsable-cite="usc/26/9802">section 9802</external-xref> of the Internal Revenue Code of 1986 is amended—</text>
<paragraph commented="no" id="HB60C971E90664390B49568DD2855C012"><enum>(1)</enum><text>in paragraph (2)(A), by inserting before the semicolon the following: <quote>except as provided in paragraph (3)</quote>; and</text></paragraph>
<paragraph commented="no" id="HEA5936B8017C4B9E86AF37468861EE99"><enum>(2)</enum><text>by adding at the end the following:</text>
<quoted-block id="HABB8E472B7614A4C00C63BB72D731BF3" style="OLC">
<paragraph commented="no" id="H75AD281A038E44D68559DE047B8C9D76"><enum>(3)</enum><header>No group-based discrimination on basis of genetic information</header>
<subparagraph commented="no" id="H6992DB6258CB4987A2E21F2CF282C223"><enum>(A)</enum><header>In general</header><text>For purposes of this section, a group health plan may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H68D8B9E347D848319B00F38535ED81"><enum>(B)</enum><header display-inline="yes-display-inline">Rule of construction</header><text display-inline="yes-display-inline">Nothing in subparagraph (A) or in paragraphs (1) and (2) of subsection (d) shall be construed to limit the ability of a group health plan to increase the premium for an employer based on the manifestation of a disease or disorder of an individual who is enrolled in the plan. In such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members and to further increase the premium for the employer.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection commented="no" id="H59EF8FFBD3B3414681E5FF272C98C8E"><enum>(b)</enum><header>Limitations on genetic testing; prohibition on collection of genetic information; application to all plans</header><text>Section 9802 of such Code is amended by redesignating subsection (c) as subsection (f) and by inserting after subsection (b) the following new subsections:</text>
<quoted-block act-name="Employee" id="H2E6BC1F4FAF54DCD8B2563BFA21C69D8" style="OLC">
<subsection commented="no" id="H0B1D1768B3F840FAA7E269E474F879CB"><enum>(c)</enum><header>Genetic testing</header>
<paragraph commented="no" id="H834BB9F065D64342A6404E911DEF65F8"><enum>(1)</enum><header>Limitation on requesting or requiring genetic testing</header><text>A group health plan may not request or require an individual or a family member of such individual to undergo a genetic test.</text></paragraph>
<paragraph display-inline="no-display-inline" id="H233A0CE0895549968EDD175601D0B2E1"><enum>(2)</enum><header>Rule of construction</header><text>Paragraph (1) shall not be construed to limit the authority of a health care professional who is providing health care services to an individual to request that such individual undergo a genetic test.</text></paragraph>
<paragraph display-inline="no-display-inline" id="H8D75BACDF48D47889698CF67B6FFB6C"><enum>(3)</enum><header>Rule of construction regarding payment</header>
<subparagraph id="H4857E5EE035B4F42BA3CB67917A2A806"><enum>(A)</enum><header>In general</header><text>Nothing in paragraph (1) shall be construed to preclude a group health plan from obtaining and using the results of a genetic test in making a determination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary of Health and Human Services under part C of title XI of the <act-name parsable-cite="SSA">Social Security Act</act-name> and section 264 of the <act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability Act of 1996</act-name>, as may be revised from time to time) consistent with subsection (a).</text></subparagraph>
<subparagraph id="H738B774B1F3C4A85A03034B6FE31F0E4"><enum>(B)</enum><header>Limitation</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), a group health plan may request only the minimum amount of information necessary to accomplish the intended purpose.</text></subparagraph></paragraph>
<paragraph commented="no" id="HF5469088A6E14E98AB1C181C82BF8F00"><enum>(4)</enum><header>Research exception</header><text>Notwithstanding paragraph (1), a group health plan may request, but not require, that a participant or beneficiary undergo a genetic test if each of the following conditions is met:</text>
<subparagraph commented="no" id="HAF37F1D787A24770BF48009B2FF4E364"><enum>(A)</enum><text>The request is made pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.</text></subparagraph>
<subparagraph commented="no" id="HD5FAA2F5B7E14C55A7BBA6DEB1ED2148"><enum>(B)</enum><text>The plan clearly indicates to each participant or beneficiary, or in the case of a minor child, to the legal guardian of such beneficiary, to whom the request is made that—</text>
<clause commented="no" id="HD25CD6014B734BCEB25F40C91DC383CE"><enum>(i)</enum><text>compliance with the request is voluntary; and</text></clause>
<clause commented="no" id="HAFEFF926B71A4872A04551EDC38643EE"><enum>(ii)</enum><text>non-compliance will have no effect on enrollment status or premium or contribution amounts.</text></clause></subparagraph>
<subparagraph commented="no" id="H72364E4E8A784FDBBDC6AF008CE57282"><enum>(C)</enum><text>No genetic information collected or acquired under this paragraph shall be used for underwriting purposes. <inline-comment display="no">Q: Aren’t these activities already generally prohibited under HIPAA after the application of the other amendments made by this Act?</inline-comment></text></subparagraph>
<subparagraph commented="no" id="HB9E838983E6E4481B4BFF765825F7FBB"><enum>(D)</enum><text>The plan notifies the Secretary in writing that the plan is conducting activities pursuant to the exception provided for under this paragraph, including a description of the activities conducted.</text></subparagraph>
<subparagraph commented="no" id="HEA0F2E5C1A9B4A81A6DBFA253324D96"><enum>(E)</enum><text>The plan complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.</text></subparagraph></paragraph></subsection>
<subsection id="HB88AD4E75CAC476F9565215F581BBD9B"><enum>(d)</enum><header>Prohibition on collection of genetic information</header>
<paragraph id="H719FACDD20B14808BC81895466DD352D"><enum>(1)</enum><header>In general</header><text>A group health plan shall not request, require, or purchase genetic information for underwriting purposes (as defined in section 9832).</text></paragraph>
<paragraph id="HA1FD037CF7FF4DF69EB389E23831C3A"><enum>(2)</enum><header>Prohibition on collection of genetic information prior to enrollment</header><text>A group health plan shall not request, require, or purchase genetic information with respect to any individual prior to such individual’s enrollment under the plan or in connection with such enrollment.</text></paragraph>
<paragraph id="HA5B135E487394A3AB0A984DEEB075E6"><enum>(3)</enum><header>Incidental collection</header><text display-inline="yes-display-inline">If a group health plan obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of paragraph (2) if such request, requirement, or purchase is not in violation of paragraph (1).</text></paragraph></subsection>
<subsection commented="no" id="H0BAF06F837F74C738950695874E92513"><enum>(e)</enum><header>Application to all plans</header><text display-inline="yes-display-inline">The provisions of subsections (a)(1)(F), (b)(3), (c), and (d) and subsection (b)(1) and section 9801 with respect to genetic information, shall apply to group health plans without regard to section 9831(a)(2).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HD4339714F25E4C1FB92C9208800068C3"><enum>(c)</enum><header>Application to genetic information of a fetus or embryo</header><text>Such section is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HC491C32A94B249588CBA7B96D15C9E10" style="OLC">
<subsection id="H07574D7217764886ADE9C39949DC88B5"><enum>(f)</enum><header>Genetic information of a fetus or embryo</header><text>Any reference in this chapter to genetic information concerning an individual or family member of an individual shall—</text>
<paragraph id="H227E8C5EE3C241FE8EA18B1F50D7EBE2"><enum>(1)</enum><text>with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and</text></paragraph>
<paragraph id="H8B99C5B567BA4330A54E5BBEF594DE1F"><enum>(2)</enum><text>with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" id="HD8186FA16AE64BD58F731635D0008B5E"><enum>(d)</enum><header>Definitions</header><text>Subsection (d) of section 9832 of such Code is amended by adding at the end the following:</text>
<quoted-block act-name="Employee" id="H2689BD5CEFCA44FDBA00F3158302E500" style="OLC">
<paragraph commented="no" id="H01FE635BA19F4F12ABA019D78C84E8EE"><enum>(6)</enum><header>Family member</header><text>The term <term>family member</term> means, with respect to any individual—</text>
<subparagraph commented="no" id="H897AE97C3227406CB35DEB512E16F09D"><enum>(A)</enum><text>a dependent (as such term is used for purposes of section 9801(f)(2)) of such individual, and</text></subparagraph>
<subparagraph commented="no" id="H67860020DA234119AC1702E149B5CFF"><enum>(B)</enum><text>any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of such individual or of an individual described in subparagraph (A).</text></subparagraph></paragraph>
<paragraph commented="no" id="HBDB9A501EE0844888F0025845B020050"><enum>(7)</enum><header>Genetic information</header>
<subparagraph commented="no" id="H24D19A816E54479DB377A49C6035FAE1"><enum>(A)</enum><header>In general</header><text>The term <term>genetic information</term> means, with respect to any individual, information about—</text>
<clause commented="no" display-inline="no-display-inline" id="H76CC488F7B87480D8B0977A6C7A238EC"><enum>(i)</enum><text>such individual’s genetic tests,</text></clause>
<clause commented="no" id="H92CD778426F345299DB1CD59D67F7500"><enum>(ii)</enum><text>the genetic tests of family members of such individual, and</text></clause>
<clause commented="no" id="HCABBDF033B534A32BEEDFA60FCC6308B"><enum>(iii)</enum><text>the manifestation of a disease or disorder in family members of such individual.</text></clause></subparagraph>
<subparagraph id="H7B67457832D04F5DA1E159F0046CA5C"><enum>(B)</enum><header>Inclusion of genetic services and participation in genetic research</header><text display-inline="yes-display-inline">Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual.</text></subparagraph>
<subparagraph commented="no" id="HC6A945B1023A4A5F9B2FA0AA027C949"><enum>(C)</enum><header>Exclusions</header><text>The term <term>genetic information</term> shall not include information about the sex or age of any individual.</text></subparagraph></paragraph>
<paragraph commented="no" id="H7F9319B7661E4D57ABB6B0F9DF19A7B7"><enum>(8)</enum><header>Genetic test</header>
<subparagraph commented="no" id="H412F3E5DB13F4E288C4D75FA90C6F0AE"><enum>(A)</enum><header>In general</header><text>The term <term>genetic test</term> means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detects genotypes, mutations, or chromosomal changes.</text></subparagraph>
<subparagraph commented="no" id="HAEA1C54C931B4C2A8421FDF62E2204B5"><enum>(B)</enum><header>Exceptions</header><text>The term <term>genetic test</term> does not mean—</text>
<clause commented="no" id="H9BB0EB4D51154F3F8D003B74AD452074"><enum>(i)</enum><text>an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes, or</text></clause>
<clause commented="no" id="H40E4B07A86A0454695F53887215CBCC5"><enum>(ii)</enum><text>an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.</text></clause></subparagraph></paragraph>
<paragraph display-inline="no-display-inline" id="HFE88DE6908F548CAA5AFA579C96B8E8"><enum>(9)</enum><header>Genetic services</header><text>The term <term>genetic services</term> means—</text>
<subparagraph id="HE1004DB540DC482E9607CEF12060E750"><enum>(A)</enum><text>a genetic test;</text></subparagraph>
<subparagraph id="HCD28C2AF289A42B8A511DD8FF9F7B898"><enum>(B)</enum><text>genetic counseling (including obtaining, interpreting, or assessing genetic information); or</text></subparagraph>
<subparagraph id="HCB4780EEE79C4238846C29E36F608B2"><enum>(C)</enum><text>genetic education.</text></subparagraph></paragraph>
<paragraph id="H120D4F63309C4C40A0CC1FF9EDE5CB64"><enum>(10)</enum><header>Underwriting purposes</header><text display-inline="yes-display-inline">The term <quote>underwriting purposes</quote> means, with respect to any group health plan, or health insurance coverage offered in connection with a group health plan—</text>
<subparagraph id="HB878DCE12E7F476200FFD3812B0600E5"><enum>(A)</enum><text>rules for, or determination of, eligibility (including enrollment and continued eligibility) for benefits under the plan or coverage;</text></subparagraph>
<subparagraph id="HA2FA9C503AA240CC8D341461D5E3B971"><enum>(B)</enum><text display-inline="yes-display-inline">the computation of premium or contribution amounts under the plan or coverage;</text></subparagraph>
<subparagraph id="H763C96CE73874278B5BB4B00ADB744EF"><enum>(C)</enum><text display-inline="yes-display-inline">the application of any pre-existing condition exclusion under the plan or coverage; and</text></subparagraph>
<subparagraph id="H0EA07B028C9A4F66AEC7ECBBD77BFB15"><enum>(D)</enum><text>other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" id="HE5E8A65A089F4DA88413ED057BA7FDAD"><enum>(e)</enum><header>Enforcement</header>
<paragraph commented="no" id="H36843A78CC7D443DB423371D6C5129F0"><enum>(1)</enum><header>In general</header><text>Subchapter C of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/26/100">chapter 100</external-xref> of the Internal Revenue Code of 1986 (relating to general provisions) is amended by adding at the end the following new section:</text>
<quoted-block display-inline="no-display-inline" id="H3A19B46E2A624A679B35FEB84508CADC" style="OLC">
