Amends ERISA and the PHSA to: (1) declare that the provisions of paragraph above do not preempt any provision of State law that protects genetic information confidentiality or privacy, or prohibits genetic discrimination, more completely than ERISA's and the PHSA's group health plan provisions; and (2) apply the requirements of the paragraph above to Medicare supplemental health insurance and similar supplemental coverage, if provided under a separate policy, certificate, or contract of insurance.
Amends the PHSA to disallow nonfederal governmental group plans from electing to be exempted from the requirements of this title.
Title II: Prohibition of Employment Discrimination on the Basis of Predictive Genetic Information - Makes it an unlawful employment practice for an employer, employment agency, labor organization, or training program to discriminate because of predictive genetic information, including making it unlawful to request, require, collect, or purchase such information.
Allows an employer to request, require, collect, or purchase such information: (1) where used for genetic monitoring of biological effects of workplace toxic substances; or (2) with consent of the employee, if results are received only by the employee (or the employee's family).
(Sec. 206) Requires employers possessing such information to treat and maintain the information as part of the employee's confidential medical records. Prohibits disclosure, subject to exception.
(Sec. 207) Empowers one or more employees, labor organization members, or training participants to bring an action in Federal or State court for violations. Applies to the Equal Employment Opportunity Commission (EEOC), for enforcement of this title, the powers, remedies, and procedures under specified provisions of the Civil Rights Act of 1964. Allows a court to award any appropriate legal or equitable relief, attorney's fees and costs, and costs of experts.
(Sec. 209) Authorizes appropriations to carry out this title.
[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1322 Introduced in Senate (IS)]
106th CONGRESS
1st Session
S. 1322
To prohibit health insurance and employment discrimination against
individuals and their family members on the basis of predictive genetic
information or genetic services.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 1, 1999
Mr. Daschle (for himself, Mr. Harkin, Mr. Dodd, and Mr. Kennedy)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To prohibit health insurance and employment discrimination against
individuals and their family members on the basis of predictive genetic
information or genetic services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Genetic Nondiscrimination in Health
Insurance and Employment Act of 1999''.
TITLE I--PROHIBITION OF HEALTH INSURANCE DISCRIMINATION ON THE BASIS OF
PREDICTIVE GENETIC INFORMATION
SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF
1974.
(a) Prohibition of Health Insurance Discrimination on the Basis of
Genetic Services or Predictive Genetic Information.--
(1) No enrollment restriction for genetic services.--
Section 702(a)(1)(F) of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1182(a)(1)(F)) is amended by inserting
before the period ``(or information about a request for or the
receipt of genetic services by such individual or family member
of such individual)''.
(2) No discrimination in group rate based on predictive
genetic information.--
(A) In general.--Subpart B of Part 7 of subtitle B
of title I of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1185 et seq.) is amended by
adding at the end the following:
``SEC. 714. PROHIBITING DISCRIMINATION AGAINST GROUPS ON THE BASIS OF
PREDICTIVE GENETIC INFORMATION.
``A group health plan, and a health insurance issuer offering group
health insurance coverage in connection with a group health plan, shall
not deny eligibility to a group or adjust premium or contribution rates
for a group on the basis of predictive genetic information concerning
an individual in the group (or information about a request for or the
receipt of genetic services by such individual or family member of such
individual).''.
(B) Conforming amendments.--
(i) Section 702(b)(2)(A) of the Employee
Retirement Income Security Act of 1974 (29
U.S.C. 1182(b)) is amended to read as follows:
``(A) to restrict the amount that an employer may
be charged for coverage under a group health plan,
except as provided in section 714; or''.
(ii) Section 732(a) of the Employee
Retirement Income Security Act of 1974 (29
U.S.C. 1191a(a)) is amended by striking
``section 711'' and inserting ``subsections
(a)(1)(F), (b) (with respect to cases relating
to genetic information or information about a
request or receipt of genetic services by an
individual or family member of such
individual), (c), (d), (e), (f), or (g) of
section 702, section 711 and section 714''.
(b) Limitations on Genetic Testing and on Collection and Disclosure
of Predictive Genetic Information.--Section 702 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1182) is amended by
adding at the end the following:
``(c) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A group health plan, or a health insurance issuer
offering health insurance coverage in connection with a group
health plan, shall not request or require an individual or a
family member of such individual to undergo a genetic test.
``(2) Rule of construction.--Nothing in this title shall be
construed to limit the authority of a health care professional,
who is providing treatment with respect to an individual and
who is employed by a group health plan or a health insurance
issuer, to request that such individual or family member of
such individual undergo a genetic test. Such a health care
professional shall not require that such individual or family
member undergo a genetic test.
``(d) Collection of Predictive Genetic Information.--Except as
provided in subsections (f) and (g), a group health plan, or a health
insurance issuer offering health insurance coverage in connection with
a group health plan, shall not request, require, collect, or purchase
predictive genetic information concerning an individual (or information
about a request for or the receipt of genetic services by such
individual or family member of such individual).
``(e) Disclosure of Predictive Genetic Information.--A group health
plan, or a health insurance issuer offering health insurance coverage
in connection with a group health plan, shall not disclose predictive
genetic information about an individual (or information about a request
for or the receipt of genetic services by such individual or family
member of such individual) to--
``(1) any entity that is a member of the same controlled
group as such issuer or plan sponsor of such group health plan;
``(2) any other group health plan or health insurance
issuer or any insurance agent, third party administrator, or
other person subject to regulation under State insurance laws;
``(3) the Medical Information Bureau or any other person
that collects, compiles, publishes, or otherwise disseminates
insurance information;
``(4) the individual's employer or any plan sponsor; or
``(5) any other person the Secretary may specify in
regulations.
``(f) Information for Payment for Genetic Services.--
``(1) In general.--With respect to payment for genetic
services conducted concerning an individual or the coordination
of benefits, a group health plan, or a health insurance issuer
offering group health insurance coverage in connection with a
group health plan, may request that the individual provide the
plan or issuer with evidence that such services were performed.
``(2) Rule of construction.--Nothing in paragraph (1) shall
be construed to--
``(A) permit a group health plan or health
insurance issuer to request (or require) the results of
the services referred to in such paragraph; or
``(B) require that a group health plan or health
insurance issuer make payment for services described in
such paragraph where the individual involved has
refused to provide evidence of the performance of such
services pursuant to a request by the plan or issuer in
accordance with such paragraph.
``(g) Information for Payment of Other Claims.--With respect to the
payment of claims for benefits other than genetic services, a group
health plan, or a health insurance issuer offering group health
insurance coverage in connection with a group health plan, may request
that an individual provide predictive genetic information so long as
such information--
``(1) is used solely for the payment of a claim;
``(2) is limited to information that is directly related to
and necessary for the payment of such claim and the claim would
otherwise be denied but for the predictive genetic information;
and
``(3) is used only by an individual (or individuals) within
such plan or issuer who needs access to such information for
purposes of payment of a claim.
``(h) Rules of Construction.--
``(1) Collection or disclosure authorized by individual.--
The provisions of subsections (d) (regarding collection) and
(e) shall not apply to an individual if the individual (or
legal representative of the individual) provides prior,
knowing, voluntary, and written authorization for the
collection or disclosure of predictive genetic information.
``(2) Disclosure for health care treatment.--Nothing in
this section shall be construed to limit or restrict the
disclosure of predictive genetic information from a health care
provider to another health care provider for the purpose of
providing health care treatment to the individual involved.
