Difference between revisions of "Genetic Information Nondiscrimination Act of 2008"
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{{Law | {{Law | ||
− | |Short title= | + | |Short title=GINA |
|Official text=https://www.govinfo.gov/content/pkg/PLAW-110publ233/pdf/PLAW-110publ233.pdf | |Official text=https://www.govinfo.gov/content/pkg/PLAW-110publ233/pdf/PLAW-110publ233.pdf | ||
|Country/Jurisdiction=United States | |Country/Jurisdiction=United States | ||
− | |||
|Date enacted=2008/05/21 | |Date enacted=2008/05/21 | ||
|Scope of the law=Individuals, Employers, Health Care Providers, Health Insurance Issuer | |Scope of the law=Individuals, Employers, Health Care Providers, Health Insurance Issuer | ||
− | | | + | |Short summary introduction=Genetic Information Nondiscrimination Act of 2008 limits the genetic testing procedures and prohibits collecting genetic information for other purposes from individuals. |
− | |Text of the law=SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974. | + | |Text of the law={{SectionHarm|Section=SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974. |Harms=Exclusion, Decisional Interference, Interrogation, Disclosure}} |
(b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLECTION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.—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: | (b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLECTION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.—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 | + | {{SectionPersonalInformation|Section=‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC |
TESTING.—A group health plan, and a health insurance issuer | TESTING.—A group health plan, and a health insurance issuer | ||
offering health insurance coverage in connection with a group | offering health insurance coverage in connection with a group | ||
health plan, shall not request or require an individual or a | health plan, shall not request or require an individual or a | ||
− | family member of such individual to undergo a genetic test. | + | family member of such individual to undergo a genetic test.|Personal=Medical and Health, Preference}} |
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be | ‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be | ||
Line 25: | Line 24: | ||
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ||
− | ‘‘(1) IN GENERAL.—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 | + | {{SectionPersonalInformation|Section=‘‘(1) IN GENERAL.—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 | genetic information for underwriting purposes (as defined in | ||
− | section 733). | + | section 733).|Personal=Credit}} |
+ | |||
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ||
PRIOR TO ENROLLMENT.—A group health plan, and a health | PRIOR TO ENROLLMENT.—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 | + | 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 |
− | purchase genetic information with respect to any individual | ||
prior to such individual’s enrollment under the plan or coverage | prior to such individual’s enrollment under the plan or coverage | ||
in connection with such enrollment. | in connection with such enrollment. | ||
+ | |||
‘‘(3) INCIDENTAL COLLECTION.—If a group health plan, or | ‘‘(3) INCIDENTAL COLLECTION.—If a group health plan, or | ||
a health insurance issuer offering health insurance coverage | a health insurance issuer offering health insurance coverage | ||
Line 45: | Line 45: | ||
EMBRYO.—Such section is further amended by adding at the end | EMBRYO.—Such section is further amended by adding at the end | ||
the following: | the following: | ||
+ | |||
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any reference in this part to genetic information concerning an individual | ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any reference in this part to genetic information concerning an individual | ||
or family member of an individual shall— | or family member of an individual shall— | ||
− | ‘‘(1) with respect to such an individual or family member | + | |
+ | {{SectionPersonalInformation|Section=‘‘(1) with respect to such an individual or family member | ||
of an individual who is a pregnant woman, include genetic | of an individual who is a pregnant woman, include genetic | ||
information of any fetus carried by such pregnant woman; | information of any fetus carried by such pregnant woman; | ||
− | and | + | and|Personal=Medical and Health, Ethnicity, Family}} |
+ | |||
‘‘(2) with respect to an individual or family member utilizing an assisted reproductive technology, include genetic | ‘‘(2) 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 | information of any embryo legally held by the individual or | ||
Line 58: | Line 61: | ||
‘‘(c) GENETIC TESTING.— | ‘‘(c) GENETIC TESTING.— | ||
+ | |||
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ||
TESTING.—A group health plan, and a health insurance issuer | TESTING.—A group health plan, and a health insurance issuer | ||
Line 63: | Line 67: | ||