<section commented="no" id="HADBEC8BBE36A4F1995B131A4327D9E42"><enum>9834.</enum><header>Enforcement</header><text display-inline="no-display-inline">For the imposition of tax on any failure of a group health plan to meet the requirements of this chapter, see section 4980D.</text></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph commented="no" id="H92A5B84FB9F04EA688ED64354D27C2C5"><enum>(2)</enum><header>Conforming amendment</header><text>The table of sections for subchapter C of chapter 100 of such Code is amended by adding at the end the following new item:</text>
<quoted-block display-inline="no-display-inline" id="HDCD32EA9F4C341E9B95E004DBD2D4773" style="OLC">
<toc container-level="quoted-block-container" idref="H3A19B46E2A624A679B35FEB84508CADC" lowest-bolded-level="division-lowest-bolded" lowest-level="section" quoted-block="no-quoted-block" regeneration="yes-regeneration">
<toc-entry idref="HADBEC8BBE36A4F1995B131A4327D9E42" level="section">Sec. 9834. Enforcement.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection commented="no" id="HF5D7005470774DA3BACA4F5004C31439"><enum>(f)</enum><header>Regulations and effective date</header>
<paragraph commented="no" id="H9D875466E5B64F2E86FBE0511D851ECA"><enum>(1)</enum><header>Regulations</header><text>The Secretary of the Treasury shall issue final regulations or other guidance not later than 12 months after the date of the enactment of this Act to carry out the amendments made by this section.</text></paragraph>
<paragraph commented="no" id="H0B20564D23E24DD6938D40F85B2FA460"><enum>(2)</enum><header>Effective date</header><text>The amendments made by this section shall apply with respect to group health plans for plan years beginning after the date that is 1 year after the date of the enactment of this Act.</text></paragraph></subsection></section>
<section id="H764DD2CAE55D46AEAD56E400D84EAD65"><enum>104.</enum><header>Amendments to title XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name> relating to medigap</header>
<subsection id="HFD23A237355E451483710815DC7E5C1C"><enum>(a)</enum><header>Nondiscrimination</header><text>Section 1882(s)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ss">42 U.S.C. 1395ss(s)(2)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H8F7A871CE61B4BCABD36619C074E2014" style="OLC">
<subparagraph id="H5735970B39F94706A15B8E27A14E2894"><enum>(E)</enum><text>An issuer of a medicare supplemental policy shall not deny or condition the issuance or effectiveness of the policy (including the imposition of any exclusion of benefits under the policy based on a pre-existing condition) and shall not discriminate in the pricing of the policy (including the adjustment of premium rates) of an individual on the basis of the genetic information with respect to such individual.</text></subparagraph>
<subparagraph commented="no" id="HFA9BCEE7F48C46AABE4100EABB0756D"><enum>(F)</enum><header>Rule of construction</header><text>Nothing in subparagraph (E) or in subparagraphs (A) or (B) of subsection (x)(2) shall be construed to limit the ability of an issuer of a medicare supplemental policy from, to the extent otherwise permitted under this title—</text>
<clause commented="no" id="H5C034576B378458584636C813C327D49"><enum>(i)</enum><text>denying or conditioning the issuance or effectiveness of the policy or increasing the premium for an employer based on the manifestation of a disease or disorder of an individual who is covered under the policy; or</text></clause>
<clause commented="no" id="HEEE5F6DB720240BE94005613A6DFDC27"><enum>(ii)</enum><text>increasing the premium for any policy issued to an individual based on the manifestation of a disease or disorder of an individual who is covered under the policy (in such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members and to further increase the premium for the employer).</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H152B3279C7154455822E114445815DF1"><enum>(b)</enum><header>Limitations on genetic testing and genetic information</header>
<paragraph id="H8C2D12F220E3491BA6653F3FCE8ECA1"><enum>(1)</enum><header>In general</header><text>Section 1882 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ss">42 U.S.C. 1395ss</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Social Security Act" id="H86B4C2D60542415DBB936B61B217F00" style="OLC">
<subsection id="H2C8E5D080237403D9DCD389C7374F76B"><enum>(x)</enum><header>Limitations on Genetic Testing and Information</header>
<paragraph id="H0EA8131392B946DB89848CE15BF3CB94"><enum>(1)</enum><header>Genetic testing</header>
<subparagraph id="HE07F105DD0224D4F96F4BA93FFE246"><enum>(A)</enum><header>Limitation on requesting or requiring genetic testing</header><text>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.</text></subparagraph>
<subparagraph display-inline="no-display-inline" id="H1DAB1BDF7FD943DD81FED00428F499B"><enum>(B)</enum><header>Rule of construction</header><text>Subparagraph (A) shall not be construed to limit the authority of a health care professional who is providing health care services to an individual to request that such individual undergo a genetic test.</text></subparagraph>
<subparagraph display-inline="no-display-inline" id="H1F472216D50041D3B7A54F692582685C"><enum>(C)</enum><header>Rule of construction regarding payment</header>
<clause id="HC15946DE40B8447685B8D4C0093B2DD"><enum>(i)</enum><header>In general</header><text>Nothing in subparagraph (A) shall be construed to preclude an issuer of a medicare supplemental policy from obtaining and using the results of a genetic test in making a determination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary under part C of title XI and section 264 of the <act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability Act of 1996</act-name>, as may be revised from time to time) consistent with subsection (s)(2)(E).</text></clause>
<clause id="H8F76A09B1FB54A8492D3B81D17920473"><enum>(ii)</enum><header>Limitation</header><text display-inline="yes-display-inline">For purposes of clause (i), an issuer of a medicare supplemental policy may request only the minimum amount of information necessary to accomplish the intended purpose.</text></clause></subparagraph>
<subparagraph commented="no" id="H3F3CE4E4466840D1B4A2FC46179197C9"><enum>(D)</enum><header>Research exception</header><text>Notwithstanding subparagraph (A), an issuer of a medicare supplemental policy may request, but not require, that an individual or a family member of such individual undergo a genetic test if each of the following conditions is met:</text>
<clause commented="no" id="HDA08E9D4A2AD464FA7CEFA183F5FA72B"><enum>(i)</enum><text>The request is made pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.</text></clause>
<clause commented="no" id="H20AE780252FD425786E912DEE650EB81"><enum>(ii)</enum><text>The issuer clearly indicates to each individual, or in the case of a minor child, to the legal guardian of such child, to whom the request is made that—</text>
<subclause commented="no" id="H7EF0DA0F9E8C48ED9F9690FE04902376"><enum>(I)</enum><text>compliance with the request is voluntary; and</text></subclause>
<subclause commented="no" id="H44B1D474BF544EAE925BDC8034BCC00"><enum>(II)</enum><text>non-compliance will have no effect on enrollment status or premium or contribution amounts.</text></subclause></clause>
<clause commented="no" id="H4D5A2FA1A02340DC8651CAA2DC4CBD7"><enum>(iii)</enum><text>No genetic information collected or acquired under this subparagraph shall be used for underwriting, determination of eligibility to enroll or maintain enrollment status, premium rating, or the creation, renewal, or replacement of a plan, contract, or coverage for health insurance or health benefits. <inline-comment display="no">Q: Aren’t these activities already generally prohibited under HIPAA after the application of the other amendments made by this Act?</inline-comment></text></clause>
<clause commented="no" id="HC851EDD9D134453586D367C008D1102"><enum>(iv)</enum><text>The issuer notifies the Secretary in writing that the issuer is conducting activities pursuant to the exception provided for under this subparagraph, including a description of the activities conducted.</text></clause>
<clause commented="no" id="H72B13720A2CA498E83B399DE7F405992"><enum>(v)</enum><text>The issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this subparagraph.</text></clause></subparagraph></paragraph>
<paragraph id="H3262679F864F4A889C1F21654C4376C7"><enum>(2)</enum><header>Prohibition on collection of genetic information</header>
<subparagraph display-inline="no-display-inline" id="H633006221B96418EB2D5F28CFE00F865"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">An issuer of a medicare supplemental policy shall not request, require, or purchase genetic information for underwriting purposes (as defined in paragraph (3)).</text></subparagraph>
<subparagraph display-inline="no-display-inline" id="HE585400B732D4250A5EDEA1EFECE9BEE"><enum>(B)</enum><header>Prohibition on collection of genetic information prior to enrollment</header><text display-inline="yes-display-inline">An issuer of a medicare supplemental policy shall not request, require, or purchase genetic information with respect to any individual prior to such individual’s enrollment under the policy in connection with such enrollment.</text></subparagraph>
<subparagraph display-inline="no-display-inline" id="HAE55EA69112148AF9100C6BA21CD7BA9"><enum>(C)</enum><header>Incidental collection</header><text display-inline="yes-display-inline">If an issuer of a medicare supplemental policy obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of subparagraph (B) if such request, requirement, or purchase is not in violation of subparagraph (A).</text></subparagraph></paragraph>
<paragraph id="HB75EAA979118452DB4AA00BE07308233"><enum>(3)</enum><header>Definitions</header><text>In this subsection:</text>
<subparagraph id="HD80BE2572C734BF8887E740300D11623"><enum>(A)</enum><header>Family member</header><text display-inline="yes-display-inline">The term <term>family member</term> means with respect to an individual, any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of such individual.</text></subparagraph>
<subparagraph id="HB2C4632EF63C4F809296EE7ED05365AD"><enum>(B)</enum><header>Genetic information</header>
<clause commented="no" display-inline="no-display-inline" id="H46EAC9AA523043E3AF2B35A8A0EAAA9"><enum>(i)</enum><header>In general</header><text>The term <term>genetic information</term> means, with respect to any individual, information about—</text>
<subclause commented="no" display-inline="no-display-inline" id="H3F988542EAB443CF852FB5F5450784D3"><enum>(I)</enum><text>such individual’s genetic tests,</text></subclause>
<subclause commented="no" id="H781CD3AFE15D4B48801B4403ABFC32C1"><enum>(II)</enum><text>the genetic tests of family members of such individual, and</text></subclause>
<subclause commented="no" id="H642E037840664FE68767569500A16800"><enum>(III)</enum><text>subject to clause (iv), the manifestation of a disease or disorder in family members of such individual.</text></subclause></clause>
<clause id="H9FAA3ABEEDD244B5895E8F4C222F006F"><enum>(ii)</enum><header>Inclusion of genetic services and participation in genetic research</header><text display-inline="yes-display-inline">Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual.</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H8EF782169128472B8956857294392DCC"><enum>(iii)</enum><header>Exclusions</header><text>The term <term>genetic information</term> shall not include information about the sex or age of any individual.</text></clause></subparagraph>
<subparagraph id="H0D72BA3D107544C60016514173802F63"><enum>(C)</enum><header>Genetic test</header>
<clause id="H2221567E962D44CC83A703EE33824DA8"><enum>(i)</enum><header>In general</header><text>The term <term>genetic test</term> means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detects genotypes, mutations, or chromosomal changes.</text></clause>
<clause id="HB4C64B2E84B04B958F57F38DACC6536B"><enum>(ii)</enum><header>Exceptions</header><text>The term <term>genetic test</term> does not mean—</text>
<subclause id="HC0140EE1B40246B5AE43359E7923E754"><enum>(I)</enum><text>an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes; or</text></subclause>
<subclause id="HE37BC363CCA34939898E5C344FE40095"><enum>(II)</enum><text>an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.</text></subclause></clause></subparagraph>
<subparagraph id="H2A3E77204A914A60937F008387AEDED6"><enum>(D)</enum><header>Genetic services</header><text>The term <term>genetic services</term> means—</text>
<clause id="HCCEE30A97B8B40E1B607D857DACA3B32"><enum>(i)</enum><text>a genetic test;</text></clause>
<clause id="H4D38E78EF42347A0AEEDE3E2009176A1"><enum>(ii)</enum><text>genetic counseling (including obtaining, interpreting, or assessing genetic information); or</text></clause>
<clause id="HC7CE0E878D5A41F0A733AE7218A54C7"><enum>(iii)</enum><text>genetic education.</text></clause></subparagraph>
<subparagraph display-inline="no-display-inline" id="H0A059C4B308342AF815B069306E84E9E"><enum>(E)</enum><header>Underwriting purposes</header><text display-inline="yes-display-inline">The term <quote>underwriting purposes</quote> means, with respect to a medicare supplemental policy—</text>
<clause id="H4498FACFC6A3448D83DF9B439BAE9BAD"><enum>(i)</enum><text>rules for, or determination of, eligibility (including enrollment and continued eligibility) for benefits under the policy;</text></clause>
<clause id="H5AC970B6D06549C6B286860767D3BD7C"><enum>(ii)</enum><text display-inline="yes-display-inline">the computation of premium or contribution amounts under the policy;</text></clause>
<clause id="HBF4B2F220A854A6A9DAB1316BCE686E1"><enum>(iii)</enum><text display-inline="yes-display-inline">the application of any pre-existing condition exclusion under the policy; and</text></clause>
<clause id="HC815F9854A0F4392A04EEFC91E7B00C6"><enum>(iv)</enum><text>other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.</text></clause></subparagraph>