``(i) Definitions.--In this section:
``(1) Controlled group.--The term `controlled group' means
any group treated as a single employer under subsections (b),
(c), (m), or (o)of section 414 of the Internal Revenue Code of
1986.
``(2) Group health plan, health insurance issuer.--The
terms `group health plan' and `health insurance issuer' include
a third party administrator or other person acting for or on
behalf of such plan or issuer.''.
(c) Enforcement.--Section 502 (29 U.S.C. 1132) is amended by adding
at the end the following:
``(n) Violation of Genetic Discrimination or Genetic Disclosure
Provisions.--In any action under this section against any administrator
of a group health plan, or health insurance issuer offering group
health insurance coverage in connection with a group health plan
(including any third party administrator or other person acting for or
on behalf of such plan or issuer) alleging a violation of subsection
(a)(1)(F), (b) (with respect to cases relating to genetic information
or information about a request or receipt of genetic services by an
individual or family member of such individual), (c), (d), (e), (f), or
(g) of section 702, or section 714, the court may award any appropriate
legal or equitable relief. Such relief may include a requirement for
the payment of attorney's fees and costs, including the costs of expert
witnesses.
``(o) Civil Penalty.--The monetary provisions of section
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for
purposes of the Secretary enforcing the provisions referred to in
subsection (n), except that any such relief awarded shall be paid only
into the general fund of the Treasury.''.
(d) Preemption.--Section 731 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1191) is amended--
(1) in subsection (a)(1), by inserting ``or (e)'' after
``subsection (b)''; and
(2) by adding at the end the following:
``(e) Special Rule in Case of Genetic Information.--With respect to
group health insurance coverage offered by a health insurance issuer,
the provisions of this part relating to genetic information (including
information about a request for or the receipt of genetic services by
an individual or a family member of such individual) shall not be
construed to supersede any provision of State law which establishes,
implements, or continues in effect a standard, requirement, or remedy
that more completely--
``(1) protects the confidentiality of genetic information
(including information about a request for or the receipt of
genetic services by an individual or a family member of such
individual) or the privacy of an individual or a family member
of the individual with respect to genetic information
(including information about a request for or the receipt of
genetic services by an individual or a family member of such
individual) than does this part; or
``(2) prohibits discrimination on the basis of genetic
information than does this part.''.
(e) Definitions.--Section 733(d) of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1191b(d)) is amended by adding at the
end the following:
``(5) Family member.--The term `family member' means with
respect to an individual--
``(A) the spouse of the individual;
``(B) a dependent child of the individual,
including a child who is born to or placed for adoption
with the individual; and
``(C) all other individuals related by blood to the
individual or the spouse or child described in
subparagraph (A) or (B).
``(6) Genetic information.--The term `genetic information'
means information about genes, gene products, or inherited
characteristics that may derive from an individual or a family
member of such individual (including information about a
request for or the receipt of genetic services by such
individual or family member of such individual).
``(7) Genetic services.--The term `genetic services' means
health services, including genetic tests, provided to obtain,
assess, or interpret genetic information for diagnostic and
therapeutic purposes, and for genetic education and counseling.
``(8) Genetic test.--The term `genetic test' means the
analysis of human DNA, RNA, chromosomes, proteins, and certain
metabolites in order to detect genotypes, mutations, or
chromosomal changes.
``(9) Predictive genetic information.--
``(A) In general.--The term `predictive genetic
information' means--
``(i) information about an individual's
genetic tests;
``(ii) information about genetic tests of
family members of the individual; or
``(iii) information about the occurrence of
a disease or disorder in family members.
``(B) Limitations.--The term `predictive genetic
information' shall not include--
``(i) information about the sex or age of
the individual;
``(ii) information about chemical, blood,
or urine analyses of the individual, unless
these analyses are genetic tests; or
``(iii) information about physical exams of
the individual, and other information relevant
to determining the current health status of the
individual.''.
(f) Amendment Concerning Supplemental Excepted Benefits.--Section
732(c)(3) of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1191a(c)(3)) is amended by inserting ``, other than the
requirements of subsections (a)(1)(F), (b) (in cases relating to
genetic information or information about a request for or the receipt
of genetic services by an individual or a family member of such
individual), (c), (d), (e), (f) and (g) of section 702 and section
714,'' after ``The requirements of this part''.
(g) Effective Date.--
(1) In general.--Except as provided in this section, this
section and the amendments made by this section shall apply
with respect to group health plans for plan years beginning
after October 1, 2000.
(2) Special rule for collective bargaining agreements.--In
the case of a group health plan maintained pursuant to one or
more collective bargaining agreements between employee
representatives and one or more employers ratified before the
date of the enactment of this Act, this section and the
amendments made by this section shall not apply to plan years
beginning before the later of--
(A) the date on which the last of the collective
bargaining agreements relating to the plan terminates
(determined without regard to any extension thereof
agreed to after the date of the enactment of this Act),
or
(B) October 1, 2000.
For purposes of subparagraph (A), any plan amendment made
pursuant to a collective bargaining agreement relating to the
plan which amends the plan solely to conform to any requirement
of the amendments made by this section shall not be treated as
a termination of such collective bargaining agreement.
SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
(a) Amendments Relating to the Group Market.--
(1) Prohibition of health insurance discrimination on the
basis of predictive genetic information or genetic services.--
(A) No enrollment restriction for genetic
services.--Section 2702(a)(1)(F) of the Public Health
Service Act (42 U.S.C. 300gg-1(a)(1)(F)) is amended by
inserting before the period the following: ``(or
information about a request for or the receipt of
genetic services by an individual or a family member of
such individual)''.
(B) No discrimination in group rate based on
predictive genetic information.--
(i) In general.--Subpart 2 of part A of
title XXVII of the Public Health Service (42
U.S.C. 300gg-4 et seq.) is amended by adding at
the end the following:
``SEC. 2707. PROHIBITING DISCRIMINATION AGAINST GROUPS ON THE BASIS OF
PREDICTIVE GENETIC INFORMATION.
``A group health plan, and a health insurance issuer offering group
health insurance coverage in connection with a group health plan, shall
not deny eligibility to a group or adjust premium or contribution rates
for a group on the basis of predictive genetic information concerning
an individual in the group (or information about a request for or the
receipt of genetic services by such individual or family member of such
individual).''.
(ii) Conforming amendments.--
(I) Section 2702(b)(2)(A) of the
Public Health Service Act (42 U.S.C.
300gg-1(b)(2)(A)) is amended to read as
follows:
``(A) to restrict the amount that an employer may
be charged for coverage under a group health plan,
except as provided in section 2707; or''.
(II) Section 2721(a) of the Public
Health Service Act (42 U.S.C. 300gg-
21(a)) is amended by inserting ``(other
than subsections (a)(1)(F), (b) (with
respect to cases relating to genetic
information or information about a
request or receipt of genetic services
by an individual or family member of
such individual), (c), (d), (e), (f),
or (g) of section 2702 and section
2707)'' after ``subparts 1 and 3''.
(2) Limitations on genetic testing and on collection and
disclosure of predictive genetic information.--Section 2702 of
the Public Health Service Act (42 U.S.C. 300gg-1) is amended by
adding at the end the following:
``(c) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A group health plan, or a health insurance issuer
offering health insurance coverage in connection with a group
health plan, shall not request or require an individual or a
family member of such individual to undergo a genetic test.
``(2) Rule of construction.--Nothing in this title shall be
construed to limit the authority of a health care professional,
who is providing treatment with respect to an individual and
who is employed by a group health plan or a health insurance
issuer, to request that such individual or family member of
such individual undergo a genetic test. Such a health care
professional shall not require that such individual or family
member undergo a genetic test.