health plan, shall not request or require an individual or a | health plan, shall not request or require an individual or a | ||
family member of such individual to undergo a genetic test. | family member of such individual to undergo a genetic test. | ||
+ | |||
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be | ‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be | ||
construed to limit the authority of a health care professional | construed to limit the authority of a health care professional | ||
who is providing health care services to an individual to request | who is providing health care services to an individual to request | ||
that such individual undergo a genetic test. | that such individual undergo a genetic test. | ||
+ | |||
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ||
+ | |||
‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be | ‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be | ||
construed to preclude a group health plan, or a health | construed to preclude a group health plan, or a health | ||
Line 78: | Line 85: | ||
and Accountability Act of 1996, as may be revised from | and Accountability Act of 1996, as may be revised from | ||
time to time) consistent with subsection (a). | time to time) consistent with subsection (a). | ||
+ | |||
‘‘(B) LIMITATION.—For purposes of subparagraph (A), | ‘‘(B) LIMITATION.—For purposes of subparagraph (A), | ||
a group health plan, or a health insurance issuer offering | a group health plan, or a health insurance issuer offering | ||
Line 83: | Line 91: | ||
health plan, may request only the minimum amount of | health plan, may request only the minimum amount of | ||
information necessary to accomplish the intended purpose. | information necessary to accomplish the intended purpose. | ||
+ | |||
‘‘(4) RESEARCH EXCEPTION.—Notwithstanding paragraph | ‘‘(4) RESEARCH EXCEPTION.—Notwithstanding paragraph | ||
(1), a group health plan, or a health insurance issuer offering | (1), a group health plan, or a health insurance issuer offering | ||
Line 88: | Line 97: | ||
plan, may request, but not require, that a participant or beneficiary undergo a genetic test if each of the following conditions | plan, may request, but not require, that a participant or beneficiary undergo a genetic test if each of the following conditions | ||
is met: | is met: | ||
+ | |||
‘‘(A) The request is made pursuant to research that | ‘‘(A) 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 | 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 | State or local law or regulations for the protection of human | ||
subjects in research. | subjects in research. | ||
+ | |||
‘‘(B) The plan or issuer clearly indicates to each participant or beneficiary, or in the case of a minor child, to | ‘‘(B) The plan or issuer 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 | the legal guardian of such beneficiary, to whom the request | ||
is made that— | is made that— | ||
+ | |||
‘‘(i) compliance with the request is voluntary; and | ‘‘(i) compliance with the request is voluntary; and | ||
+ | |||
‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts. | ‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts. | ||
− | ‘‘(C) No genetic information collected or acquired under | + | |
− | this paragraph shall be used for underwriting purposes. | + | {{SectionHarm|Section=‘‘(C) No genetic information collected or acquired under |
+ | this paragraph shall be used for underwriting purposes.|Harms=Surveillance, Secondary Use}} | ||
+ | |||
‘‘(D) The plan or issuer notifies the Secretary in writing | ‘‘(D) The plan or issuer notifies the Secretary in writing | ||
that the plan or issuer is conducting activities pursuant | that the plan or issuer is conducting activities pursuant | ||
to the exception provided for under this paragraph, | to the exception provided for under this paragraph, | ||
including a description of the activities conducted. | including a description of the activities conducted. | ||
+ | |||
‘‘(E) The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph. | ‘‘(E) The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph. | ||
+ | |||
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ||
+ | |||
‘‘(1) IN GENERAL.—A group health plan, and a health insurance issuer offering health insurance coverage in connection | ‘‘(1) IN GENERAL.—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 | with a group health plan, shall not request, require, or purchase | ||
genetic information for underwriting purposes (as defined in | genetic information for underwriting purposes (as defined in | ||
section 2791). | section 2791). | ||
+ | |||
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ||
PRIOR TO ENROLLMENT.—A group health plan, and a health | PRIOR TO ENROLLMENT.—A group health plan, and a health | ||
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prior to such individual’s enrollment under the plan or coverage | prior to such individual’s enrollment under the plan or coverage | ||
in connection with such enrollment. | in connection with such enrollment. | ||
+ | |||