<subparagraph id="HC92428F84BAF491F84FD00756C01D4D"><enum>(F)</enum><header>Issuer of a medicare supplemental policy</header><text>The term <term>issuer of a medicare supplemental policy</term> includes a third-party administrator or other person acting for or on behalf of such issuer.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="HE7DB782328B943F38E402CBB655600F2"><enum>(2)</enum><header>Application to genetic information of a fetus or embryo</header><text>Section 1882(x) of such Act, as added by paragraph (1), is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H88801070B389402CA012E3F2AE46744F" style="OLC">
<paragraph display-inline="no-display-inline" id="HD96C7FDFE2BC47AEAA44887B6F232656"><enum>(4)</enum><header>Genetic information of a fetus or embryo</header><text>Any reference in this section to genetic information concerning an individual or family member of an individual shall—</text>
<subparagraph id="H5DDC066A92F0499B8CFD84A036F78C1C"><enum>(A)</enum><text>with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and</text></subparagraph>
<subparagraph id="H55307782CD2B4732B4981F95959775CA"><enum>(B)</enum><text>with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H66D1492E080D4D2AAB5480E6CA00D654"><enum>(3)</enum><header>Conforming amendment</header><text>Section 1882(o) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ss">42 U.S.C. 1395ss(o)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Social Security Act" id="H1D63BB3CE07A47029E60F4EC121CA5FC" style="OLC">
<paragraph id="H7B331C6F589B4A038ECFC708002764AD"><enum>(4)</enum><text>The issuer of the medicare supplemental policy complies with subsection (s)(2)(E) and subsection (x).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H7E84314F46F54A02B2B2CBAFD78515D2"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply with respect to an issuer of a medicare supplemental policy for policy years beginning on or after the date that is 1 year after the date of enactment of this Act.</text></subsection>
<subsection id="H546F7D6EEE5F450CB05D348D476980DA"><enum>(d)</enum><header>Transition Provisions</header>
<paragraph id="HEE41857D6C5649B2947092EAC2D69A"><enum>(1)</enum><header>In general</header><text>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 <act-name parsable-cite="SSA">Social Security Act</act-name> due solely to failure to make such change until the date specified in paragraph (4).</text></paragraph>
<paragraph id="H6936B568504249F185D5C26C8682B7D9"><enum>(2)</enum><header>NAIC standards</header><text>If, not later than October 31, 2008, the National Association of Insurance Commissioners (in this subsection referred to as the <quote>NAIC</quote>) modifies its NAIC Model Regulation relating to section 1882 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (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.</text></paragraph>
<paragraph id="HA2890B89A32641939B26260275124CB"><enum>(3)</enum><header>Secretary standards</header><text>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 July 1, 2009, 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.</text></paragraph>
<paragraph id="H747F3EE0AF3A453393F5A4A121E5FBCD"><enum>(4)</enum><header>Date specified</header>
<subparagraph id="H67E5B42B91B54045803415BE50290193"><enum>(A)</enum><header>In general</header><text>Subject to subparagraph (B), the date specified in this paragraph for a State is the earlier of—</text>
<clause id="H835FD926FEE74565B196079B8687781E"><enum>(i)</enum><text>the date the State changes its statutes or regulations to conform its regulatory program to the changes made by this section, or</text></clause>
<clause id="H659183D03B2F4F22A37EA512230320B1"><enum>(ii)</enum><text>July 1, 2009.</text></clause></subparagraph>
<subparagraph id="HB9F6B6F0CDAE4BF4BFA2CB14E97D0317"><enum>(B)</enum><header>Additional legislative action required</header><text>In the case of a State which the Secretary identifies as—</text>
<clause id="HBA5AB57B78E04C0483870049134CCAC8"><enum>(i)</enum><text>requiring State legislation (other than legislation appropriating funds) to conform its regulatory program to the changes made in this section, but</text></clause>
<clause id="H1AC88A2F2D944C2796B9061DDE865F08"><enum>(ii)</enum><text>having a legislature which is not scheduled to meet in 2009 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, 2009. 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.</text></clause></subparagraph></paragraph></subsection></section>
<section display-inline="no-display-inline" id="H067D049CF7E547500087A1B0D13E062E" section-type="subsequent-section"><enum>105.</enum><header>Privacy and confidentiality</header>
<subsection id="HF05448DC20324F14A9BE16D672251146"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Part C of title XI of the Social Security Act is amended by adding at the end the following new section:</text>
<quoted-block id="HAAA370401D65490DB6A67C4ECA76BDAA" style="traditional">
<section id="H2AD54BAB4FF2470CA9202069A3DA5B28"><enum>1180.</enum><header>Application of HIPAA regulations to genetic information</header>
<subsection commented="no" display-inline="yes-display-inline" id="H49A63D77BC75433200F4C06FDE65D8C"><enum>(a)</enum><header>In general</header><text>The Secretary shall revise the HIPAA privacy regulation (as defined in subsection (b)) so it is consistent with the following:</text>
<paragraph commented="no" id="HDB647455F8B94BB9BF532B00CD022C38"><enum>(1)</enum><text display-inline="yes-display-inline">Genetic information shall be treated as health information described in section 1171(4)(B).</text></paragraph>
<paragraph id="HD28C58AEAFC94CCAA2F4C5E3903208AC"><enum>(2)</enum><text>The use or disclosure by a covered entity that is a group health plan, health insurance issuer that issues health insurance coverage, or issuer of a medicare supplemental policy of protected health information that is genetic information about an individual for underwriting purposes under the group health plan, health insurance coverage, or medicare supplemental policy shall not be a permitted use or disclosure.</text></paragraph></subsection>
<subsection id="H9DA802809993456A87555F92CBAB0238"><enum>(b)</enum><header>Definitions</header><text>For purposes of this section:</text>
<paragraph id="HF2AF4A2F94074F709BC41843EE271BB7"><enum>(1)</enum><header>Genetic information; genetic test; family member</header><text>The terms <quote>genetic information</quote>, <quote>genetic test</quote>, and <quote>family member</quote> have the meanings given such terms in section 2791 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-91">42 U.S.C. 300gg–91</external-xref>), as amended by the Genetic Information Nondiscrimination Act of 2007.</text></paragraph>
<paragraph id="HEB6D88AF093B40C0951D48748B42D342"><enum>(2)</enum><header>Group health plan; health insurance coverage; medicare supplemental policy</header><text>The terms <quote>group health plan</quote> and <quote>health insurance coverage</quote> have the meanings given such terms under section 2791 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-91">42 U.S.C. 300gg–91</external-xref>), and the term <quote>medicare supplemental policy</quote> has the meaning given such term in section 1882(g).</text></paragraph>
<paragraph id="H68DB36A615B74B1499F2802070603DB0"><enum>(3)</enum><header>HIPAA privacy regulation</header><text display-inline="yes-display-inline">The term <quote>HIPAA privacy regulation</quote> means the regulations promulgated by the Secretary under this part and section 264 of the <act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability Act of 1996</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> note).</text></paragraph>
<paragraph id="H7AB8D609815D4CC7ACF3855F32CD1D98"><enum>(4)</enum><header>Underwriting purposes</header><text display-inline="yes-display-inline">The term <quote>underwriting purposes</quote> means, with respect to a group health plan, health insurance coverage, or a medicare supplemental policy—</text>
<subparagraph id="H4351F2FF3B3D460BB467EAD7EA53EF7"><enum>(A)</enum><text>rules for, or determination of, eligibility (including enrollment and continued eligibility) for, or determination of, benefits under the plan, coverage, or policy;</text></subparagraph>
<subparagraph id="H82DDDFAC9F8C49A9A2151DD1B90669D1"><enum>(B)</enum><text>the computation of premium or contribution amounts under the plan, coverage, or policy;</text></subparagraph>
<subparagraph id="H30F36C418A914CA5BDBF57E59369A1C1"><enum>(C)</enum><text>the application of any pre-existing condition exclusion under the plan, coverage, or policy; and</text></subparagraph>
<subparagraph id="H77C97B8B82FB4E8FABA92E58AAEDBC1"><enum>(D)</enum><text>other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.</text></subparagraph></paragraph></subsection>
<subsection id="H7547C2FEDBD44218AB4573006B2FD03B"><enum>(c)</enum><header>Procedure</header><text>The revisions under subsection (a) shall be made by notice in the Federal Register published not later than 60 days after the date of the enactment of this section and shall be effective upon publication, without opportunity for any prior public comment, but may be revised, consistent with this section, after opportunity for public comment.</text></subsection>
<subsection id="H01B3C82393424CF1B8E0731EBF512788"><enum>(d)</enum><header>Enforcement</header><text>In addition to any other sanctions or remedies that may be available under law, a covered entity that is a group health plan, health insurance issuer, or issuer of a medicare supplemental policy and that violates the HIPAA privacy regulation (as revised under subsection (a) or otherwise) with respect to the use or disclosure of genetic information shall be subject to the penalties described in sections 1176 and 1177 in the same manner and to the same extent that such penalties apply to violations of this part.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H2AA8A8F222CA46AF8EAE198876AFB8BF"><enum>(b)</enum><header>Regulations; effective date</header>
<paragraph id="H5D7C9032C4044EEF88911C7D6C63A904"><enum>(1)</enum><header>Regulations</header><text display-inline="yes-display-inline">Not later than 12 months after the date of the enactment of this Act, the Secretary of Health and Human Services shall issue final regulations to carry out the revision required by section 1180(a) of the Social Security Act, as added by subsection (a). The Secretary has the sole authority to promulgate such regulations, but shall promulgate such regulations in consultation with the Secretaries of Labor and the Treasury.</text></paragraph>
<paragraph id="H4616F146951F4F0D8ED58B908BF2052B"><enum>(2)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendment made by subsection (a) shall take effect on the date that is 1 year after the date of the enactment of this Act.</text></paragraph></subsection></section>
<section display-inline="no-display-inline" id="HAE2B4B9C342C42F689AFF34BCE7106A0"><enum>106.</enum><header>Assuring coordination</header><text display-inline="no-display-inline">Except as provided in section 105(b)(1), 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—</text>
<paragraph id="HC875D6C23EDC4AF099D5AAA700169190"><enum>(1)</enum><text>regulations, rulings, and interpretations issued by such Secretaries relating to the same matter over which two or more such Secretaries have responsibility under this title (and the amendments made by this title) are administered so as to have the same effect at all times; and</text></paragraph>
<paragraph id="HE39977094E604BF6AE21516018DDC308"><enum>(2)</enum><text>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.</text></paragraph></section>
<enum>II</enum><header>PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF GENETIC INFORMATION</header>
<section id="H2D513B193C6F42E18F01267B2C004CE3"><enum>201.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text>
<paragraph id="H12E78929E67C414F95D2FD4642B6F786"><enum>(1)</enum><header>Commission</header><text>The term <term>Commission</term> means the Equal Employment Opportunity Commission as created by section 705 of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e-4">42 U.S.C. 2000e–4</external-xref>).</text></paragraph>
<paragraph id="HA47744E02CF1490496D540BE4D9BA1AA"><enum>(2)</enum><header>Employee; employer; employment agency; labor organization; member</header>
<subparagraph id="H74C7D945F518426FB60025FD4320B579"><enum>(A)</enum><header>In general</header><text>The term <term>employee</term> means—</text>
<clause id="H2D91B501F67D4723B59500013989D6AE"><enum>(i)</enum><text>an employee (including an applicant), as defined in section 701(f) of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e">42 U.S.C. 2000e(f)</external-xref>);</text></clause>
<clause id="H778D90B31AF347D7AB7F935B7DB01765"><enum>(ii)</enum><text>a State employee (including an applicant) described in section 304(a) of the Government Employee Rights Act of 1991 (42 U.S.C. 2000e–16c(a));</text></clause>
<clause id="HB80F91A7FFAF4D0BA9B2F3F789017B9B"><enum>(iii)</enum><text>a covered employee (including an applicant), as defined in section 101 of the Congressional Accountability Act of 1995 (<external-xref legal-doc="usc" parsable-cite="usc/2/1301">2 U.S.C. 1301</external-xref>);</text></clause>
<clause id="H40A7F18E49AE4EE68E91002734AA585D"><enum>(iv)</enum><text>a covered employee (including an applicant), as defined in <external-xref legal-doc="usc" parsable-cite="usc/3/411">section 411(c)</external-xref> of title 3, United States Code; or</text></clause>
<clause id="H13BAD04345E4458BA02E19453D9412C2"><enum>(v)</enum><text>an employee or applicant to which section 717(a) of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e-16">42 U.S.C. 2000e–16(a)</external-xref>) applies.</text></clause></subparagraph>