``(d) Collection of Predictive Genetic Information.--Except as
provided in subsections (f) and (g), a group health plan, or a health
insurance issuer offering health insurance coverage in connection with
a group health plan, shall not request, require, collect, or purchase
predictive genetic information concerning an individual (or information
about a request for or the receipt of genetic services by such
individual or family member of such individual).
``(e) Disclosure of Predictive Genetic Information.--A group health
plan, or a health insurance issuer offering health insurance coverage
in connection with a group health plan, shall not disclose predictive
genetic information about an individual (or information about a request
for or the receipt of genetic services by such individual or family
member of such individual) to--
``(1) any entity that is a member of the same controlled
group as such issuer or plan sponsor of such group health plan;
``(2) any other group health plan or health insurance
issuer or any insurance agent, third party administrator, or
other person subject to regulation under State insurance laws;
``(3) the Medical Information Bureau or any other person
that collects, compiles, publishes, or otherwise disseminates
insurance information;
``(4) the individual's employer or any plan sponsor; or
``(5) any other person the Secretary may specify in
regulations.
``(f) Information for Payment for Genetic Services.--
``(1) In general.--With respect to payment for genetic
services conducted concerning an individual or the coordination
of benefits, a group health plan, or a health insurance issuer
offering group health insurance coverage in connection with a
group health plan, may request that the individual provide the
plan or issuer with evidence that such services were performed.
``(2) Rule of construction.--Nothing in paragraph (1) shall
be construed to--
``(A) permit a group health plan or health
insurance issuer to request (or require) the results of
the services referred to in such paragraph; or
``(B) require that a group health plan or health
insurance issuer make payment for services described in
such paragraph where the individual involved has
refused to provide evidence of the performance of such
services pursuant to a request by the plan or issuer in
accordance with such paragraph.
``(g) Information for Payment of Other Claims.--With respect to the
payment of claims for benefits other than genetic services, a group
health plan, or a health insurance issuer offering group health
insurance coverage in connection with a group health plan, may request
that an individual provide predictive genetic information so long as
such information--
``(1) is used solely for the payment of a claim;
``(2) is limited to information that is directly related to
and necessary for the payment of such claim and the claim would
otherwise be denied but for the predictive genetic information;
and
``(3) is used only by an individual (or individuals) within
such plan or issuer who needs access to such information for
purposes of payment of a claim.
``(h) Rules of Construction.--
``(1) Collection or disclosure authorized by individual.--
The provisions of subsections (d) (regarding collection) and
(e) shall not apply to an individual if the individual (or
legal representative of the individual) provides prior,
knowing, voluntary, and written authorization for the
collection or disclosure of predictive genetic information.
``(2) Disclosure for health care treatment.--Nothing in
this section shall be construed to limit or restrict the
disclosure of predictive genetic information from a health care
provider to another health care provider for the purpose of
providing health care treatment to the individual involved.
``(i) Definitions.--In this section:
``(1) Controlled group.--The term `controlled group' means
any group treated as a single employer under subsections (b),
(c), (m), or (o) of section 414 of the Internal Revenue Code of
1986.
``(2) Group health plan, health insurance issuer.--The
terms `group health plan' and `health insurance issuer' include
a third party administrator or other person acting for or on
behalf of such plan or issuer.''.
(3) Definitions.--Section 2791(d) of the Public Health
Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at the
end the following new paragraphs:
``(15) Family member.--The term `family member' means with
respect to an individual--
``(A) the spouse of the individual;
``(B) a dependent child of the individual,
including a child who is born to or placed for adoption
with the individual; and
``(C) all other individuals related by blood to the
individual or the spouse or child described in
subparagraph (A) or (B).
``(16) Genetic information.--The term `genetic information'
means information about genes, gene products, or inherited
characteristics that may derive from an individual or a family
member of such individual (including information about a
request for or the receipt of genetic services by such
individual or family member of such individual).
``(17) Genetic services.--The term `genetic services' means
health services, including genetic tests, provided to obtain,
assess, or interpret genetic information for diagnostic and
therapeutic purposes, and for genetic education and
counselling.
``(18) Genetic test.--The term `genetic test' means the
analysis of human DNA, RNA, chromosomes, proteins, and certain
metabolites in order to detect genotypes, mutations, or
chromosomal changes.
``(19) Predictive genetic information.--
``(A) In general.--The term `predictive genetic
information' means--
``(i) information about an individual's
genetic tests;
``(ii) information about genetic tests of
family members of the individual; or
``(iii) information about the occurrence of
a disease or disorder in family members.
``(B) Limitations.--The term `predictive genetic
information' shall not include--
``(i) information about the sex or age of
the individual;
``(ii) information about chemical, blood,
or urine analyses of the individual, unless
these analyses are genetic tests; or
``(iii) information about physical exams of
the individual, and other information relevant
to determining the current health status of the
individual.''.
(b) Amendment Relating to the Individual Market.--The first subpart
3 of part B of title XXVII of the Public Health Service Act (42 U.S.C.
300gg-51 et seq.) is amended--
(1) by redesignating such subpart as subpart 2; and
(2) by adding at the end the following:
``SEC. 2753. PROHIBITION OF HEALTH INSURANCE DISCRIMINATION AGAINST
INDIVIDUALS ON THE BASIS OF PREDICTIVE GENETIC
INFORMATION.
``(a) In Eligibility To Enroll.--A health insurance issuer offering
health insurance coverage in the individual market shall not establish
rules for eligibility to enroll in individual health insurance coverage
that are based on predictive genetic information concerning the
individual (or information about a request for or the receipt of
genetic services by such individual or family member of such
individual).
``(b) In Premium Rates.--A health insurance issuer offering health
insurance coverage in the individual market shall not adjust premium
rates on the basis of predictive genetic information concerning an
individual (or information about a request for or the receipt of
genetic services by such individual or family member of such
individual).
``SEC. 2754. LIMITATIONS ON GENETIC TESTING AND ON COLLECTION AND
DISCLOSURE OF PREDICTIVE GENETIC INFORMATION.
``(a) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A health insurance issuer offering health insurance
coverage in the individual market shall not request or require
an individual or a family member of such individual to undergo
a genetic test.
``(2) Rule of construction.--Nothing in this title shall be
construed to limit the authority of a health care professional,
who is providing treatment with respect to an individual and
who is employed by a group health plan or a health insurance
issuer, to request that such individual or family member of
such individual undergo a genetic test. Such a health care
professional shall not require that such individual or family
member undergo a genetic test.
``(b) Collection of Predictive Genetic Information.--Except as
provided in subsections (d) and (e), a health insurance issuer offering
health insurance coverage in the individual market shall not request,
require, collect, or purchase predictive genetic information concerning
an individual (or information about a request for or the receipt of
genetic services by such individual or family member of such
individual).
``(c) Disclosure of Predictive Genetic Information.--A health
insurance issuer offering health insurance coverage in the individual
market shall not disclose predictive genetic information about an
individual (or information about a request for or the receipt of
genetic services by such individual or family member of such
individual) to--
``(1) any entity that is a member of the same controlled
group as such issuer or plan sponsor of such group health plan;
``(2) any other group health plan or health insurance
issuer or any insurance agent, third party administrator, or
other person subject to regulation under State insurance laws;
``(3) the Medical Information Bureau or any other person
that collects, compiles, publishes, or otherwise disseminates
insurance information;
``(4) the individual's employer or any plan sponsor; or
``(5) any other person the Secretary may specify in
regulations.