‘‘(3) INCIDENTAL COLLECTION.—If a group health plan, or | ‘‘(3) INCIDENTAL COLLECTION.—If a group health plan, or | ||
a health insurance issuer offering health insurance coverage | a health insurance issuer offering health insurance coverage | ||
Line 122: | Line 142: | ||
of paragraph (2) if such request, requirement, or purchase | of paragraph (2) if such request, requirement, or purchase | ||
is not in violation of paragraph (1). | is not in violation of paragraph (1). | ||
+ | |||
(3) APPLICATION TO GENETIC INFORMATION OF A FETUS OR | (3) APPLICATION TO GENETIC INFORMATION OF A FETUS OR | ||
EMBRYO.—Such section is further amended by adding at the | EMBRYO.—Such section is further amended by adding at the | ||
end the following: | end the following: | ||
+ | |||
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any reference in this part to genetic information concerning an individual | ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any reference in this part to genetic information concerning an individual | ||
or family member of an individual shall— | or family member of an individual shall— | ||
+ | |||
‘‘(1) with respect to such an individual or family member | ‘‘(1) with respect to such an individual or family member | ||
of an individual who is a pregnant woman, include genetic | of an individual who is a pregnant woman, include genetic | ||
information of any fetus carried by such pregnant woman; | information of any fetus carried by such pregnant woman; | ||
and | and | ||
+ | |||
‘‘(2) with respect to an individual or family member utilizing an assisted reproductive technology, include genetic | ‘‘(2) 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 | information of any embryo legally held by the individual or | ||
family member.’’. | family member.’’. | ||
+ | |||
‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS | ‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS | ||
OF GENETIC INFORMATION. | OF GENETIC INFORMATION. | ||
+ | |||
‘‘(a) PROHIBITION ON GENETIC INFORMATION AS A CONDITION | ‘‘(a) PROHIBITION ON GENETIC INFORMATION AS A CONDITION | ||
OF ELIGIBILITY.— | OF ELIGIBILITY.— | ||
+ | |||
‘‘(1) IN GENERAL.—A health insurance issuer offering health | ‘‘(1) IN GENERAL.—A health insurance issuer offering health | ||
insurance coverage in the individual market may not establish | insurance coverage in the individual market may not establish | ||
Line 143: | Line 170: | ||
individual to enroll in individual health insurance coverage | individual to enroll in individual health insurance coverage | ||
based on genetic information. | based on genetic information. | ||
+ | |||
‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) | ‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) | ||
or in paragraphs (1) and (2) of subsection (e) shall be construed | or in paragraphs (1) and (2) of subsection (e) shall be construed | ||
Line 151: | Line 179: | ||
individual where such family member is covered under the | individual where such family member is covered under the | ||
policy that covers such individual. | policy that covers such individual. | ||
+ | |||
‘‘(b) PROHIBITION ON GENETIC INFORMATION IN SETTING PREMIUM RATES.— | ‘‘(b) PROHIBITION ON GENETIC INFORMATION IN SETTING PREMIUM RATES.— | ||
+ | |||
‘‘(1) IN GENERAL.—A health insurance issuer offering health | ‘‘(1) IN GENERAL.—A health insurance issuer offering health | ||
insurance coverage in the individual market shall not adjust | insurance coverage in the individual market shall not adjust | ||
Line 157: | Line 187: | ||
basis of genetic information concerning the individual or a | basis of genetic information concerning the individual or a | ||
family member of the individual. | family member of the individual. | ||
+ | |||
‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) | ‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) | ||
or in paragraphs (1) and (2) of subsection (e) shall be construed | or in paragraphs (1) and (2) of subsection (e) shall be construed | ||
Line 168: | Line 199: | ||
other individuals covered under the policy issued to such individual and to further increase premiums or contribution | other individuals covered under the policy issued to such individual and to further increase premiums or contribution | ||
amounts. | amounts. | ||
+ | |||
‘‘(c) PROHIBITION ON GENETIC INFORMATION AS PREEXISTING | ‘‘(c) PROHIBITION ON GENETIC INFORMATION AS PREEXISTING | ||
CONDITION.— | CONDITION.— | ||
+ | |||
‘‘(1) IN GENERAL.—A health insurance issuer offering health | ‘‘(1) IN GENERAL.—A health insurance issuer offering health | ||
insurance coverage in the individual market may not, on the | insurance coverage in the individual market may not, on the | ||
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exclusion (as defined in section 2701(b)(1)(A)) with respect to | exclusion (as defined in section 2701(b)(1)(A)) with respect to | ||
such coverage. | such coverage. | ||
+ | |||
‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) | ‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) | ||