<subparagraph id="HC15BA37E87944DDDA6524149A1A3BF6E"><enum>(B)</enum><header>Employer</header><text>The term <term>employer</term> means—</text>
<clause id="HFD786A36C0C54B4E94B30260A0D52CA0"><enum>(i)</enum><text>an employer (as defined in section 701(b) of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e">42 U.S.C. 2000e(b)</external-xref>));</text></clause>
<clause id="H5B7CC2F26EA34F0BBC006C6DDE819969"><enum>(ii)</enum><text>an entity employing a State employee described in section 304(a) of the Government Employee Rights Act of 1991;</text></clause>
<clause id="H54B0A1C6899C48A6AA3577478FDFCE7B"><enum>(iii)</enum><text>an employing office, as defined in section 101 of the Congressional Accountability Act of 1995;</text></clause>
<clause id="H53C3132ADFDC467CA3463348D5092615"><enum>(iv)</enum><text>an employing office, as defined in <external-xref legal-doc="usc" parsable-cite="usc/3/411">section 411(c)</external-xref> of title 3, United States Code; or</text></clause>
<clause id="HC8A29FB7EE8D4A8BAFDC7ECEB594CA5"><enum>(v)</enum><text>an entity to which section 717(a) of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> applies.</text></clause></subparagraph>
<subparagraph id="HE1F05BB696D14F02812E7DF7CA80B776"><enum>(C)</enum><header>Employment agency; labor organization</header><text>The terms <term>employment agency</term> and <term>labor organization</term> have the meanings given the terms in section 701 of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e">42 U.S.C. 2000e</external-xref>).</text></subparagraph>
<subparagraph id="H56DDB58ED2424965B9485DE37B598CE1"><enum>(D)</enum><header>Member</header><text>The term <term>member</term>, with respect to a labor organization, includes an applicant for membership in a labor organization.</text></subparagraph></paragraph>
<paragraph display-inline="no-display-inline" id="HBE43B85C54C04BE5B1EA14EDFEA3AC8E"><enum>(3)</enum><header>Family member</header><text>The term <term>family member</term> means, with respect to an individual—</text>
<subparagraph commented="no" id="H1584D266F8944CBDB4B007DC795B2FF"><enum>(A)</enum><text>a dependent (as such term is used for purposes of section 701(f)(2) of the Employee Retirement Income Security Act of 1974) of such individual, and</text></subparagraph>
<subparagraph commented="no" id="H691E89102D9B468BAAA17F94DBCB8C68"><enum>(B)</enum><text>any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of such individual or of an individual described in subparagraph (A).</text></subparagraph></paragraph>
<paragraph id="H6719023EA1A34EB89D609FCC07099503"><enum>(4)</enum><header>Genetic information</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H5E868A0046D6428CB11CDA33991336D1"><enum>(A)</enum><header>In general</header><text>The term <term>genetic information</term> means, with respect to any individual, information about—</text>
<clause commented="no" display-inline="no-display-inline" id="HF33FD8014EA544EDAE0060771268DFF3"><enum>(i)</enum><text>such individual’s genetic tests,</text></clause>
<clause commented="no" id="HF8635359C1704472AE50F005165A5A8"><enum>(ii)</enum><text>the genetic tests of family members of such individual, and</text></clause>
<clause commented="no" id="H596E4A94AC8042DB8E792646FE7FD700"><enum>(iii)</enum><text>the manifestation of a disease or disorder in family members of such individual.</text></clause></subparagraph>
<subparagraph id="H59068070844144CEA6B951B76677DC93"><enum>(B)</enum><header>Inclusion of genetic services and participation in genetic research</header><text display-inline="yes-display-inline">Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual.</text></subparagraph>
<subparagraph commented="no" id="H3DCC19F8B53842529DBAF173879DE159"><enum>(C)</enum><header>Exclusions</header><text>The term <term>genetic information</term> shall not include information about the sex or age of any individual.</text></subparagraph></paragraph>
<paragraph id="HA6BA635A4D0C447600E5530718E20078"><enum>(5)</enum><header>Genetic monitoring</header><text>The term <term>genetic monitoring</term> 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.</text></paragraph>
<paragraph id="H4ECA2628A41E4C10A13E7C947EF3DC9B"><enum>(6)</enum><header>Genetic services</header><text>The term <term>genetic services</term> means—</text>
<subparagraph id="H74BD86EC9D704087908BD33831E0044E"><enum>(A)</enum><text>a genetic test;</text></subparagraph>
<subparagraph id="H90E6B8833E074D9BB911FC00EBEB3230"><enum>(B)</enum><text>genetic counseling (including obtaining, interpreting, or assessing genetic information); or</text></subparagraph>
<subparagraph id="H7CF56BE59D744D19B35E08FDCC6CB7C5"><enum>(C)</enum><text>genetic education.</text></subparagraph></paragraph>
<paragraph id="HFB46A3D235D744598FCDADE094622BE5"><enum>(7)</enum><header>Genetic test</header>
<subparagraph id="HF19DB1F8E14047E000BBD805008595A3"><enum>(A)</enum><header>In general</header><text>The term <term>genetic test</term> means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detects genotypes, mutations, or chromosomal changes.</text></subparagraph>
<subparagraph id="H210B8154F84D42CEBD8252066316658D"><enum>(B)</enum><header>Exceptions</header><text display-inline="yes-display-inline">The term <term>genetic test</term> does not mean an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes.</text></subparagraph></paragraph></section>
<section id="HF3B43A1A4A7449228B3068BBFB86387"><enum>202.</enum><header>Employer practices</header>
<subsection id="HB5BD140C54B64DFAB827413EEFCD3D07"><enum>(a)</enum><header>Discrimination based on Genetic Information</header><text>It shall be an unlawful employment practice for an employer—</text>
<paragraph id="H1F804ADBC9984242877141103900CC30"><enum>(1)</enum><text>to fail or refuse to hire, or to discharge, any employee, or otherwise to discriminate against any employee with respect to the compensation, terms, conditions, or privileges of employment of the employee, because of genetic information with respect to the employee; or</text></paragraph>
<paragraph id="HAE71700D2EF14D4F99BFA882A32C8C81"><enum>(2)</enum><text>to limit, segregate, or classify the employees of the employer in any way that would deprive or tend to deprive any employee of employment opportunities or otherwise adversely affect the status of the employee as an employee, because of genetic information with respect to the employee.</text></paragraph></subsection>
<subsection commented="no" id="H9C3C6827E15C4E629319A780BE85AED6"><enum>(b)</enum><header>Acquisition of Genetic Information</header><text>It shall be an unlawful employment practice for an employer to request, require, or purchase genetic information with respect to an employee or a family member of the employee except—</text>
<paragraph commented="no" id="H80579123DC7442E493094E5C89DFF292"><enum>(1)</enum><text>where an employer inadvertently requests or requires family medical history of the employee or family member of the employee;</text></paragraph>
<paragraph commented="no" id="H14B856B915284F88AB16062341114955"><enum>(2)</enum><text>where—</text>
<subparagraph commented="no" id="HBF90FDE83CEA47F783B8E4B6972D73BE"><enum>(A)</enum><text>health or genetic services are offered by the employer, including such services offered as part of a wellness program;</text></subparagraph>
<subparagraph commented="no" id="H66FDD443CF3D4DFDBE84EE6EC063C187"><enum>(B)</enum><text>the employee provides prior, knowing, voluntary, and written authorization;</text></subparagraph>
<subparagraph commented="no" id="HFCB7CBD2E17448E4BA9406F06D704044"><enum>(C)</enum><text>only the employee (or family member if the family member is receiving genetic services) and the licensed health care professional or board certified genetic counselor involved in providing such services receive individually identifiable information concerning the results of such services; and</text></subparagraph>
<subparagraph commented="no" id="H54BAC5F81685435396FED2F3DFA34BB"><enum>(D)</enum><text>any individually identifiable genetic information provided under subparagraph (C) in connection with the services provided under subparagraph (A) is only available for purposes of such services and shall not be disclosed to the employer except in aggregate terms that do not disclose the identity of specific employees;</text></subparagraph></paragraph>
<paragraph commented="no" id="H08ABC1673D894467892058B7B5A51FB1"><enum>(3)</enum><text>where an employer requests or requires family medical history from the employee to comply with the certification provisions of section 103 of the Family and Medical Leave Act of 1993 (<external-xref legal-doc="usc" parsable-cite="usc/29/2613">29 U.S.C. 2613</external-xref>) or such requirements under State family and medical leave laws;</text></paragraph>
<paragraph commented="no" id="H8D00044AB87D469C8CE81959BDD687F"><enum>(4)</enum><text>where an employer purchases documents that are commercially and publicly available (including newspapers, magazines, periodicals, and books, but not including medical databases or court records) that include family medical history;</text></paragraph>
<paragraph commented="no" id="H5E25BA30E9D24EEEBED28F14F807F272"><enum>(5)</enum><text>where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—</text>
<subparagraph commented="no" id="H146973DE3DCB418BA185B27EF4898C4E"><enum>(A)</enum><text>the employer provides written notice of the genetic monitoring to the employee;</text></subparagraph>
<subparagraph commented="no" id="H4FD42D4B71E44086B0CD4C969B38BD76"><enum>(B)</enum>
<clause commented="no" display-inline="yes-display-inline" id="HEA6AE95377F34A958164B3CFBE288146"><enum>(i)</enum><text>the employee provides prior, knowing, voluntary, and written authorization; or</text></clause>
<clause commented="no" id="H79D9FDFCF0684DAC8F2831BC0436F17E" indent="up1"><enum>(ii)</enum><text>the genetic monitoring is required by Federal or State law;</text></clause></subparagraph>
<subparagraph commented="no" id="HDE4C3A301DC74BC18CB2DAA300AE98DD"><enum>(C)</enum><text>the employee is informed of individual monitoring results;</text></subparagraph>
<subparagraph commented="no" id="H012ACAF3F72C4F2F869DAA7148D1E23D"><enum>(D)</enum><text>the monitoring is in compliance with—</text>
<clause commented="no" id="H183034ED6477415694F7199422652407"><enum>(i)</enum><text>any Federal genetic monitoring regulations, including any such regulations that may be promulgated by the Secretary of Labor pursuant to the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>), the Federal Mine Safety and Health Act of 1977 (<external-xref legal-doc="usc" parsable-cite="usc/30/801">30 U.S.C. 801 et seq.</external-xref>), or the <act-name parsable-cite="AEA54">Atomic Energy Act of 1954</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2011">42 U.S.C. 2011 et seq.</external-xref>); or</text></clause>
<clause commented="no" id="HC64D45CAEEF845E4A3137457F8D1E7F"><enum>(ii)</enum><text>State genetic monitoring regulations, in the case of a State that is implementing genetic monitoring regulations under the authority of the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>); and</text></clause></subparagraph>
<subparagraph commented="no" id="H3761171766D349609B2200CFF0600BA"><enum>(E)</enum><text>the employer, excluding any licensed health care professional or board certified genetic counselor 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</text></subparagraph></paragraph>
<paragraph id="H10F869616EE94036A8E598B3A17E71CD"><enum>(6)</enum><text display-inline="yes-display-inline">where the employer conducts DNA analysis for law enforcement purposes as a forensic laboratory or for purposes of human remains identification, and requests or requires genetic information of such employer’s employees, but only to the extent that such genetic information is used for analysis of DNA identification markers for quality control to detect sample contamination.</text></paragraph></subsection>
<subsection id="HEF084ABE3D8E4C6FBA55862F1BADA63D"><enum>(c)</enum><header>Preservation of Protections</header><text>In the case of information to which any of paragraphs (1) through (6) of subsection (b) applies, such information may not be used in violation of paragraph (1) or (2) of subsection (a) or treated or disclosed in a manner that violates section 206.</text></subsection></section>
<section id="H2971AC923B5B4B99987493C8B5EC639C"><enum>203.</enum><header>Employment agency practices</header>
<subsection id="H029C80BCEE084152B2F38ECD9C0044BC"><enum>(a)</enum><header>Discrimination based on Genetic Information</header><text>It shall be an unlawful employment practice for an employment agency—</text>
<paragraph id="HAE47B23D77EE48E88672039D18F4643C"><enum>(1)</enum><text>to fail or refuse to refer for employment, or otherwise to discriminate against, any individual because of genetic information with respect to the individual;</text></paragraph>
<paragraph id="H1F1B9D3D44364EA5B3678202A3088509"><enum>(2)</enum><text>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 otherwise adversely affect the status of the individual as an employee, because of genetic information with respect to the individual; or</text></paragraph>
<paragraph id="H6E3960D9413E4349AE017DA58D0099B1"><enum>(3)</enum><text>to cause or attempt to cause an employer to discriminate against an individual in violation of this title.</text></paragraph></subsection>
<subsection id="HD8F73CE4C7CC44238E202240CA096670"><enum>(b)</enum><header>Acquisition of Genetic Information</header><text display-inline="yes-display-inline">It shall be an unlawful employment practice for an employment agency to request, require, or purchase genetic information with respect to an individual or a family member of the individual except—</text>
