[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1993 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                S. 1993

   To restrict Federal funding for health care entities that do not 
               respect all human life and patient rights.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 26, 2019

Mr. Cramer (for himself, Mr. Daines, and Mrs. Blackburn) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To restrict Federal funding for health care entities that do not 
               respect all human life and patient rights.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patient Rights Act''.

SEC. 2. RESTRICTION ON FEDERAL FUNDING FOR HEALTH CARE ENTITIES THAT DO 
              NOT RESPECT ALL HUMAN LIFE AND PATIENT RIGHTS.

    (a) In General.--Subject to section 4, no funds appropriated by 
Congress for the purpose of paying (directly or indirectly, in whole or 
in part) for the provision of health care services shall be paid to any 
entity, unless the entity certifies to the Secretary of Health and 
Human Services (referred to in this Act as the ``Secretary'') that the 
entity respects all human life and patient rights by ensuring that any 
health care practitioner employed by, or utilizing the facilities or 
resources of, such entity--
            (1) exercises the same degree of professional skill, care, 
        and diligence to preserve the life and health of any patient as 
        a reasonably diligent and conscientious health care 
        practitioner would render to a patient in a different state of 
        functionality, development, or degree of dependence, including 
        a patient who is--
                    (A) unborn;
                    (B) newly born;
                    (C) born prematurely;
                    (D) pregnant;
                    (E) elderly;
                    (F) mentally or physically disabled;
                    (G) terminally ill;
                    (H) in a persistent vegetative state;
                    (I) unresponsive or comatose; or
                    (J) otherwise incapable of self-advocacy;
            (2) does not intentionally end the life of, or otherwise 
        harm, any patient, including any patient described in paragraph 
        (1), by any means or for any reason, including by the use or 
        prescription of any instrument, medicine, drug, or any other 
        substance or device; and
            (3) does not institute a do-not-resuscitate order or a 
        similar order with respect to any patient for any reason 
        without obtaining the prior consent of an applicable individual 
        described in section 4(1)(A).
    (b) Rule of Construction.--Subsection (a) describes the minimum 
standard of care required of entities described in such paragraph. 
Nothing in this subsection shall be construed as a reason for a 
practitioner to not help a patient who is in a worse or different 
condition than the cases described in paragraph (1).

SEC. 3. VIOLATIONS.

    (a) Review by the Secretary.--Beginning not later than 1 year after 
the date of enactment of this Act, the Secretary, not less frequently 
than once every 5 years, shall conduct a review of each entity that 
receives funds described in section 2 to determine whether such 
entities are in compliance with such section.
    (b) Suspected Violation Reports.--The Secretary shall establish a 
process by which--
            (1) suspected violations of section 2 may be confidentially 
        reported to the Director of the Office for Civil Rights of the 
        Department of Health and Human Services; and
            (2) the Secretary fully investigates each report received 
        under paragraph (1).
    (c) Public Database.--The Secretary shall establish and maintain a 
public, online, searchable database of the entities subject to this 
section, indicating whether each such entity is in compliance with the 
requirements of section 2.
    (d) Enforcement.--Any entity found to violate the requirements of 
section 2 shall be ineligible for funding described in such subsections 
for a period of at least 1 year. After such 1-year period, such funding 
shall be reinstated upon a review conducted by the Secretary that 
confirms that the entity is in compliance with such requirements.
    (e) Civil Action for Certain Violations.--
            (1) In general.--The Attorney General or any person 
        adversely affected by an actual or threatened violation of 
        section 2, including the parents, children, spouse, or legal 
        guardian of a patient, may, in a civil action, obtain 
        appropriate relief with regard to such violation.
            (2) Administrative remedies not required.--An action under 
        this subsection may be commenced, and relief may be granted, 
        without regard to whether the party commencing the action has 
        sought or exhausted available administrative remedies.
            (3) Defendants in actions under this section may include 
        governmental entities or others.--An action under this 
        subsection may be maintained against, among others, a party 
        that is a Federal, State, or local governmental entity. Relief 
        in an action under this paragraph may include money damages 
        even if the defendant is such a governmental entity. An action 
        under this paragraph may not be maintained against a woman upon 
        whom an abortion is performed or attempted to be performed in 
        violation of section 2.
            (4) Nature of relief.--In an action under this subsection, 
        the court shall grant--
                    (A) all necessary equitable and legal relief, 
                including, where appropriate, declaratory relief, 
                injunctive relief, civil penalties, and compensatory 
                damages, to prevent the occurrence, continuance, or 
                repetition of the actual or threatened violation of 
                section 2 and to compensate for losses resulting from 
                such violation; and
                    (B) to a prevailing plaintiff, reasonable 
                attorneys' fees and litigation expenses as part of the 
                costs.