or in paragraphs (1) and (2) of subsection (e) shall be construed | or in paragraphs (1) and (2) of subsection (e) shall be construed | ||
Line 180: | Line 214: | ||
health insurance coverage on the basis of a manifestation of | health insurance coverage on the basis of a manifestation of | ||
a disease or disorder in that individual. | a disease or disorder in that individual. | ||
+ | |||
‘‘(d) GENETIC TESTING.— | ‘‘(d) GENETIC TESTING.— | ||
+ | |||
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ||
TESTING.—A health insurance issuer offering health insurance | TESTING.—A health insurance issuer offering health insurance | ||
Line 186: | Line 222: | ||
an individual or a family member of such individual to undergo | an individual or a family member of such individual to undergo | ||
a genetic test. | a genetic test. | ||
+ | |||
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be | ‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be | ||
construed to limit the authority of a health care professional | construed to limit the authority of a health care professional | ||
who is providing health care services to an individual to request | who is providing health care services to an individual to request | ||
that such individual undergo a genetic test. | that such individual undergo a genetic test. | ||
− | ‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— ‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be | + | |
+ | ‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ||
+ | |||
+ | ‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be | ||
construed to preclude a health insurance issuer offering | construed to preclude a health insurance issuer offering | ||
health insurance coverage in the individual market from | health insurance coverage in the individual market from | ||
Line 199: | Line 239: | ||
Security Act and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised | Security Act and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised | ||
from time to time) consistent with subsection (a) and (c). | from time to time) consistent with subsection (a) and (c). | ||
+ | |||
‘‘(B) LIMITATION.—For purposes of subparagraph (A), | ‘‘(B) LIMITATION.—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 | 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. | intended purpose. | ||
+ | |||
‘‘(4) RESEARCH EXCEPTION.—Notwithstanding paragraph | ‘‘(4) RESEARCH EXCEPTION.—Notwithstanding paragraph | ||
(1), a health insurance issuer offering health insurance coverage | (1), a health insurance issuer offering health insurance coverage | ||
Line 207: | Line 249: | ||
an individual or a family member of such individual undergo | an individual or a family member of such individual undergo | ||
a genetic test if each of the following conditions is met: | a genetic test if each of the following conditions is met: | ||
+ | |||
‘‘(A) The request is made pursuant to research that | ‘‘(A) 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 | 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 | State or local law or regulations for the protection of human | ||
subjects in research. | subjects in research. | ||
− | + | ||
+ | in the case of a minor child, to the legal guardian | ||
of such child, to whom the request is made that— | of such child, to whom the request is made that— | ||
+ | |||
‘‘(i) compliance with the request is voluntary; and | ‘‘(i) compliance with the request is voluntary; and | ||
+ | |||
‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts. | ‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts. | ||
+ | |||
‘‘(C) No genetic information collected or acquired under | ‘‘(C) No genetic information collected or acquired under | ||
this paragraph shall be used for underwriting purposes. | this paragraph shall be used for underwriting purposes. | ||
+ | |||
‘‘(D) The issuer notifies the Secretary in writing that | ‘‘(D) The issuer notifies the Secretary in writing that | ||
the issuer is conducting activities pursuant to the exception | the issuer is conducting activities pursuant to the exception | ||
provided for under this paragraph, including a description | provided for under this paragraph, including a description | ||
of the activities conducted. | of the activities conducted. | ||
+ | |||
‘‘(E) The issuer complies with such other conditions | ‘‘(E) The issuer complies with such other conditions | ||
as the Secretary may by regulation require for activities | as the Secretary may by regulation require for activities | ||
conducted under this paragraph. | conducted under this paragraph. | ||
− | ‘‘(e) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— ‘‘(1) IN GENERAL. | + | |
+ | ‘‘(e) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ||
+ | |||
+ | ‘‘(1) IN GENERAL.— | ||
+ | |||
+ | A health insurance issuer offering health | ||
insurance coverage in the individual market shall not request, | insurance coverage in the individual market shall not request, | ||
require, or purchase genetic information for underwriting purposes (as defined in section 2791). | require, or purchase genetic information for underwriting purposes (as defined in section 2791). | ||