<paragraph id="H2A3697CCF49041F092AF516E93305188"><enum>(1)</enum><text display-inline="yes-display-inline">where an employment agency inadvertently requests or requires family medical history of the individual or family member of the individual;</text></paragraph>
<paragraph id="HA5D6FDE0BCEF47A78B898912C7DE9613"><enum>(2)</enum><text>where—</text>
<subparagraph id="H2EEBB1BB1A6F4D46856420525174D026"><enum>(A)</enum><text>health or genetic services are offered by the employment agency, including such services offered as part of a wellness program;</text></subparagraph>
<subparagraph id="HDD440990847844A0A2B229F100061D08"><enum>(B)</enum><text>the individual provides prior, knowing, voluntary, and written authorization;</text></subparagraph>
<subparagraph id="H80DAC69268FF44A184005B145F12FA28"><enum>(C)</enum><text>only the individual (or family member if the family member is receiving genetic services) and the licensed health care professional or board certified genetic counselor involved in providing such services receive individually identifiable information concerning the results of such services; and</text></subparagraph>
<subparagraph id="HD3ED9481862545E2ACB6DAFD10B4AB87"><enum>(D)</enum><text>any individually identifiable genetic information provided under subparagraph (C) in connection with the services provided under subparagraph (A) is only available for purposes of such services and shall not be disclosed to the employment agency except in aggregate terms that do not disclose the identity of specific individuals;</text></subparagraph></paragraph>
<paragraph id="HCAD6E99AB5E74A24B22C92AB6FC47328"><enum>(3)</enum><text>where an employment agency requests or requires family medical history from the individual to comply with the certification provisions of section 103 of the Family and Medical Leave Act of 1993 (<external-xref legal-doc="usc" parsable-cite="usc/29/2613">29 U.S.C. 2613</external-xref>) or such requirements under State family and medical leave laws;</text></paragraph>
<paragraph id="H56090DC4B0834EF1B55F1739ECDF5E11"><enum>(4)</enum><text>where an employment agency purchases documents that are commercially and publicly available (including newspapers, magazines, periodicals, and books, but not including medical databases or court records) that include family medical history; or</text></paragraph>
<paragraph id="H828EEA2FD2894B2DB24B55EA4FA4BC6D"><enum>(5)</enum><text>where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—</text>
<subparagraph id="HADEC8F7430F54C53A12BB62EF3BD4600"><enum>(A)</enum><text>the employment agency provides written notice of the genetic monitoring to the individual;</text></subparagraph>
<subparagraph id="H8D8FE2E3036F4FBA969043FF8C0003B6"><enum>(B)</enum>
<clause commented="no" display-inline="yes-display-inline" id="H196111C879A44AC9B321C9726262F73"><enum>(i)</enum><text>the individual provides prior, knowing, voluntary, and written authorization; or</text></clause>
<clause id="HB6C85B1FB08E4045AC27D485167CC1E1" indent="up1"><enum>(ii)</enum><text>the genetic monitoring is required by Federal or State law;</text></clause></subparagraph>
<subparagraph id="H13E5E6460E37409985A8001136911961"><enum>(C)</enum><text>the individual is informed of individual monitoring results;</text></subparagraph>
<subparagraph id="HB53F47B09B3A4928A2C400F9F9E29CB2"><enum>(D)</enum><text>the monitoring is in compliance with—</text>
<clause id="H2B019866E9BB403CAC7CAAF561817B10"><enum>(i)</enum><text>any Federal genetic monitoring regulations, including any such regulations that may be promulgated by the Secretary of Labor pursuant to the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>), the Federal Mine Safety and Health Act of 1977 (<external-xref legal-doc="usc" parsable-cite="usc/30/801">30 U.S.C. 801 et seq.</external-xref>), or the <act-name parsable-cite="AEA54">Atomic Energy Act of 1954</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2011">42 U.S.C. 2011 et seq.</external-xref>); or</text></clause>
<clause id="HD0A3BD99BF5F4557AE8B39AAFA2D5C9"><enum>(ii)</enum><text>State genetic monitoring regulations, in the case of a State that is implementing genetic monitoring regulations under the authority of the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>); and</text></clause></subparagraph>
<subparagraph id="H1DD508AB5C774ACA9667B1C7006484E4"><enum>(E)</enum><text>the employment agency, excluding any licensed health care professional or board certified genetic counselor 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 individuals.</text></subparagraph></paragraph></subsection>
<subsection id="H6ABEFDF5D7F446C700E9043795A5FF00"><enum>(c)</enum><header>Preservation of Protections</header><text>In the case of information to which any of paragraphs (1) through (5) of subsection (b) applies, such information may not be used in violation of paragraph (1), (2), or (3) of subsection (a) or treated or disclosed in a manner that violates section 206.</text></subsection></section>
<section id="HA042C835B887400DAB00F7C4CEFE733"><enum>204.</enum><header>Labor organization practices</header>
<subsection id="HE797144FDB6E4D21B13F004646B60965"><enum>(a)</enum><header>Discrimination based on Genetic Information</header><text>It shall be an unlawful employment practice for a labor organization—</text>
<paragraph id="HAF9DC6ACCBA6484CBA6900031E2BE818"><enum>(1)</enum><text>to exclude or to expel from the membership of the organization, or otherwise to discriminate against, any member because of genetic information with respect to the member;</text></paragraph>
<paragraph id="HCC9FE46602384ACA9D072BC3BB00003B"><enum>(2)</enum><text>to limit, segregate, or classify the members of the organization, or fail or refuse to refer for employment any member, in any way that would deprive or tend to deprive any member of employment opportunities, or otherwise adversely affect the status of the member as an employee, because of genetic information with respect to the member; or</text></paragraph>
<paragraph id="HFCB60DEB28D642CCA9F7B04B8E8955B"><enum>(3)</enum><text>to cause or attempt to cause an employer to discriminate against a member in violation of this title.</text></paragraph></subsection>
<subsection id="H7B8DD359DA2F4CAAB18512BFC416FAD1"><enum>(b)</enum><header>Acquisition of Genetic Information</header><text display-inline="yes-display-inline">It shall be an unlawful employment practice for a labor organization to request, require, or purchase genetic information with respect to a member or a family member of the member except—</text>
<paragraph id="H883F7DAA033D487E9C826D6DFD6132BA"><enum>(1)</enum><text display-inline="yes-display-inline">where a labor organization inadvertently requests or requires family medical history of the member or family member of the member;</text></paragraph>
<paragraph id="HFD90B51F5FF042D2887D17C0ECC7471E"><enum>(2)</enum><text>where—</text>
<subparagraph id="H1B1262664D19481A8CC9F46BB2B1CD80"><enum>(A)</enum><text>health or genetic services are offered by the labor organization, including such services offered as part of a wellness program;</text></subparagraph>
<subparagraph id="H72D1622E88BB4769A607C0409278CD12"><enum>(B)</enum><text>the member provides prior, knowing, voluntary, and written authorization;</text></subparagraph>
<subparagraph id="HA0C1A2785E2E4F51A683D6C54BB8CE7D"><enum>(C)</enum><text>only the member (or family member if the family member is receiving genetic services) and the licensed health care professional or board certified genetic counselor involved in providing such services receive individually identifiable information concerning the results of such services; and</text></subparagraph>
<subparagraph id="H9C04292FFE31410895C89D41CEA31DDD"><enum>(D)</enum><text>any individually identifiable genetic information provided under subparagraph (C) in connection with the services provided under subparagraph (A) is only available for purposes of such services and shall not be disclosed to the labor organization except in aggregate terms that do not disclose the identity of specific members;</text></subparagraph></paragraph>
<paragraph id="H2AC2FBA1F64345DE823DE434E08E3BB4"><enum>(3)</enum><text>where a labor organization requests or requires family medical history from the members to comply with the certification provisions of section 103 of the Family and Medical Leave Act of 1993 (<external-xref legal-doc="usc" parsable-cite="usc/29/2613">29 U.S.C. 2613</external-xref>) or such requirements under State family and medical leave laws;</text></paragraph>
<paragraph id="H8034A6D75C314FA3AAA2789897120880"><enum>(4)</enum><text>where a labor organization purchases documents that are commercially and publicly available (including newspapers, magazines, periodicals, and books, but not including medical databases or court records) that include family medical history; or</text></paragraph>
<paragraph id="H6AE351BEB57A4C2E87FD2C66A42086C9"><enum>(5)</enum><text>where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—</text>
<subparagraph id="H1E00683ED2C0494EB593E9D0B5425F6F"><enum>(A)</enum><text>the labor organization provides written notice of the genetic monitoring to the member;</text></subparagraph>
<subparagraph id="H68E6BFBB10FB43FC9CC15727781FC1B3"><enum>(B)</enum>
<clause commented="no" display-inline="yes-display-inline" id="H0DB9466E4FD744D68B59F4447317DCB9"><enum>(i)</enum><text>the member provides prior, knowing, voluntary, and written authorization; or</text></clause>
<clause id="H38E7EBEC40A041E59FB61CF8703B995" indent="up1"><enum>(ii)</enum><text>the genetic monitoring is required by Federal or State law;</text></clause></subparagraph>
<subparagraph id="HC5A86884AF214D389F749768EA19C2B5"><enum>(C)</enum><text>the member is informed of individual monitoring results;</text></subparagraph>
<subparagraph id="HDB9A738C124548AC009805CDB3E27BBB"><enum>(D)</enum><text>the monitoring is in compliance with—</text>
<clause id="HF8A381EC72264F9AB010773BFB5E6049"><enum>(i)</enum><text>any Federal genetic monitoring regulations, including any such regulations that may be promulgated by the Secretary of Labor pursuant to the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>), the Federal Mine Safety and Health Act of 1977 (<external-xref legal-doc="usc" parsable-cite="usc/30/801">30 U.S.C. 801 et seq.</external-xref>), or the <act-name parsable-cite="AEA54">Atomic Energy Act of 1954</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2011">42 U.S.C. 2011 et seq.</external-xref>); or</text></clause>
<clause id="H338E6D7941C540269D44005485C03EE1"><enum>(ii)</enum><text>State genetic monitoring regulations, in the case of a State that is implementing genetic monitoring regulations under the authority of the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>); and</text></clause></subparagraph>
<subparagraph id="HDEBD368CC05B4666BEEC0CDE1F8FF22"><enum>(E)</enum><text>the labor organization, excluding any licensed health care professional or board certified genetic counselor 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 members.</text></subparagraph></paragraph></subsection>
<subsection id="H26C42CBB23FD4A53983D9322A7718E92"><enum>(c)</enum><header>Preservation of Protections</header><text>In the case of information to which any of paragraphs (1) through (5) of subsection (b) applies, such information may not be used in violation of paragraph (1), (2), or (3) of subsection (a) or treated or disclosed in a manner that violates section 206.</text></subsection></section>
<section id="HCDF48C9845FD45F284369552F8DE9EB"><enum>205.</enum><header>Training programs</header>
<subsection id="HBF783D466ECB4F3F9F97DC1C9F355F2D"><enum>(a)</enum><header>Discrimination based on Genetic Information</header><text>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—</text>
<paragraph id="HFE588BC6D89940F293CE28ADB6134A2"><enum>(1)</enum><text>to discriminate against any individual because of genetic information with respect to the individual in admission to, or employment in, any program established to provide apprenticeship or other training or retraining;</text></paragraph>
<paragraph id="HA1CE65A7AF2B42BCBAB700A2882C86F9"><enum>(2)</enum><text>to limit, segregate, or classify the applicants for or participants in such apprenticeship or other training or retraining, 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 otherwise adversely affect the status of the individual as an employee, because of genetic information with respect to the individual; or</text></paragraph>
<paragraph id="H72D329EF680A4BD289443122022D5CB7"><enum>(3)</enum><text>to cause or attempt to cause an employer to discriminate against an applicant for or a participant in such apprenticeship or other training or retraining in violation of this title.</text></paragraph></subsection>
<subsection id="H9CE53626CB70474B98E50030865B6CAF"><enum>(b)</enum><header>Acquisition of Genetic Information</header><text display-inline="yes-display-inline">It shall be an unlawful employment practice for an employer, labor organization, or joint labor-management committee described in subsection (a) to request, require, or purchase genetic information with respect to an individual or a family member of the individual except—</text>
<paragraph id="H9D72BB2920E54461A8741B71B7C5A130"><enum>(1)</enum><text display-inline="yes-display-inline">where the employer, labor organization, or joint labor-management committee inadvertently requests or requires family medical history of the individual or family member of the individual;</text></paragraph>
<paragraph id="H4FEDE7DAAB034F3DAFBC8068B08392"><enum>(2)</enum><text>where—</text>
<subparagraph id="H50369C93E5C0437D8BC36313E17DEBAF"><enum>(A)</enum><text>health or genetic services are offered by the employer, labor organization, or joint labor-management committee, including such services offered as part of a wellness program;</text></subparagraph>