``(d) Information for Payment for Genetic Services.--
``(1) In general.--With respect to payment for genetic
services conducted concerning an individual or the coordination
of benefits, a health insurance issuer offering health
insurance coverage in the individual market may request that
the individual provide the plan or issuer with evidence that
such services were performed.
``(2) Rule of construction.--Nothing in paragraph (1) shall
be construed to--
``(A) permit a health insurance issuer to request
(or require) the results of the services referred to in
such paragraph; or
``(B) require that a health insurance issuer make
payment for services described in such paragraph where
the individual involved has refused to provide evidence
of the performance of such services pursuant to a
request by the plan or issuer in accordance with such
paragraph.
``(e) Information for Payment of Other Claims.--With respect to the
payment of claims for benefits other than genetic services, a health
insurance issuer offering health insurance coverage in the individual
market may request that an individual provide predictive genetic
information so long as such information--
``(1) is used solely for the payment of a claim;
``(2) is limited to information that is directly related to
and necessary for the payment of such claim and the claim would
otherwise be denied but for the predictive genetic information;
and
``(3) is used only by an individual (or individuals) within
such plan or issuer who needs access to such information for
purposes of payment of a claim.
``(f) Rules of Construction.--
``(1) Collection or disclosure authorized by individual.--
The provisions of subsections (c) (regarding collection) and
(d) shall not apply to an individual if the individual (or
legal representative of the individual) provides prior,
knowing, voluntary, and written authorization for the
collection or disclosure of predictive genetic information.
``(2) Disclosure for health care treatment.--Nothing in
this section shall be construed to limit or restrict the
disclosure of predictive genetic information from a health care
provider to another health care provider for the purpose of
providing health care treatment to the individual involved.
``(g) Definitions.--In this section:
``(1) Controlled group.--The term `controlled group' means
any group treated as a single employer under subsections (b),
(c), (m), or (o) of section 414 of the Internal Revenue Code of
1986.
``(2) Group health plan, health insurance issuer.--The
terms `group health plan' and `health insurance issuer' include
a third party administrator or other person acting for or on
behalf of such plan or issuer.''.
(c) Enforcement.--
(1) Group plans.--Section 2722 of the Public Health Service
Act (42 U.S.C. 300gg-22) is amended by adding at the end the
following:
``(c) Violation of Genetic Discrimination or Genetic Disclosure
Provisions.--In any action under this section against any administrator
of a group health plan, or health insurance issuer offering group
health insurance coverage in connection with a group health plan
(including any third party administrator or other person acting for or
on behalf of such plan or issuer) alleging a violation of subsections
(a)(1)(F), (b) (with respect to cases relating to genetic information
or information about a request or receipt of genetic services by an
individual or family member of such individual), (c), (d), (e), (f), or
(g) of section 2702 and section 2707 the court may award any
appropriate legal or equitable relief. Such relief may include a
requirement for the payment of attorney's fees and costs, including the
costs of expert witnesses.
``(d) Civil Penalty.--The monetary provisions of section
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for
purposes of the Secretary enforcing the provisions referred to in
subsection (c), except that any such relief awarded shall be paid only
into the general fund of the Treasury.''.
(2) Individual plans.--Section 2761 of the Public Health
Service Act (42 U.S.C. 300gg-45) is amended by adding at the
end the following:
``(c) Violation of Genetic Discrimination or Genetic Disclosure
Provisions.--In any action under this section against any health
insurance issuer offering health insurance coverage in the individual
market (including any other person acting for or on behalf of such
issuer) alleging a violation of section 2753 and 2754 the court in
which the action is commenced may award any appropriate legal or
equitable relief. Such relief may include a requirement for the payment
of attorney's fees and costs, including the costs of expert witnesses.
``(d) Civil Penalty.--The monetary provisions of section
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for
purposes of the Secretary enforcing the provisions referred to in
subsection (c), except that any such relief awarded shall be paid only
into the general fund of the Treasury.''.
(d) Preemption.--
(1) Group market.--Section 2723 of the Public Health
Service Act (42 U.S.C. 300gg-23) is amended--
(A) in subsection (a)(1), by inserting ``or (e)''
after ``subsection (b)''; and
(B) by adding at the end the following:
``(e) Special Rule in Case of Genetic Information.--With respect to
group health insurance coverage offered by a health insurance issuer,
the provisions of this part relating to genetic information (including
information about a request for or the receipt of genetic services by
an individual or a family member of such individual) shall not be
construed to supersede any provision of State law which establishes,
implements, or continues in effect a standard, requirement, or remedy
that more completely--
``(1) protects the confidentiality of genetic information
(including information about a request for or the receipt of
genetic services by an individual or a family member of such
individual) or the privacy of an individual or a family member
of the individual with respect to genetic information
(including information about a request for or the receipt of
genetic services by an individual or a family member of such
individual); or
``(2) prohibits discrimination on the basis of genetic
information than does this part.''.
(2) Individual market.--Section 2762 of the Public Health
Service Act (42 U.S.C. 300gg-46) is amended--
(A) in subsection (a), by inserting ``and except as
provided in subsection (c),'' after ``Subject to
subsection (b),''; and
(B) by adding at the end the following:
``(c) Special Rule in Case of Genetic Information.--With respect to
individual health insurance coverage offered by a health insurance
issuer, the provisions of this part (or part C insofar as it applies to
this part) relating to genetic information (including information about
a request for or the receipt of genetic services by an individual or a
family member of such individual) shall not be construed to supersede
any provision of State law (as defined in section 2723(d)) which
establishes, implements, or continues in effect a standard,
requirement, or remedy that more completely--
``(1) protects the confidentiality of genetic information
(including information about a request for or the receipt of
genetic services of an individual or a family member of such
individual) or the privacy of an individual or a family member
of the individual with respect to genetic information
(including information about a request for or the receipt of
genetic services by an individual or a family member of such
individual) than does this part (or part C insofar as it
applies to this part); or
``(2) prohibits discrimination on the basis of genetic
information than does this part (or part C insofar as it
applies to this part).''.
(e) Elimination of Option of Non-Federal Governmental Plans To Be
Excepted From Requirements Concerning Genetic Information.--Section
2721(b)(2) of the Public Health Service Act (42 U.S. C. 300gg-21(b)(2))
is amended--
(1) in subparagraph (A), by striking ``If the plan
sponsor'' and inserting ``Except as provided in subparagraph
(D), if the plan sponsor''; and
(2) by adding at the end the following:
``(D) Election not applicable to requirements
concerning genetic information.--The election described
in subparagraph (A) shall not be available with respect
to the provisions of subsections (a)(1)(F), (c), (d),
(e), (f), and (g) of section 2702 and section 2707, and
the provisions of section 2702(b) to the extent that
they apply to genetic information (or information about
a request for or the receipt of genetic services by an
individual or a family member of such individual).''.
(f) Amendment Concerning Supplemental Excepted Benefits.--
(1) Group market.--Section 2721(d)(3) of the Public Health
Service Act (42 U.S.C. 300gg-23(d)(3)) is amended by inserting
``, other than the requirements of subsections (a)(1)(F), (b)
(in cases relating to genetic information or information about
a request for or the receipt of genetic services by an
individual or a family member of such individual)), (c), (d),
(e), (f) and (g) of section 2702 and section 2707,'' after
``The requirements of this part''.