+ | |||
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ||
− | PRIOR TO ENROLLMENT. | + | PRIOR TO ENROLLMENT.— |
+ | |||
+ | A health insurance issuer offering | ||
health insurance coverage in the individual market shall not | health insurance coverage in the individual market shall not | ||
request, require, or purchase genetic information with respect | request, require, or purchase genetic information with respect | ||
to any individual prior to such individual’s enrollment under | to any individual prior to such individual’s enrollment under | ||
the plan in connection with such enrollment. | the plan in connection with such enrollment. | ||
− | ‘‘(3) INCIDENTAL COLLECTION. | + | |
+ | ‘‘(3) INCIDENTAL COLLECTION.— | ||
+ | |||
+ | If a health insurance issuer | ||
offering health insurance coverage in the individual market | offering health insurance coverage in the individual market | ||
obtains genetic information incidental to the requesting, | obtains genetic information incidental to the requesting, | ||
Line 240: | Line 300: | ||
be considered a violation of paragraph (2) if such request, | be considered a violation of paragraph (2) if such request, | ||
requirement, or purchase is not in violation of paragraph (1). | requirement, or purchase is not in violation of paragraph (1). | ||
− | ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO. | + | ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.— |
+ | |||
+ | Any reference in this part to genetic information concerning an individual | ||
or family member of an individual shall— | or family member of an individual shall— | ||
+ | |||
‘‘(1) with respect to such an individual or family member | ‘‘(1) with respect to such an individual or family member | ||
of an individual who is a pregnant woman, include genetic | of an individual who is a pregnant woman, include genetic | ||
information of any fetus carried by such pregnant woman; | information of any fetus carried by such pregnant woman; | ||
and | and | ||
+ | |||
‘‘(2) with respect to an individual or family member utilizing an assisted reproductive technology, include genetic | ‘‘(2) 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 | information of any embryo legally held by the individual or | ||
family member.’’. | family member.’’. | ||
+ | |||
SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986. | SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986. | ||
+ | |||
(a) NO DISCRIMINATION IN GROUP PREMIUMS BASED ON GENETIC | (a) NO DISCRIMINATION IN GROUP PREMIUMS BASED ON GENETIC | ||
− | INFORMATION. | + | INFORMATION.— |
+ | |||
+ | Subsection (b) of section 9802 of the Internal Revenue Code of 1986 is amended— | ||
+ | |||
(1) in paragraph (2)(A), by inserting before the semicolon | (1) in paragraph (2)(A), by inserting before the semicolon | ||
the following: ‘‘except as provided in paragraph (3)’’; and | the following: ‘‘except as provided in paragraph (3)’’; and | ||
+ | |||
(2) by adding at the end the following: | (2) by adding at the end the following: | ||
+ | |||
‘‘(3) NO GROUP-BASED DISCRIMINATION ON BASIS OF GENETIC | ‘‘(3) NO GROUP-BASED DISCRIMINATION ON BASIS OF GENETIC | ||
INFORMATION.— | INFORMATION.— | ||
+ | |||
‘‘(A) IN GENERAL.—For purposes of this section, a group | ‘‘(A) IN GENERAL.—For purposes of this section, a group | ||
health plan may not adjust premium or contribution | health plan may not adjust premium or contribution | ||
amounts for the group covered under such plan on the | amounts for the group covered under such plan on the | ||
basis of genetic information. | basis of genetic information. | ||
− | ‘‘(B) RULE OF CONSTRUCTION. | + | |
+ | ‘‘(B) RULE OF CONSTRUCTION.— | ||
+ | |||
+ | Nothing in subparagraph (A) or in paragraphs (1) and (2) of subsection (d) | ||
shall be construed to limit the ability of a group health | shall be construed to limit the ability of a group health | ||
plan to increase the premium for an employer based on | plan to increase the premium for an employer based on | ||
Line 269: | Line 344: | ||
used as genetic information about other group members | used as genetic information about other group members | ||
and to further increase the premium for the employer.’’. | and to further increase the premium for the employer.’’. | ||
− | (b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLECTION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS. | + | |
+ | (b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLECTION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.— | ||
+ | |||
+ | Section 9802 of such Code is amended by redesignating subsection | ||
(c) as subsection (f) and by inserting after subsection (b) the following new subsections: | (c) as subsection (f) and by inserting after subsection (b) the following new subsections: | ||
+ | |||
‘‘(c) GENETIC TESTING.— | ‘‘(c) GENETIC TESTING.— | ||
+ | |||
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ||
− | TESTING. | + | TESTING.— |
+ | |||
+ | A group health plan may not request or require | ||