<subparagraph id="H5E97857C6AFB45F8AB56F84588BA1DC2"><enum>(B)</enum><text>the individual provides prior, knowing, voluntary, and written authorization;</text></subparagraph>
<subparagraph id="HC3E9BADC1DB54B988FEAAFEF8013769D"><enum>(C)</enum><text>only the individual (or family member if the family member is receiving genetic services) and the licensed health care professional or board certified genetic counselor involved in providing such services receive individually identifiable information concerning the results of such services; and</text></subparagraph>
<subparagraph id="H08BA328BA81D459DABC2A659633F452E"><enum>(D)</enum><text>any individually identifiable genetic information provided under subparagraph (C) in connection with the services provided under subparagraph (A) is only available for purposes of such services and shall not be disclosed to the employer, labor organization, or joint labor-management committee except in aggregate terms that do not disclose the identity of specific individuals;</text></subparagraph></paragraph>
<paragraph id="H203F4E3F56954A25AD10E8058776CB5F"><enum>(3)</enum><text>where the employer, labor organization, or joint labor-management committee requests or requires family medical history from the individual to comply with the certification provisions of section 103 of the Family and Medical Leave Act of 1993 (<external-xref legal-doc="usc" parsable-cite="usc/29/2613">29 U.S.C. 2613</external-xref>) or such requirements under State family and medical leave laws;</text></paragraph>
<paragraph id="H2F78D2EECBBF43249DB2E0C9616E3F00"><enum>(4)</enum><text>where the employer, labor organization, or joint labor-management committee purchases documents that are commercially and publicly available (including newspapers, magazines, periodicals, and books, but not including medical databases or court records) that include family medical history;</text></paragraph>
<paragraph id="HDA3E9FB2F6BC466E802FBCD0A4100375"><enum>(5)</enum><text>where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—</text>
<subparagraph id="H7309941836BE4568887F731497D4FEF1"><enum>(A)</enum><text>the employer, labor organization, or joint labor-management committee provides written notice of the genetic monitoring to the individual;</text></subparagraph>
<subparagraph id="HAB58C11C16694A909D052D9384B8A276"><enum>(B)</enum>
<clause commented="no" display-inline="yes-display-inline" id="H085C5F59410F470BB6EB3CD4C590D3E1"><enum>(i)</enum><text>the individual provides prior, knowing, voluntary, and written authorization; or</text></clause>
<clause id="H12E5ADC8D68E41C39E00CB62BEADCE39" indent="up1"><enum>(ii)</enum><text>the genetic monitoring is required by Federal or State law;</text></clause></subparagraph>
<subparagraph id="HF87CA9A3E07D4CA8B117892347BE7BE7"><enum>(C)</enum><text>the individual is informed of individual monitoring results;</text></subparagraph>
<subparagraph id="HF7F2BBAC44BA402C9972970022000282"><enum>(D)</enum><text>the monitoring is in compliance with—</text>
<clause id="H32DE0539048F4719946C412EDACD1BA9"><enum>(i)</enum><text>any Federal genetic monitoring regulations, including any such regulations that may be promulgated by the Secretary of Labor pursuant to the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>), the Federal Mine Safety and Health Act of 1977 (<external-xref legal-doc="usc" parsable-cite="usc/30/801">30 U.S.C. 801 et seq.</external-xref>), or the <act-name parsable-cite="AEA54">Atomic Energy Act of 1954</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2011">42 U.S.C. 2011 et seq.</external-xref>); or</text></clause>
<clause id="H17DF65EE56E745988755C88517B441CD"><enum>(ii)</enum><text>State genetic monitoring regulations, in the case of a State that is implementing genetic monitoring regulations under the authority of the Occupational Safety and Health Act of 1970 (<external-xref legal-doc="usc" parsable-cite="usc/29/651">29 U.S.C. 651 et seq.</external-xref>); and</text></clause></subparagraph>
<subparagraph id="H0A37A56448394BCC9103C9B33222A680"><enum>(E)</enum><text>the employer, labor organization, or joint labor-management committee, excluding any licensed health care professional or board certified genetic counselor 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 individuals; or</text></subparagraph></paragraph>
<paragraph id="H3E533AEDCCDD4D37AB272C5C736F00FB"><enum>(6)</enum><text display-inline="yes-display-inline">where the employer conducts DNA analysis for law enforcement purposes as a forensic laboratory or for purposes of human remains identification, and requests or requires genetic information of such employer’s apprentices or trainees, but only to the extent that such genetic information is used for analysis of DNA identification markers for quality control to detect sample contamination.</text></paragraph></subsection>
<subsection id="H30537C2877E2448383005284442762B4"><enum>(c)</enum><header>Preservation of Protections</header><text>In the case of information to which any of paragraphs (1) through (6) of subsection (b) applies, such information may not be used in violation of paragraph (1), (2), or (3) of subsection (a) or treated or disclosed in a manner that violates section 206.</text></subsection></section>
<section commented="no" id="HF042C4825D02416088C95C517142B0B9"><enum>206.</enum><header>Confidentiality of genetic information</header>
<subsection commented="no" id="H94580AFCA1394F418FFA8A0CCD27EED"><enum>(a)</enum><header>Treatment of Information as Part of Confidential Medical Record</header><text display-inline="yes-display-inline">If an employer, employment agency, labor organization, or joint labor-management committee possesses genetic information about an employee or member, such information shall be maintained on separate forms and in separate medical files and be treated as a confidential medical record of the employee or member. An employer, employment agency, labor organization, or joint labor-management committee shall be considered to be in compliance with the maintenance of information requirements of this subsection with respect to genetic information subject to this subsection that is maintained with and treated as a confidential medical record under section 102(d)(3)(B) of the Americans With Disabilities Act (<external-xref legal-doc="usc" parsable-cite="usc/42/12112">42 U.S.C. 12112(d)(3)(B)</external-xref>).</text></subsection>
<subsection commented="no" id="HB0B315EF087D40149C23934EB59EC707"><enum>(b)</enum><header>Limitation on Disclosure</header><text>An employer, employment agency, labor organization, or joint labor-management committee shall not disclose genetic information concerning an employee or member except—</text>
<paragraph commented="no" id="HE0F91384F03641F6B2266B6E41E3CD3"><enum>(1)</enum><text>to the employee or member of a labor organization (or family member if the family member is receiving the genetic services) at the written request of the employee or member of such organization;</text></paragraph>
<paragraph commented="no" id="H997A95A7C79C438F8B14855FA2749196"><enum>(2)</enum><text>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;</text></paragraph>
<paragraph commented="no" id="H3CD1484567F14F49A3CD738E042FFE03"><enum>(3)</enum><text>in response to an order of a court, except that—</text>
<subparagraph commented="no" id="H9FC5B5AED0A4445690053DDE2F8E19CA"><enum>(A)</enum><text>the employer, employment agency, labor organization, or joint labor-management committee may disclose only the genetic information expressly authorized by such order; and</text></subparagraph>
<subparagraph commented="no" id="H9DB29B103D4C414F93CA8B20BB9C7E1"><enum>(B)</enum><text>if the court order was secured without the knowledge of the employee or member to whom the information refers, the employer, employment agency, labor organization, or joint labor-management committee shall inform the employee or member of the court order and any genetic information that was disclosed pursuant to such order;</text></subparagraph></paragraph>
<paragraph commented="no" id="HD4400DA33478489A858BEAE6C7F29377"><enum>(4)</enum><text>to government officials who are investigating compliance with this title if the information is relevant to the investigation;</text></paragraph>
<paragraph commented="no" id="H75DAB63EDF0E4C81B26F8D959B790087"><enum>(5)</enum><text>to the extent that such disclosure is made in connection with the employee’s compliance with the certification provisions of section 103 of the Family and Medical Leave Act of 1993 (<external-xref legal-doc="usc" parsable-cite="usc/29/2613">29 U.S.C. 2613</external-xref>) or such requirements under State family and medical leave laws; or</text></paragraph>
<paragraph commented="no" id="H1464986E20D449E7BF064ED61E6380FA"><enum>(6)</enum><text>to a Federal, State, or local public health agency only with regard to information that is described in section 201(4)(A)(iii) and that concerns a contagious disease that presents an imminent hazard of death or life-threatening illness, and that the employee whose family member or family members is or are the subject of a disclosure under this paragraph is notified of such disclosure.</text></paragraph></subsection>
<subsection id="H5BE542D14DD540BE98CF461561E32904"><enum>(c)</enum><header>Relationship to HIPAA regulations</header><text>With respect to the regulations promulgated by the Secretary of Health and Human Services under part C of title XI of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d">42 U.S.C. 1320d et seq.</external-xref>) and section 264 of the Health Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> note), this title does not prohibit a covered entity under such regulations from any use or disclosure of health information that is authorized for the covered entity under such regulations. The previous sentence does not affect the authority of such Secretary to modify such regulations.</text></subsection></section>
<section id="HCBB80EB199E648C99CB97B8B72A3967C"><enum>207.</enum><header>Remedies and enforcement</header>
<subsection id="HD1990A196433491A83523D565860289C"><enum>(a)</enum><header>Employees Covered by Title <enum-in-header>VII</enum-in-header> of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name></header>
<paragraph id="H57A36EF367E24C3F9124DD3D8D646FD5"><enum>(1)</enum><header>In general</header><text>The powers, procedures, and remedies provided in sections 705, 706, 707, 709, 710, and 711 of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e-4">42 U.S.C. 2000e–4 et seq.</external-xref>) to the Commission, the Attorney General, or any person, alleging a violation of title VII of that Act (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e">42 U.S.C. 2000e et seq.</external-xref>) shall be the powers, procedures, and remedies this title provides to the Commission, the Attorney General, or any person, respectively, alleging an unlawful employment practice in violation of this title against an employee described in section 201(2)(A)(i), except as provided in paragraphs (2) and (3).</text></paragraph>
<paragraph id="H580F862B13764E868F9011EFCEDD14DF"><enum>(2)</enum><header>Costs and fees</header><text>The powers, remedies, and procedures provided in subsections (b) and (c) of section 722 of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1988">42 U.S.C. 1988</external-xref>), shall be powers, remedies, and procedures this title provides to the Commission, the Attorney General, or any person, alleging such a practice.</text></paragraph>
<paragraph id="HE26B1A13BB394866B4A869002D08C1C6"><enum>(3)</enum><header>Damages</header><text>The powers, remedies, and procedures provided in section 1977A of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1981a">42 U.S.C. 1981a</external-xref>), including the limitations contained in subsection (b)(3) of such section 1977A, shall be powers, remedies, and procedures this title provides to the Commission, the Attorney General, or any person, alleging such a practice (not an employment practice specifically excluded from coverage under section 1977A(a)(1) of the Revised Statutes of the United States).</text></paragraph></subsection>
<subsection id="H11437E314D0E49FAA7AF39A9EA6E7C2E"><enum>(b)</enum><header>Employees Covered by Government Employee Rights Act of 1991</header>
<paragraph id="H9E9DEB5FFC6C4AEA8012E3823FABE822"><enum>(1)</enum><header>In general</header><text>The powers, remedies, and procedures provided in sections 302 and 304 of the Government Employee Rights Act of 1991 (42 U.S.C. 2000e–16b, 2000e–16c) to the Commission, or any person, alleging a violation of section 302(a)(1) of that Act (42 U.S.C. 2000e–16b(a)(1)) shall be the powers, remedies, and procedures this title provides to the Commission, or any person, respectively, alleging an unlawful employment practice in violation of this title against an employee described in section 201(2)(A)(ii), except as provided in paragraphs (2) and (3).</text></paragraph>
<paragraph id="HD68252956A604960B7E2BF70024B802"><enum>(2)</enum><header>Costs and fees</header><text>The powers, remedies, and procedures provided in subsections (b) and (c) of section 722 of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1988">42 U.S.C. 1988</external-xref>), shall be powers, remedies, and procedures this title provides to the Commission, or any person, alleging such a practice.</text></paragraph>
<paragraph id="H62E6A6521F164E3FB921DCDDD0009F56"><enum>(3)</enum><header>Damages</header><text>The powers, remedies, and procedures provided in section 1977A of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1981a">42 U.S.C. 1981a</external-xref>), including the limitations contained in subsection (b)(3) of such section 1977A, shall be powers, remedies, and procedures this title provides to the Commission, or any person, alleging such a practice (not an employment practice specifically excluded from coverage under section 1977A(a)(1) of the Revised Statutes of the United States).</text></paragraph></subsection>