(2) Individual market.--Section 2763(b) of the Public
Health Service Act (42 U.S.C. 300gg-47(b)) is amended--
(A) by striking ``The requirements of this part''
and inserting the following:
``(1) In general.--Except as provided in paragraph (2), the
requirements of this part''; and
(B) by adding at the end the following:
``(2) Limitation.--The requirements of sections 2753 and
2754 shall apply to excepted benefits described in section
2791(c)(4).''.
(g) Effective Date.--
(1) In general.--The amendments made by this section shall
apply with respect to--
(A) group health plans, and health insurance
coverage offered in connection with group health plans,
for plan years beginning; and
(B) health insurance coverage offered, sold,
issued, renewed, in effect, or operated in the
individual market, after;
October 1, 2000.
(2) Special rule for collective bargaining agreements.--In
the case of a group health plan maintained pursuant to one or
more collective bargaining agreements between employee
representatives and one or more employers ratified before the
date of the enactment of this Act, the amendments made by this
section shall not apply to plan years beginning before the
later of--
(A) the date on which the last of the collective
bargaining agreements relating to the plan terminates
(determined without regard to any extension thereof
agreed to after the date of the enactment of this Act);
or
(B) October 1, 2000.
For purposes of subparagraph (A), any plan amendment made
pursuant to a collective bargaining agreement relating to the
plan which amends the plan solely to conform to any requirement
of the amendments made by this section shall not be treated as
a termination of such collective bargaining agreement.
SEC. 103. AMENDMENTS TO INTERNAL REVENUE CODE OF 1986.
(a) Prohibition of Health Insurance Discrimination on the Basis of
Genetic Services or Predictive Genetic Information.--
(1) No enrollment restriction for genetic services.--
Section 9802(a)(1)(F) of the Internal Revenue Code of 1986 is
amended by inserting before the period ``(or information about
a request for or the receipt of genetic services by such
individual or family member of such individual)''.
(2) No discrimination in group rate based on predictive
genetic information.--
(A) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at
the end the following:
``SEC. 9813. PROHIBITING DISCRIMINATION AGAINST GROUPS ON THE BASIS OF
PREDICTIVE GENETIC INFORMATION.
``A group health plan shall not deny eligibility to a group or
adjust premium or contribution rates for a group on the basis of
predictive genetic information concerning an individual in the group
(or information about a request for or the receipt of genetic services
by such individual or family member of such individual).''.
(B) Conforming amendments.--
(i) Section 9802(b)(2)(A) of the Internal
Revenue Code of 1986 is amended to read as
follows:
``(A) to restrict the amount that an employer may
be charged for coverage under a group health plan,
except as provided in section 9813; or''.
(ii) Section 9831(a) of the Internal
Revenue Code of 1986 is amended by inserting
``(other than subsections (a)(1)(F), (b) (with
respect to cases relating to genetic
information or information about a request for
or receipt of genetic services by an individual
or family member of such individual), (d) (e),
(f), (g) or (h) of section 9802 or section
9813) after ``chapter''.
(b) Limitations on Genetic Testing and on Collection and Disclosure
of Predictive Genetic Information.--Section 9802 of the Internal
Revenue Code of 1986 is amended by adding at the end the following:
``(d) Genetic Testing.--
``(1) Limitation on requesting or requiring genetic
testing.--A group health plan shall not request or require an
individual or a family member of such individual to undergo a
genetic test.
``(2) Rule of construction.--Nothing in this title shall be
construed to limit the authority of a health care professional,
who is providing treatment with respect to an individual and
who is employed by a group health plan, to request that such
individual or family member of such individual undergo a
genetic test. Such a health care professional shall not require
that such individual or family member undergo a genetic test.
``(e) Collection of Predictive Genetic Information.--Except as
provided in subsections (g) and (h), a group health plan shall not
request, require, collect, or purchase predictive genetic information
concerning an individual (or information about a request for or the
receipt of genetic services by such individual or family member of such
individual).
``(f) Disclosure of Predictive Genetic Information.--A group health
plan shall not disclose predictive genetic information about an
individual (or information about a request for or the receipt of
genetic services by such individual or family member of such
individual) to--
``(1) any entity that is a member of the same controlled
group as such issuer or plan sponsor of such group health plan;
``(2) any other group health plan or health insurance
issuer or any insurance agent, third party administrator, or
other person subject to regulation under State insurance laws;
``(3) the Medical Information Bureau or any other person
that collects, compiles, publishes, or otherwise disseminates
insurance information;
``(4) the individual's employer or any plan sponsor; or
``(5) any other person the Secretary may specify in
regulations.
``(g) Information for Payment for Genetic Services.--
``(1) In general.--With respect to payment for genetic
services conducted concerning an individual or the coordination
of benefits, a group health plan may request that the
individual provide the plan with evidence that such services
were performed.
``(2) Rule of construction.--Nothing in paragraph (1) shall
be construed to--
``(A) permit a group health plan to request (or
require) the results of the services referred to in
such paragraph; or
``(B) require that a group health plan make payment
for services described in such paragraph where the
individual involved has refused to provide evidence of
the performance of such services pursuant to a request
by the plan in accordance with such paragraph.
``(h) Information for Payment of Other Claims.--With respect to the
payment of claims for benefits other than genetic services, a group
health plan may request that an individual provide predictive genetic
information so long as such information--
``(1) is used solely for the payment of a claim;
``(2) is limited to information that is directly related to
and necessary for the payment of such claim and the claim would
otherwise be denied but for the predictive genetic information;
and
``(3) is used only by an individual (or individuals) within
such plan or issuer who needs access to such information for
purposes of payment of a claim.
``(i) Rules of Construction.--
``(1) Collection or disclosure authorized by individual.--
The provisions of subsections (e) (regarding collection) and
(f) shall not apply to an individual if the individual (or
legal representative of the individual) provides prior,
knowing, voluntary, and written authorization for the
collection or disclosure of predictive genetic information.
``(2) Disclosure for health care treatment.--Nothing in
this section shall be construed to limit or restrict the
disclosure of predictive genetic information from a health care
provider to another health care provider for the purpose of
providing health care treatment to the individual involved.
``(j) Definitions.--In this section:
``(1) Controlled group.--The term `controlled group' means
any group treated as a single employer under subsections (b),
(c), (m), or (o) of section 414.
``(2) Group health plan, health insurance issuer.--The
terms `group health plan' and `health insurance issuer' include
a third party administrator or other person acting for or on
behalf of such plan or issuer.
``(k) Violation of Genetic Discrimination or Genetic Disclosure
Provisions.--In any action under this section against any administrator
of a group health plan (including any third party administrator or
other person acting for or on behalf of such plan) alleging a violation
of subsection (a)(1)(F), (b) (with respect to cases relating to genetic
information or information about a request or receipt of genetic
services by an individual or family member of such individual), (d),
(e), (f), (g) or (h) of this section or section 9813, the court may
award any appropriate legal or equitable relief. Such relief may
include a requirement for the payment of attorney's fees and costs,
including the costs of expert witnesses.
``(l) Civil Penalty.--The monetary provisions of section
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall apply for
purposes of the Secretary enforcing the provisions referred to in
subsection (k), except that any such relief awarded shall be paid only
into the general fund of the Treasury.''.
(c) Definitions.--Section 9832(d) of the Internal Revenue Code of
1986 is amended by adding at the end the following:
``(6) Family member.--The term `family member' means with
respect to an individual--
``(A) the spouse of the individual;
``(B) a dependent child of the individual,
including a child who is born to or placed for adoption
with the individual; and
``(C) all other individuals related by blood to the
individual or the spouse or child described in
subparagraph (A) or (B).