SEC. 4. CONSTRUCTION AND TREATMENT OF CERTAIN SERVICES.

    Nothing in this Act shall be construed to apply to or to affect any 
limitation relating to--
            (1) the withholding or withdrawing of life-saving or life-
        sustaining medical treatment or medical care if--
                    (A)(i) such withholding or withdrawing is after 
                informed consent has been provided by--
                            (I) the patient;
                            (II) in the case where the patient is 
                        incapable of decision making, an individual 
                        authorized to make health care decisions on 
                        behalf of, and in the best interests of, the 
                        patient; or
                            (III) in the case where the patient is a 
                        minor, the patient and the patient's parent or 
                        legal guardian, or another individual 
                        authorized to make health care decisions on 
                        behalf of, and in the best interests of, the 
                        patient; or
                    (ii) in the case where an individual described in 
                clause (i) is not available to provide informed 
                consent, as described in such clause, the entity 
                provides sufficient opportunity for an individual 
                described in clause (i)(II) to present and provide 
                informed consent for such withholding or withdrawing; 
                and
                    (B) any individual providing informed consent as 
                described in subparagraph (A) is afforded sufficient 
                opportunity to arrange for the patient's transfer to 
                another health care provider willing to provide life-
                saving or life-sustaining medical treatment or medical 
                care that is not available in the entity;
            (2) the withholding or withdrawing of nutrition or 
        hydration if--
                    (A) such withholding or withdrawing is not for the 
                purpose of causing, or the purpose of assisting in 
                causing, death, for any reason; and
                    (B) the conditions of paragraph (1) are met;
            (3) the use of an item, good, benefit, or service furnished 
        for the purpose of alleviating pain or discomfort, even if such 
        use may increase the risk of death, so long as such item, good, 
        benefit, or service is not also furnished for the purpose of 
        causing, or the purpose of assisting in causing, death, for any 
        reason; or
            (4) any medical procedure required to prevent the death of 
        a pregnant woman or her unborn child, so long as every 
        reasonable effort is made to preserve the life of all patients.

SEC. 5. LIST OF PROGRAMS TO WHICH RESTRICTIONS APPLY.

    (a) Federal Health Care Funding Programs.--Section 2 applies to 
funds appropriated under or to carry out the following:
            (1) The Medicare program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).
            (2) The Medicaid program under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.).
            (3) Title XX of the Social Security Act (42 U.S.C. 1397 et 
        seq.).
            (4) Title V of the Social Security Act (42 U.S.C. 701 et 
        seq.).
            (5) The Public Health Service Act (42 U.S.C. 201 et seq.).
            (6) The Indian Health Care Improvement Act (25 U.S.C. 1601 
        et seq.).
            (7) The Federal Employees Health Benefits program under 
        chapter 89 of title 5, United States Code.
            (8) The Military health care system (including TRICARE and 
        CHAMPUS programs) under chapter 55 of title 10, United States 
        Code.
            (9) Veterans medical care under chapter 17 of title 38, 
        United States Code.
            (10) Health services for Peace Corps volunteers under 
        section 5(e) of the Peace Corps Act (22 U.S.C. 2504(e)).
            (11) Medical services for Federal prisoners under section 
        4005(a) of title 18, United States Code.
            (12) The Patient Protection and Affordable Care Act (Public 
        Law 111-148).
    (b) Federal Facilities and Personnel.--The provisions of section 2 
apply to facilities and personnel of the following:
            (1) The Department of Defense operating under chapter 55 of 
        title 10, United States Code.
            (2) The Veterans Health Administration of the Department of 
        Veterans Affairs.
            (3) The Public Health Service.
    (c) Nonexclusive List.--Nothing in this section shall be construed 
as limiting the application of section 2 to the programs specified in 
subsection (a) or the facilities and personnel specified in subsection 
(b).

SEC. 6. RELATION TO OTHER LAWS.

    The provisions of this Act supersede other Federal laws (including 
laws enacted after the date of the enactment of this Act) except to the 
extent such laws specifically supersede the provisions of this Act.

SEC. 7. EFFECTIVE DATE.

    (a) In General.--The provisions of this Act take effect on the 
dates of enactment of this Act and apply to Federal payments made 
pursuant to obligations incurred after the date of the enactment of 
this Act.
    (b) Application to Contracts.--Such provisions shall apply with 
respect to contracts entered into, renewed, or extended after the date 
of the enactment of this Act and shall also apply to a contract entered 
into before such date to the extent permitted under such contract.
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