<subsection id="H67E8627A6F554AB1966BB254E16C21D9"><enum>(c)</enum><header>Employees Covered by Congressional Accountability Act of 1995</header>
<paragraph id="HED9C383D60A04B58AB394E13F24388EF"><enum>(1)</enum><header>In general</header><text>The powers, remedies, and procedures provided in the Congressional Accountability Act of 1995 (<external-xref legal-doc="usc" parsable-cite="usc/2/1301">2 U.S.C. 1301 et seq.</external-xref>) to the Board (as defined in section 101 of that Act (<external-xref legal-doc="usc" parsable-cite="usc/2/1301">2 U.S.C. 1301</external-xref>)), or any person, alleging a violation of section 201(a)(1) of that Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1311">42 U.S.C. 1311(a)(1)</external-xref>) shall be the powers, remedies, and procedures this title provides to that Board, or any person, alleging an unlawful employment practice in violation of this title against an employee described in section 201(2)(A)(iii), except as provided in paragraphs (2) and (3).</text></paragraph>
<paragraph id="HDF7B15313CD14AC0AEAB277975E55903"><enum>(2)</enum><header>Costs and fees</header><text>The powers, remedies, and procedures provided in subsections (b) and (c) of section 722 of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1988">42 U.S.C. 1988</external-xref>), shall be powers, remedies, and procedures this title provides to that Board, or any person, alleging such a practice.</text></paragraph>
<paragraph id="HD7D6C123D95347619CC888E000BC12CE"><enum>(3)</enum><header>Damages</header><text>The powers, remedies, and procedures provided in section 1977A of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1981a">42 U.S.C. 1981a</external-xref>), including the limitations contained in subsection (b)(3) of such section 1977A, shall be powers, remedies, and procedures this title provides to that Board, or any person, alleging such a practice (not an employment practice specifically excluded from coverage under section 1977A(a)(1) of the Revised Statutes of the United States).</text></paragraph>
<paragraph id="H4E8C360135FA4D91A45F79DCCB4327D4"><enum>(4)</enum><header>Other applicable provisions</header><text>With respect to a claim alleging a practice described in paragraph (1), title III of the Congressional Accountability Act of 1995 (<external-xref legal-doc="usc" parsable-cite="usc/2/1381">2 U.S.C. 1381 et seq.</external-xref>) shall apply in the same manner as such title applies with respect to a claim alleging a violation of section 201(a)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/2/1311">2 U.S.C. 1311(a)(1)</external-xref>).</text></paragraph></subsection>
<subsection id="HABBE5463B39D476591C5004E68B22975"><enum>(d)</enum><header>Employees Covered by Chapter <enum-in-header>5</enum-in-header> of Title <enum-in-header>3</enum-in-header>, United States Code</header>
<paragraph id="H6FD5843E110E46389D1F3834315F306C"><enum>(1)</enum><header>In general</header><text>The powers, remedies, and procedures provided in <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/3/5">chapter 5</external-xref> of title 3, United States Code, to the President, the Commission, the Merit Systems Protection Board, or any person, alleging a violation of section 411(a)(1) of that title, shall be the powers, remedies, and procedures this title provides to the President, the Commission, such Board, or any person, respectively, alleging an unlawful employment practice in violation of this title against an employee described in section 201(2)(A)(iv), except as provided in paragraphs (2) and (3).</text></paragraph>
<paragraph id="H78C687BE8DAE4000BFEDD7168CBE6012"><enum>(2)</enum><header>Costs and fees</header><text>The powers, remedies, and procedures provided in subsections (b) and (c) of section 722 of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1988">42 U.S.C. 1988</external-xref>), shall be powers, remedies, and procedures this title provides to the President, the Commission, such Board, or any person, alleging such a practice.</text></paragraph>
<paragraph id="H27FBC38FEBCE4BC9914B8100C93E5F14"><enum>(3)</enum><header>Damages</header><text display-inline="yes-display-inline">The powers, remedies, and procedures provided in section 1977A of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1981a">42 U.S.C. 1981a</external-xref>), including the limitations contained in subsection (b)(3) of such section 1977A, shall be powers, remedies, and procedures this title provides to the President, the Commission, such Board, or any person, alleging such a practice (not an employment practice specifically excluded from coverage under section 1977A(a)(1) of the Revised Statutes of the United States).</text></paragraph></subsection>
<subsection id="H6B5C1A23CDC7423996C3684E74EDFF29"><enum>(e)</enum><header>Employees Covered by Section <enum-in-header>717</enum-in-header> of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name></header>
<paragraph id="HB8D1A48B5EBC4A2DBD13C7D5BE00B0A8"><enum>(1)</enum><header>In general</header><text>The powers, remedies, and procedures provided in section 717 of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e-16">42 U.S.C. 2000e–16</external-xref>) to the Commission, the Attorney General, the Librarian of Congress, or any person, alleging a violation of that section shall be the powers, remedies, and procedures this title provides to the Commission, the Attorney General, the Librarian of Congress, or any person, respectively, alleging an unlawful employment practice in violation of this title against an employee or applicant described in section 201(2)(A)(v), except as provided in paragraphs (2) and (3).</text></paragraph>
<paragraph id="HEEF3A9A386344697BE00BA26F14E7D19"><enum>(2)</enum><header>Costs and fees</header><text display-inline="yes-display-inline">The powers, remedies, and procedures provided in subsections (b) and (c) of section 722 of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1988">42 U.S.C. 1988</external-xref>), shall be powers, remedies, and procedures this title provides to the Commission, the Attorney General, the Librarian of Congress, or any person, alleging such a practice.</text></paragraph>
<paragraph id="H1BC7A40A668A481D968C4D9242BD4328"><enum>(3)</enum><header>Damages</header><text display-inline="yes-display-inline">The powers, remedies, and procedures provided in section 1977A of the Revised Statutes of the United States (<external-xref legal-doc="usc" parsable-cite="usc/42/1981a">42 U.S.C. 1981a</external-xref>), including the limitations contained in subsection (b)(3) of such section 1977A, shall be powers, remedies, and procedures this title provides to the Commission, the Attorney General, the Librarian of Congress, or any person, alleging such a practice (not an employment practice specifically excluded from coverage under section 1977A(a)(1) of the Revised Statutes of the United States).</text></paragraph></subsection>
<subsection commented="no" id="H44D10B76C4DF42278C9CE2DEECDAD173"><enum>(f)</enum><header>Prohibition against retaliation</header><text>No person shall discriminate against any individual because such individual has opposed any act or practice made unlawful by this title or because such individual made a charge, testified, assisted, or participated in any manner in an investigation, proceeding, or hearing under this title. The remedies and procedures otherwise provided for under this section shall be available to aggrieved individuals with respect to violations of this subsection.</text></subsection>
<subsection id="HEB982C2545F8406D8B9CE4783EFD7FDB"><enum>(g)</enum><header>Definition</header><text>In this section, the term <term>Commission</term> means the Equal Employment Opportunity Commission.</text></subsection></section>
<section id="HBC03C591968441EF9DC070ADEEAF5901"><enum>208.</enum><header>Disparate impact</header>
<subsection id="HA44B2CBFA7D041C68691F04DBC78FE3C"><enum>(a)</enum><header>General Rule</header><text>Notwithstanding any other provision of this Act, <quote>disparate impact</quote>, as that term is used in section 703(k) of the <act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/2000e-2">42 U.S.C. 2000e–2(k)</external-xref>), on the basis of genetic information does not establish a cause of action under this Act.</text></subsection>
<subsection id="HA45E2554894746BCB9687F390673D7D6"><enum>(b)</enum><header>Commission</header><text>On the date that is 6 years after the date of enactment of this Act, there shall be established a commission, to be known as the Genetic Nondiscrimination Study Commission (referred to in this section as the <quote>Commission</quote>) to review the developing science of genetics and to make recommendations to Congress regarding whether to provide a disparate impact cause of action under this Act.</text></subsection>
<subsection id="HD52221144AFF4CDBBF6B68E7A347CF00"><enum>(c)</enum><header>Membership</header>
<paragraph id="HD35EEB44D5B349FF8D4CE000CF1706FD"><enum>(1)</enum><header>In general</header><text>The Commission shall be composed of 8 members, of which—</text>
<subparagraph id="HEA8880B7D1F64E4F9361F71BA9CE0854"><enum>(A)</enum><text>1 member shall be appointed by the Majority Leader of the Senate;</text></subparagraph>
<subparagraph id="H61319A5CA2894C1D8BAD9BFB987D0084"><enum>(B)</enum><text>1 member shall be appointed by the Minority Leader of the Senate;</text></subparagraph>
<subparagraph id="H7ACFE3198BBA4C27B85F9822889C6066"><enum>(C)</enum><text>1 member shall be appointed by the Chairman of the Committee on Health, Education, Labor, and Pensions of the Senate;</text></subparagraph>
<subparagraph id="H172114E6B17C454C003488ABFB92C8C4"><enum>(D)</enum><text>1 member shall be appointed by the ranking minority member of the Committee on Health, Education, Labor, and Pensions of the Senate;</text></subparagraph>
<subparagraph id="H2456E5B17631434E9100CDA291469800"><enum>(E)</enum><text>1 member shall be appointed by the Speaker of the House of Representatives;</text></subparagraph>
<subparagraph id="H37C7EBEBB36E497EB1E013B5ECAEB67C"><enum>(F)</enum><text>1 member shall be appointed by the Minority Leader of the House of Representatives;</text></subparagraph>
<subparagraph id="H0CC6AE707D7244F682D3733159C785E"><enum>(G)</enum><text>1 member shall be appointed by the Chairman of the Committee on Education and Labor of the House of Representatives; and</text></subparagraph>
<subparagraph id="HFB37555EC3B94E5F9841E522AF6E86E3"><enum>(H)</enum><text>1 member shall be appointed by the ranking minority member of the Committee on Education and Labor of the House of Representatives.</text></subparagraph></paragraph>
<paragraph id="HB8BEF34CE35A402EBC0665C7E2068180"><enum>(2)</enum><header>Compensation and expenses</header><text>The members of the Commission shall not receive compensation for the performance of services for the Commission, but shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/57">chapter 57</external-xref> of title 5, United States Code, while away from their homes or regular places of business in the performance of services for the Commission.</text></paragraph></subsection>
<subsection id="H3F274D4021344B36A9F61029525B58D"><enum>(d)</enum><header>Administrative Provisions</header>
<paragraph id="HC17044A3B9034010BD92A6C48208AF09"><enum>(1)</enum><header>Location</header><text>The Commission shall be located in a facility maintained by the Equal Employment Opportunity Commission.</text></paragraph>
<paragraph id="HDDBFEC504D304B4480703B2E885561BF"><enum>(2)</enum><header>Detail of government employees</header><text>Any Federal Government employee may be detailed to the Commission without reimbursement, and such detail shall be without interruption or loss of civil service status or privilege.</text></paragraph>
<paragraph id="H5516A52308AE4E79AE5E90C3770AB52"><enum>(3)</enum><header>Information from federal agencies</header><text>The Commission may secure directly from any Federal department or agency such information as the Commission considers necessary to carry out the provisions of this section. Upon request of the Commission, the head of such department or agency shall furnish such information to the Commission.</text></paragraph>
<paragraph id="H09D8A5D4D3E741A682454F409949A550"><enum>(4)</enum><header>Hearings</header><text>The Commission may hold such hearings, sit and act at such times and places, take such testimony, and receive such evidence as the Commission considers advisable to carry out the objectives of this section, except that, to the extent possible, the Commission shall use existing data and research.</text></paragraph>
<paragraph id="HE9612C2F0FB546C685FC57177324006F"><enum>(5)</enum><header>Postal services</header><text>The Commission may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government.</text></paragraph></subsection>
<subsection id="H62B0A639FB7240B2AAD577DAEB9646D5"><enum>(e)</enum><header>Report</header><text>Not later than 1 year after all of the members are appointed to the Commission under subsection (c)(1), the Commission shall submit to Congress a report that summarizes the findings of the Commission and makes such recommendations for legislation as are consistent with this Act.</text></subsection>
<subsection id="HD5FEF7AFECC5457ABFF1D7D062B4C706"><enum>(f)</enum><header>Authorization of Appropriations</header><text>There are authorized to be appropriated to the Equal Employment Opportunity Commission such sums as may be necessary to carry out this section.</text></subsection></section>
<section id="HD8EE274F9ECE4D0DB2A63FFEE2C3F146"><enum>209.</enum><header>Construction</header>
<subsection id="HB597A4EB1A324EDDAF2F77B93500D735"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Nothing in this title shall be construed to—</text>