``(7) Genetic information.--The term `genetic information'
means information about genes, gene products, or inherited
characteristics that may derive from an individual or a family
member of such individual (including information about a
request for or the receipt of genetic services by such
individual or family member of such individual).
``(8) Genetic services.--The term `genetic services' means
health services, including genetic tests, provided to obtain,
assess, or interpret genetic information for diagnostic and
therapeutic purposes, and for genetic education and counseling.
``(9) Genetic test.--The term `genetic test' means the
analysis of human DNA, RNA, chromosomes, proteins, and certain
metabolites in order to detect genotypes, mutations, or
chromosomal changes.
``(10) Predictive genetic information.--
``(A) In general.--The term `predictive genetic
information' means--
``(i) information about an individual's
genetic tests;
``(ii) information about genetic tests of
family members of the individual; or
``(iii) information about the occurrence of
a disease or disorder in family members.
``(B) Limitations.--The term `predictive genetic
information' shall not include--
``(i) information about the sex or age of
the individual;
``(ii) information about chemical, blood,
or urine analyses of the individual, unless
these analyses are genetic tests; or
``(iii) information about physical exams of
the individual, and other information relevant
to determining the current health status of the
individual.''.
(d) Effective Date.--
(1) In general.--Except as provided in this section, this
section and the amendments made by this section shall apply
with respect to group health plans for plan years beginning
after October 1, 2000.
(2) Special rule for collective bargaining agreements.--In
the case of a group health plan maintained pursuant to one or
more collective bargaining agreements between employee
representatives and one or more employers ratified before the
date of the enactment of this Act, this section and the
amendments made by this section shall not apply to plan years
beginning before the later of--
(A) the date on which the last of the collective
bargaining agreements relating to the plan terminates
(determined without regard to any extension thereof
agreed to after the date of the enactment of this Act),
or
(B) October 1, 2000.
For purposes of subparagraph (A), any plan amendment made
pursuant to a collective bargaining agreement relating to the
plan which amends the plan solely to conform to any requirement
of the amendments made by this section shall not be treated as
a termination of such collective bargaining agreement.
SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY ACT RELATING
TO MEDIGAP.
(a) Nondiscrimination.--
(1) In general.--Section 1882(s)(2) of the Social Security
Act (42 U.S.C. 1395ss(s)(2)) is amended by adding at the end
the following:
``(E)(i) An issuer of a medicare supplemental
policy shall not deny or condition the issuance or
effectiveness of the policy, and shall not discriminate
in the pricing of the policy (including the adjustment
of premium rates) of an eligible individual on the
basis of predictive genetic information concerning the
individual (or information about a request for, or the
receipt of, genetic services by such individual or
family member of such individual).
``(ii) For purposes of clause (i), the terms
`family member', `genetic services', and `predictive
genetic information' shall have the meanings given such
terms in subsection (v).''.
(2) Effective date.--The amendment made by paragraph (1)
shall apply with respect to a policy for policy years beginning
after October 1, 2000.
(b) Limitations on Genetic Testing and on Collection and Disclosure
of Predictive Genetic Information.--
(1) In general.--Section 1882 of the Social Security Act
(42 U.S.C. 1395ss) is amended by adding at the end the
following:
``(v) Limitations on Genetic Testing and on Collection and
Disclosure of Predictive Genetic Information.--
``(1) Genetic testing.--
``(A) Limitation on requesting or requiring genetic
testing.--An issuer of a medicare supplemental policy
shall not request or require an individual or a family
member of such individual to undergo a genetic test.
``(B) Rule of construction.--Nothing in this title
shall be construed to limit the authority of a health
care professional, who is providing treatment with
respect to an individual and who is employed by an
issuer of a medicare supplemental policy, to request
that such individual or family member of such
individual undergo a genetic test. Such a health care
professional shall not require that such individual or
family member undergo a genetic test.
``(2) Collection of predictive genetic information.--Except
as provided in paragraphs (4) and (5), an issuer of a medicare
supplemental policy shall not request, require, collect, or
purchase predictive genetic information concerning an
individual (or information about a request for or the receipt
of genetic services by such individual or family member of such
individual).
``(3) Disclosure of predictive genetic information.--An
issuer of a medicare supplemental policy shall not disclose
predictive genetic information about an individual (or
information about a request for or the receipt of genetic
services by such individual or family member of such
individual) to--
``(A) any entity that is a member of the same
controlled group as such issuer;
``(B) any issuer of a medicare supplemental policy,
group health plan or health insurance issuer, or any
insurance agent, third party administrator, or other
person subject to regulation under State insurance
laws;
``(C) the Medical Information Bureau or any other
person that collects, compiles, publishes, or otherwise
disseminates insurance information;
``(D) the individual's employer or any plan
sponsor; or
``(E) any other person the Secretary may specify in
regulations.
``(4) Information for payment for genetic services.--
``(A) In general.--With respect to payment for
genetic services conducted concerning an individual or
the coordination of benefits, an issuer of a medicare
supplemental policy may request that the individual
provide the issuer with evidence that such services
were performed.
``(B) Rule of construction.--Nothing in
subparagraph (A) shall be construed to--
``(i) permit an issuer to request (or
require) the results of the services referred
to in such subparagraph; or
``(ii) require that an issuer make payment
for services described in such subparagraph
where the individual involved has refused to
provide evidence of the performance of such
services pursuant to a request by the issuer in
accordance with such subparagraph.
``(5) Information for payment of other claims.--With
respect to the payment of claims for benefits other than
genetic services, an issuer of a medicare supplemental policy
may request that an individual provide predictive genetic
information so long as such information--
``(A) is used solely for the payment of a claim;
``(B) is limited to information that is directly
related to and necessary for the payment of such claim
and the claim would otherwise be denied but for the
predictive genetic information; and
``(C) is used only by an individual (or
individuals) within such issuer who needs access to
such information for purposes of payment of a claim.
``(6) Rules of construction.--
``(A) Collection or disclosure authorized by
individual.--The provisions of paragraphs (2)
(regarding collection) and (3) shall not apply to an
individual if the individual (or legal representative
of the individual) provides prior, knowing, voluntary,
and written authorization for the collection or
disclosure of predictive genetic information.
``(B) Disclosure for health care treatment.--
Nothing in this section shall be construed to limit or
restrict the disclosure of predictive genetic
information from a health care provider to another
health care provider for the purpose of providing
health care treatment to the individual involved.
``(7) Violation of genetic discrimination or genetic
disclosure provisions.--In any action under this subsection
against any administrator of a medicare supplemental policy
(including any third party administrator or other person acting
for or on behalf of such policy) alleging a violation of this
subsection, the court may award any appropriate legal or
equitable relief. Such relief may include a requirement for the
payment of attorney's fees and costs, including the costs of
expert witnesses.
``(8) Civil penalty.--The monetary provisions of section
308(b)(2)(C) of Public Law 101-336 (42 U.S.C. 12188(b)) shall
apply for purposes of the Secretary enforcing the provisions of
this subsection, except that any such relief awarded shall be
paid only into the general fund of the Treasury.
``(9) Special rule in case of genetic information.--This
subsection (relating to genetic information or information
about a request for, or the receipt of, genetic services by an
individual or a family member of such individual) shall not be
construed to supersede any provision of State law which
establishes, implements, or continues in effect a standard,
requirement, or remedy that more completely--
``(A) protects the confidentiality of genetic
information (including information about a request for,
or the receipt of, genetic services by an individual or
a family member of such individual) or the privacy of
an individual or a family member of the individual with
respect to genetic information (including information
about a request for, or the receipt of, genetic
services by an individual or a family member of such
individual) than does this subsection; or
``(B) prohibits discrimination on the basis of
genetic information than does this subsection.
``(10) Definitions.--In this subsection:
``(A) Controlled group.--The term `controlled
group' means any group treated as a single employer
under subsection (b), (c), (m), or (o) of section 414
of the Internal Revenue Code of 1986.
``(B) Family member.--The term `family member'
means with respect to an individual--
``(i) the spouse of the individual;
``(ii) a dependent child of the individual,
including a child who is born to or placed for
adoption with the individual; and
``(iii) all other individuals related by
blood to the individual or the spouse or child
described in clause (i) or (ii).
``(C) Genetic information.--The term `genetic
information' means information about genes, gene
products, or inherited characteristics that may derive
from an individual or a family member of such
individual (including information about a request for,
or the receipt of, genetic services by such individual
or family member of such individual).
``(D) Genetic services.--The term `genetic
services' means health services, including genetic
tests, provided to obtain, assess, or interpret genetic
information for diagnostic and therapeutic purposes,
and for genetic education and counseling.
``(E) Genetic test.--The term `genetic test' means
the analysis of human DNA, RNA, chromosomes, proteins,
and certain metabolites in order to detect genotypes,
mutations, or chromosomal changes.
``(F) Issuer of a medicare supplemental policy.--
The term `issuer of a medicare supplemental policy'
includes a third-party administrator or other person
acting for or on behalf of such issuer.
``(G) Predictive genetic information.--
``(i) In general.--The term `predictive
genetic information' means--
``(I) information about an
individual's genetic tests;
``(II) information about genetic
tests of family members of the
individual; or
``(III) information about the
occurrence of a disease or disorder in
family members.
``(ii) Limitations.--The term `predictive
genetic information' shall not include--
``(I) information about the sex or
age of the individual;
``(II) information about chemical,
blood, or urine analyses of the
individual, unless these analyses are
genetic tests; or
``(III) information about physical
exams of the individual, and other
information relevant to determining the
current health status of the
individual.''.
(2) Conforming amendment.--Section 1882(o) of the Social
Security Act (42 U.S.C. 1395ss(o)) is amended by adding at the
end the following:
``(4) The issuer of the medicare supplemental policy
complies with subsection (s)(2)(E) and subsection (v).''.
(3) Effective date.--The amendments made by this subsection
shall apply with respect to an issuer of a medicare
supplemental policy for policy years beginning after October 1,
2000.
(c) Transition Provisions.--
(1) In general.--If the Secretary of Health and Human
Services identifies a State as requiring a change to its
statutes or regulations to conform its regulatory program to
the changes made by this section, the State regulatory program
shall not be considered to be out of compliance with the
requirements of section 1882 of the Social Security Act due
solely to failure to make such change until the date specified
in paragraph (4).
(2) NAIC standards.--If, not later than June 30, 2000, the
National Association of Insurance Commissioners (in this
subsection referred to as the ``NAIC'') modifies its NAIC Model
Regulation relating to section 1882 of the Social Security Act
(referred to in such section as the 1991 NAIC Model Regulation,
as subsequently modified) to conform to the amendments made by
this section, such revised regulation incorporating the
modifications shall be considered to be the applicable NAIC
model regulation (including the revised NAIC model regulation
and the 1991 NAIC Model Regulation) for the purposes of such
section.
(3) Secretary standards.--If the NAIC does not make the
modifications described in paragraph (2) within the period
specified in such paragraph, the Secretary of Health and Human
Services shall, not later than October 1, 2000, make the
modifications described in such paragraph and such revised
regulation incorporating the modifications shall be considered
to be the appropriate regulation for the purposes of such
section.
(4) Date specified.--
(A) In general.--Subject to subparagraph (B), the
date specified in this paragraph for a State is the
earlier of--
(i) the date the State changes its statutes
or regulations to conform its regulatory
program to the changes made by this section, or
(ii) October 1, 2000.
(B) Additional legislative action required.--In the
case of a State which the Secretary identifies as--
(i) requiring State legislation (other than
legislation appropriating funds) to conform its
regulatory program to the changes made in this
section, but
(ii) having a legislature which is not
scheduled to meet in 2000 in a legislative
session in which such legislation may be
considered,
the date specified in this paragraph is the first day
of the first calendar quarter beginning after the close
of the first legislative session of the State
legislature that begins on or after July 1, 2000. For
purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year
of such session shall be deemed to be a separate
regular session of the State legislature.
TITLE II--PROHIBITION OF EMPLOYMENT DISCRIMINATION ON THE BASIS OF
PREDICTIVE GENETIC INFORMATION
SEC. 201. DEFINITIONS.
In this title:
(1) Employee; employer; employment agency; labor
organization; member.--The terms ``employee'', ``employer'',
``employment agency'', and ``labor organization'' have the
meanings given such terms in section 701 of the Civil Rights
Act of 1964 (42 U.S.C. 2000e), except that the terms
``employee'' and ``employer'' shall also include the meanings
given such terms in section 717 of the Civil Rights Act of 1964
(42 U.S.C. 2000e-16). The terms ``employee'' and ``member''
include an applicant for employment and an applicant for
membership in a labor organization, respectively.
(2) Family member.--The term ``family member'' means with
respect to an individual--
(A) the spouse of the individual;
(B) a dependent child of the individual, including
a child who is born to or placed for adoption with the
individual; and
(C) all other individuals related by blood to the
individual or the spouse or child described in
subparagraph (A) or (B).
(3) Genetic monitoring.--The term ``genetic monitoring''
means the periodic examination of employees to evaluate
acquired modifications to their genetic material, such as
chromosomal damage or evidence of increased occurrence of
mutations, that may have developed in the course of employment
due to exposure to toxic substances in the workplace, in order
to identify, evaluate, and respond to the effects of or control
adverse environmental exposures in the workplace.
(4) Genetic services.--The term ``genetic services'' means
health services, including genetic tests, provided to obtain,
assess, or interpret genetic information for diagnostic and
therapeutic purposes, and for genetic education and counseling.
(5) Genetic test.--The term ``genetic test'' means the
analysis of human DNA, RNA, chromosomes, proteins, and certain
metabolites in order to detect genotypes, mutations, or
chromosomal changes.
(6) Predictive genetic information.--
(A) In general.--The term ``predictive genetic
information'' means--
(i) information about an individual's
genetic tests;
(ii) information about genetic tests of
family members of the individual; or
(iii) information about the occurrence of a
disease or disorder in family members.
(B) Limitations.--The term ``predictive genetic
information'' shall not include--
(i) information about the sex or age of the
individual;
(ii) information about chemical, blood, or
urine analyses of the individual, unless these
analyses are genetic tests; or
(iii) information about physical exams of
the individual, and other information relevant
to determining the current health status of the
individual.
SEC. 202. EMPLOYER PRACTICES.