<paragraph id="HD8CF8AB1C5A549A9834316C7609BCF98"><enum>(1)</enum><text>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 or protections provided for under this title, including the protections of an individual under the Americans with Disabilities Act of 1990 (<external-xref legal-doc="usc" parsable-cite="usc/42/12101">42 U.S.C. 12101 et seq.</external-xref>) (including coverage afforded to individuals under section 102 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/12112">42 U.S.C. 12112</external-xref>)), or under the <act-name parsable-cite="REH">Rehabilitation Act of 1973</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/29/701">29 U.S.C. 701 et seq.</external-xref>);</text></paragraph>
<paragraph id="HA6B9C8561F8844A9990932A2A1B45634"><enum>(2)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H95ECED1716BC44F29D95C8008D30E692"><enum>(A)</enum><text>limit the rights or protections of an individual to bring an action under this title against an employer, employment agency, labor organization, or joint labor-management committee for a violation of this title; or</text></subparagraph>
<subparagraph commented="no" id="HAF43FD7C634F41E384757F439549BF1E" indent="up1"><enum>(B)</enum><text>provide for enforcement of, or penalties for violation of, any requirement or prohibition applicable to any employer, employment agency, labor organization, or joint labor-management committee subject to enforcement for a violation under—</text>
<clause commented="no" id="H09C2DF136FB3405580F3A0AD3E3785AF"><enum>(i)</enum><text>the amendments made by title I of this Act;</text></clause>
<clause commented="no" id="H07AED57B80484973BB7F89E44234C86"><enum>(ii)(I)</enum><text>subsection (a) of section 701 of the Employee Retirement Income Security Act of 1974 as such section applies with respect to genetic information pursuant to subsection (b)(1)(B) of such section;</text></clause>
<clause commented="no" id="HBBCD82B0673841FE9D121B40B8CA7016"><enum>(II)</enum><text>section 702(a)(1)(F) of such Act; or</text></clause>
<clause commented="no" id="H41E53D74755F441DABDDD4FA3C009F9B"><enum>(III)</enum><text>section 702(b)(1) of such Act as such section applies with respect to genetic information as a health status-related factor;</text></clause>
<clause commented="no" id="H72B31AFB022D4612A3B9142CD7C100E9"><enum>(iii)(I)</enum><text>subsection (a) of section 2701 of the Public Health Service Act as such section applies with respect to genetic information pursuant to subsection (b)(1)(B) of such section;</text></clause>
<clause commented="no" id="HCFA87C76B5AC412A9B81566C9CC9B516"><enum>(II)</enum><text>section 2702(a)(1)(F) of such Act; or</text></clause>
<clause commented="no" id="HD007D23D6CF349F6ACD1A25D7C48FBDA"><enum>(III)</enum><text>section 2702(b)(1) of such Act as such section applies with respect to genetic information as a health status-related factor; or</text></clause>
<clause commented="no" id="H0DD2301D096A441E9380C4AFB4A9789B"><enum>(iv)(I)</enum><text>subsection (a) of <external-xref legal-doc="usc" parsable-cite="usc/26/9801">section 9801</external-xref> of the Internal Revenue Code of 1986 as such section applies with respect to genetic information pursuant to subsection (b)(1)(B) of such section;</text></clause>
<clause commented="no" id="H1BCDCBA6BD7347D18CF6AF9CCA432CD"><enum>(II)</enum><text>section 9802(a)(1)(F) of such Act; or</text></clause>
<clause commented="no" id="H0E4555A76D2B4C56972D3FA1A8CC5304"><enum>(III)</enum><text>section 9802(b)(1) of such Act as such section applies with respect to genetic information as a health status-related factor;</text></clause></subparagraph></paragraph>
<paragraph id="H003401AACD8C42A6BE342D97E68E8B4B"><enum>(3)</enum><text>apply to the Armed Forces Repository of Specimen Samples for the Identification of Remains;</text></paragraph>
<paragraph id="H8894377B78E9451692339B55F95D0012"><enum>(4)</enum><text>limit or expand the protections, rights, or obligations of employees or employers under applicable workers’ compensation laws;</text></paragraph>
<paragraph id="H428245CAD2274BE3BBF0A6481DBF2B24"><enum>(5)</enum><text>limit the authority of a Federal department or agency to conduct or sponsor occupational or other health research that is conducted in compliance with the regulations contained in part 46 of title 45, Code of Federal Regulations (or any corresponding or similar regulation or rule);</text></paragraph>
<paragraph id="HE4BB44347FCD4D38859CAEBE4770949F"><enum>(6)</enum><text>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; or</text></paragraph>
<paragraph commented="no" id="H8DCD76B59E5C434BA5C02D87F4D3AFA3"><enum>(7)</enum><text>require any specific benefit for an employee or member or a family member of an employee or member under any group health plan or health insurance issuer offering group health insurance coverage in connection with a group health plan.</text></paragraph></subsection>
<subsection id="HB4E413A4810B4D8284AFD8785F4A3BA"><enum>(b)</enum><header>Genetic information of a fetus or embryo</header><text>Any reference in this title to genetic information concerning an individual or family member of an individual shall—</text>
<paragraph id="H14ED0650B4A342EAA7CF5DBBE100AAD5"><enum>(1)</enum><text>with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and</text></paragraph>
<paragraph id="H5EFDABD2A05445418CEF522673E52D1"><enum>(2)</enum><text>with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.</text></paragraph></subsection>
<subsection id="H39B850641CBF40EFAFF6EA2C00581035"><enum>(c)</enum><header>Relation to authorities under title I</header><text>With respect to a group health plan, or a health insurance issuer offering group health insurance coverage in connection with a group health plan, this title does not prohibit any activity of such plan or issuer that is authorized for the plan or issuer under any provision of law referred to in clauses (i) through (iv) of subsection (a)(2)(B).</text></subsection></section>
<section commented="no" id="HB6B1E451B1F34322BCF4C46F576F60C"><enum>210.</enum><header>Medical information that is not genetic information</header><text display-inline="no-display-inline">An employer, employment agency, labor organization, or joint labor-management committee shall not be considered to be in violation of this title based on the use, acquisition, or disclosure of medical information that is not genetic information about a manifested disease, disorder, or pathological condition of an employee or member, including a manifested disease, disorder, or pathological condition that has or may have a genetic basis.</text></section>
<section id="HEF1D35F13CD1417BA94274DA23000676"><enum>211.</enum><header>Regulations</header><text display-inline="no-display-inline">Not later than 1 year after the date of enactment of this title, the Commission shall issue final regulations to carry out this title.</text></section>
<section id="H45BE8E2D56F847199B86A805CE2547B5"><enum>212.</enum><header>Authorization of appropriations</header><text display-inline="no-display-inline">There are authorized to be appropriated such sums as may be necessary to carry out this title (except for section 208).</text></section>
<section id="H11E4FA736D4740D696BAF9DF137A1BE"><enum>213.</enum><header>Effective date</header><text display-inline="no-display-inline">This title takes effect on the date that is 18 months after the date of enactment of this Act.</text></section>
<enum>III</enum><header>MISCELLANEOUS PROVISIONS</header>
<section commented="no" display-inline="no-display-inline" id="HC90F6A0ADF0E4E8591561B09009D5905" section-type="subsequent-section"><enum>301.</enum><header>Severability</header><text display-inline="no-display-inline">If any provision of this Act, an amendment made by this Act, or the application of such provision or amendment to any person or circumstance is held to be unconstitutional, the remainder of this Act, the amendments made by this Act, and the application of such provisions to any person or circumstance shall not be affected thereby.</text></section>
<section commented="no" display-inline="no-display-inline" id="H1F3273BBB1C4489383355150EF42D1A8" section-type="subsequent-section"><enum>302.</enum><header>Child labor protections</header>
<subsection commented="no" id="H47B8DF336C124914A5BCEEED6088245"><enum>(a)</enum><header>In general</header><text>Section 16(e) of the Fair Labor Standards Act of 1938 (<external-xref legal-doc="usc" parsable-cite="usc/29/216">29 U.S.C. 216(e)</external-xref>) is amended to read as follows:</text>
<quoted-block id="H131A05D06A6648199B39261799DA7C40" style="OLC">
<subsection commented="no" id="H20434719F63C46D58632DA00EFAC5030"><enum>(e)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="HCABECCE4EEBE4B9F95F817BCA6981376"><enum>(1)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H7EB30752307D49EA865358CB3E96A297"><enum>(A)</enum><text>Any person who violates the provisions of sections 12 or 13(c), relating to child labor, or any regulation issued pursuant to such sections, shall be subject to a civil penalty not to exceed—</text>
<clause commented="no" id="HA1E29896B7124D1A92BAF2BAFA6CF43"><enum>(i)</enum><text>$11,000 for each employee who was the subject of such a violation; or</text></clause>
<clause commented="no" id="H2D73DBFDAD7840CCB6B7254DA6CB2406"><enum>(ii)</enum><text>$50,000 with regard to each such violation that causes the death or serious injury of any employee under the age of 18 years, which penalty may be doubled where the violation is a repeated or willful violation.</text></clause></subparagraph>
<subparagraph commented="no" id="H814DFC79DCB04AFFA046B169F96C459F" indent="up2"><enum>(B)</enum><text>For purposes of subparagraph (A), the term <term>serious injury</term> means—</text>
<clause commented="no" id="H279956BB4FE546CAAF5D181BAE3B0743"><enum>(i)</enum><text>permanent loss or substantial impairment of one of the senses (sight, hearing, taste, smell, tactile sensation);</text></clause>
<clause commented="no" id="H0F4871DA5DAE4C27AD632358FF1EDCFD"><enum>(ii)</enum><text>permanent loss or substantial impairment of the function of a bodily member, organ, or mental faculty, including the loss of all or part of an arm, leg, foot, hand or other body part; or</text></clause>
<clause commented="no" id="HF2AB9B3B04A4409CA2FA9905EEC000D1"><enum>(iii)</enum><text>permanent paralysis or substantial impairment that causes loss of movement or mobility of an arm, leg, foot, hand or other body part.</text></clause></subparagraph></paragraph>
<paragraph commented="no" id="H9EECE59EB2C24A3F96BA2DC6D8D4C8FF" indent="up1"><enum>(2)</enum><text>Any person who repeatedly or willfully violates section 6 or 7, relating to wages, shall be subject to a civil penalty not to exceed $1,100 for each such violation.</text></paragraph>
<paragraph commented="no" id="H3A336882CE6B4B34A28417FDD8D69402" indent="up1"><enum>(3)</enum><text>In determining the amount of any penalty under this subsection, the appropriateness of such penalty to the size of the business of the person charged and the gravity of the violation shall be considered. The amount of any penalty under this subsection, when finally determined, may be—</text>
<subparagraph commented="no" id="H55BA92FD45E24C43B506EEF786D2D6D2"><enum>(A)</enum><text>deducted from any sums owing by the United States to the person charged;</text></subparagraph>
<subparagraph commented="no" id="H071BA3745DBD42058DBBED6CE58E32E1"><enum>(B)</enum><text>recovered in a civil action brought by the Secretary in any court of competent jurisdiction, in which litigation the Secretary shall be represented by the Solicitor of Labor; or</text></subparagraph>
<subparagraph commented="no" id="H3946B487E6784259BCC342921EC9DCD0"><enum>(C)</enum><text>ordered by the court, in an action brought for a violation of section 15(a)(4) or a repeated or willful violation of section 15(a)(2), to be paid to the Secretary.</text></subparagraph></paragraph>
<paragraph commented="no" id="HC64D7FB261104F5100E786BEDB7F51C2" indent="up1"><enum>(4)</enum><text>Any administrative determination by the Secretary of the amount of any penalty under this subsection shall be final, unless within 15 days after receipt of notice thereof by certified mail the person charged with the violation takes exception to the determination that the violations for which the penalty is imposed occurred, in which event final determination of the penalty shall be made in an administrative proceeding after opportunity for hearing in accordance with <external-xref legal-doc="usc" parsable-cite="usc/5/554">section 554</external-xref> of title 5, United States Code, and regulations to be promulgated by the Secretary.</text></paragraph>
<paragraph commented="no" id="HA35364ACBF56420AA35B15D7C03106AD" indent="up1"><enum>(5)</enum><text display-inline="yes-display-inline">Except for civil penalties collected for violations of section 12, sums collected as penalties pursuant to this section shall be applied toward reimbursement of the costs of determining the violations and assessing and collecting such penalties, in accordance with the provision of section 2 of the Act entitled <quote>An Act to authorize the Department of Labor to make special statistical studies upon payment of the cost thereof and for other purposes</quote> (<external-xref legal-doc="usc" parsable-cite="usc/29/9a">29 U.S.C. 9a</external-xref>). Civil penalties collected for violations of section 12 shall be deposited in the general fund of the Treasury.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H3FE18CEAFF594FCF006C4D5B807B9F1D"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on the date of the enactment of this Act.</text></subsection></section>
Speaker of the House of Representatives.Vice President of the United States and President of the Senate.