(a) In General.--It shall be an unlawful employment practice for an
employer--
(1) to fail or refuse to hire or to discharge any
individual, or otherwise to discriminate against any individual
with respect to the compensation, terms, conditions, or
privileges of employment of the individual, because of
predictive genetic information with respect to the individual
(or information about a request for or the receipt of genetic
services by such individual or family member of such
individual;
(2) to limit, segregate, or classify the employees of the
employer in any way that would deprive or tend to deprive any
individual of employment opportunities or otherwise adversely
affect the status of the individual as an employee, because of
predictive genetic information with respect to the individual,
or information about a request for or the receipt of genetic
services by such individual or family member of such
individual; or
(3) to request, require, collect or purchase predictive
genetic information with respect to an individual or a family
member of the individual except--
(A) where used for genetic monitoring of biological
effects of toxic substances in the workplace, but only
if--
(i) the employee has provided prior,
knowing, voluntary, and written authorization;
(ii) the employee is informed of individual
monitoring results;
(iii) the monitoring conforms to any
genetic monitoring regulations that may be
promulgated by the Secretary of Labor pursuant
to the Occupational Safety and Health Act of
1970 (29 U.S.C. 651 et seq.) or the Federal
Mine Safety and Health Act of 1977 (30 U.S.C.
801 et seq.); and
(iv) the employer, excluding any licensed
health care professional that is involved in
the genetic monitoring program, receives the
results of the monitoring only in aggregate
terms that do not disclose the identity of
specific employees; or
(B) where genetic services are offered by the
employer and the employee provides prior, knowing,
voluntary, and written authorization, and only the
employee or family member of such employee receives the
results of such services.
(b) Limitation.--In the case of predictive genetic information to
which subparagraph (A) or (B) of subsection (a)(3) applies, such
information may not be used in violation of paragraph (1) or (2) of
subsection (a).
SEC. 203. EMPLOYMENT AGENCY PRACTICES.
It shall be an unlawful employment practice for an employment
agency--
(1) to fail or refuse to refer for employment, or otherwise
to discriminate against, any individual because of predictive
genetic information with respect to the individual (or
information about a request for or the receipt of genetic
services by such individual or family member of such
individual);
(2) to limit, segregate, or classify individuals or fail or
refuse to refer for employment any individual in any way that
would deprive or tend to deprive any individual of employment
opportunities or would limit the employment opportunities or
otherwise adversely affect the status of the individual as an
employee, because of predictive genetic information with
respect to the individual (or information about a request for
or the receipt of genetic services by such individual or family
member of such individual);
(3) to request, require, collect or purchase predictive
genetic information with respect to an individual (or
information about a request for or the receipt of genetic
services by such individual or family member of such
individual); or
(4) to cause or attempt to cause an employer to
discriminate against an individual in violation of this title.
SEC. 204. LABOR ORGANIZATION PRACTICES.
It shall be an unlawful employment practice for a labor
organization--
(1) to exclude or to expel from the membership of the
organization, or otherwise to discriminate against, any
individual because of predictive genetic information with
respect to the individual (or information about a request for
or the receipt of genetic services by such individual or family
member of such individual);
(2) to limit, segregate, or classify the members of the
organization, or fail or refuse to refer for employment any
individual, in any way that would deprive or tend to deprive
any individual of employment opportunities, or would limit the
employment opportunities or otherwise adversely affect the
status of the individual as an employee, because of predictive
genetic information with respect to the individual (or
information about a request for or the receipt of genetic
services by such individual or family member of such
individual);
(3) to request, require, collect or purchase predictive
genetic information with respect to an individual (or
information about a request for or the receipt of genetic
services by such individual or family member of such
individual); or
(4) to cause or attempt to cause an employer to
discriminate against an individual in violation of this title.
SEC. 205. TRAINING PROGRAMS.
It shall be an unlawful employment practice for any employer, labor
organization, or joint labor-management committee controlling
apprenticeship or other training or retraining, including on-the-job
training programs--
(1) to discriminate against any individual because of
predictive genetic information with respect to the individual
(or information about a request for or the receipt of genetic
services by such individual), in admission to, or employment
in, any program established to provide apprenticeship or other
training or retraining;
(2) to limit, segregate, or classify the members of the
organization, or fail or refuse to refer for employment any
individual, in any way that would deprive or tend to deprive
any individual of employment opportunities, or would limit the
employment opportunities or otherwise adversely affect the
status of the individual as an employee, because of predictive
genetic information with respect to the individual (or
information about a request for or receipt of genetic services
by such individual or family member of such individual);
(3) to request, require, collect or purchase predictive
genetic information with respect to an individual (or
information about a request for or receipt of genetic services
by such individual or family member of such individual); or
(4) to cause or attempt to cause an employer to
discriminate against an individual in violation of this title.
SEC. 206. MAINTENANCE AND DISCLOSURE OF PREDICTIVE GENETIC INFORMATION.
(a) Maintenance of Predictive Genetic Information.--If an employer
possesses predictive genetic information about an employee (or
information about a request for or receipt of genetic services by such
employee or family member of such employee), such information shall be
treated or maintained as part of the employee's confidential medical
records.
(b) Disclosure of Predictive Genetic Information.--An employer
shall not disclose predictive genetic information (or information about
a request for or receipt of genetic services by such employee or family
member of such employee) except--
(1) to the employee who is the subject of the information
at the request of the employee;
(2) to an occupational or other health researcher if the
research is conducted in compliance with the regulations and
protections provided for under part 46 of title 45, Code of
Federal Regulations;
(3) under legal compulsion of a Federal court order, except
that if the court order was secured without the knowledge of
the individual to whom the information refers, the employer
shall provide the individual with adequate notice to challenge
the court order unless the court order also imposes
confidentiality requirements; and
(4) to government officials who are investigating
compliance with this Act if the information is relevant to the
investigation.
SEC. 207. CIVIL ACTION.
(a) In General.--One or more employees, members of a labor
organization, or participants in training programs may bring an action
in a Federal or State court of competent jurisdiction against an
employer, employment agency, labor organization, or joint labor-
management committee or training program who commits a violation of
this title.
(b) Enforcement by the Equal Employment Opportunity Commission.--
(1) In general.--The powers, remedies, and procedures set
forth in sections 705, 706, 707, 709, 710, and 717 of the Civil
Rights Act of 1964 (42 U.S.C. 2000e-4, 2000e-5, 2000e-6, 2000e-
8, 2000e-9, and 2000e-16) shall be the powers, remedies, and
procedures provided to the Equal Employment Opportunity
Commission to enforce this title. The Commission may promulgate
regulations to implement these powers, remedies, and
procedures.
(2) Exhaustion of remedies.--Nothing in this subsection
shall be construed to require that an individual exhaust the
administrative remedies available through the Equal Employment
Opportunity Commission prior to commencing a civil action under
this section, except that if an individual files a charge of
discrimination with the Commission that alleges a violation of
this title, the individual shall exhaust the administrative
remedies available through the Commission prior to commencing a
civil action under this section.
(c) Remedy.--A Federal or State court may award any appropriate
legal or equitable relief under this section. Such relief may include a
requirement for the payment of attorney's fees and costs, including the
costs of experts.
SEC. 208. CONSTRUCTION.
Nothing in this title shall be construed to--
(1) limit the rights or protections of an individual under
the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.), including coverage afforded to individuals under section
102 of such Act;
(2) limit the rights or protections of an individual under
the Rehabilitation Act of 1973 (29 U.S.C. 701 et seq.);
(3) limit the rights or protections of an individual under
any other Federal or State statute that provides equal or
greater protection to an individual than the rights accorded
under this Act;
(4) apply to the Armed Forces Repository of Specimen
Samples for the Identification of Remains; or
(5) limit the statutory or regulatory authority of the
Occupational Safety and Health Administration or the Mine
Safety and Health Administration to promulgate or enforce
workplace safety and health laws and regulations.
SEC. 209. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated such sums as may be
necessary to carry out this title.
SEC. 210. EFFECTIVE DATE.
This title shall become effective on October 1, 2000.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S8104-8015)
Read twice and referred to the Committee on HELP.
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