an individual or a family member of such individual to undergo | an individual or a family member of such individual to undergo | ||
a genetic test. | a genetic test. | ||
− | ‘‘(2) RULE OF CONSTRUCTION. | + | |
+ | ‘‘(2) RULE OF CONSTRUCTION.— | ||
+ | |||
+ | Paragraph (1) shall not be | ||
construed to limit the authority of a health care professional | construed to limit the authority of a health care professional | ||
who is providing health care services to an individual to request | who is providing health care services to an individual to request | ||
that such individual undergo a genetic test. | that such individual undergo a genetic test. | ||
+ | |||
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ||
− | ‘‘(A) IN GENERAL. | + | |
+ | ‘‘(A) IN GENERAL.— | ||
+ | |||
+ | Nothing in paragraph (1) shall be | ||
construed to preclude a group health plan from obtaining | 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 | and using the results of a genetic test in making a determination regarding payment (as such term is defined for | ||
Line 290: | Line 379: | ||
of 1996, as may be revised from time to time) consistent | of 1996, as may be revised from time to time) consistent | ||
with subsection (a). | with subsection (a). | ||
− | ‘‘(B) LIMITATION. | + | |
+ | ‘‘(B) LIMITATION.— | ||
+ | |||
+ | For purposes of subparagraph (A), | ||
a group health plan may request only the minimum amount | a group health plan may request only the minimum amount | ||
of information necessary to accomplish the intended purpose. | of information necessary to accomplish the intended purpose. | ||
− | ‘‘(4) RESEARCH EXCEPTION. | + | |
+ | ‘‘(4) RESEARCH EXCEPTION.— | ||
+ | |||
+ | Notwithstanding paragraph | ||
+ | |||
(1), a group health plan may request, but not require, that | (1), a group health plan may request, but not require, that | ||
a participant or beneficiary undergo a genetic test if each | a participant or beneficiary undergo a genetic test if each | ||
of the following conditions is met: | of the following conditions is met: | ||
+ | |||
‘‘(A) The request is made pursuant to research that | ‘‘(A) 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 | 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 | State or local law or regulations for the protection of human | ||
subjects in research. | subjects in research. | ||
+ | |||
‘‘(B) The plan clearly indicates to each participant or | ‘‘(B) The plan clearly indicates to each participant or | ||
beneficiary, or in the case of a minor child, to the legal | beneficiary, or in the case of a minor child, to the legal | ||
guardian of such beneficiary, to whom the request is made | guardian of such beneficiary, to whom the request is made | ||
that— | that— | ||
+ | |||
‘‘(i) compliance with the request is voluntary; and | ‘‘(i) compliance with the request is voluntary; and | ||
+ | |||
‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts. | ‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts. | ||
+ | |||
‘‘(C) No genetic information collected or acquired under | ‘‘(C) No genetic information collected or acquired under | ||
this paragraph shall be used for underwriting purposes. | this paragraph shall be used for underwriting purposes. | ||
+ | |||
‘‘(D) The plan notifies the Secretary in writing that | ‘‘(D) The plan notifies the Secretary in writing that | ||
the plan is conducting activities pursuant to the exception | the plan is conducting activities pursuant to the exception | ||
provided for under this paragraph, including a description | provided for under this paragraph, including a description | ||
of the activities conducted. | of the activities conducted. | ||
+ | |||
‘‘(E) The plan complies with such other conditions as | ‘‘(E) The plan complies with such other conditions as | ||
the Secretary may by regulation require for activities conducted under this paragraph. | the Secretary may by regulation require for activities conducted under this paragraph. | ||
+ | |||
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— | ||
+ | |||
‘‘(1) IN GENERAL.—A group health plan shall not request, | ‘‘(1) IN GENERAL.—A group health plan shall not request, | ||
require, or purchase genetic information for underwriting purposes (as defined in section 9832). | require, or purchase genetic information for underwriting purposes (as defined in section 9832). | ||
+ | |||
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION | ||
PRIOR TO ENROLLMENT.—A group health plan shall not request, | PRIOR TO ENROLLMENT.—A group health plan shall not request, | ||
Line 323: | Line 429: | ||
individual prior to such individual’s enrollment under the plan | individual prior to such individual’s enrollment under the plan | ||
or in connection with such enrollment. | or in connection with such enrollment. | ||
+ | |||
‘‘(3) INCIDENTAL COLLECTION.—If a group health plan | ‘‘(3) INCIDENTAL COLLECTION.—If a group health plan | ||
obtains genetic information incidental to the requesting, | obtains genetic information incidental to the requesting, | ||
Line 329: | Line 436: | ||
be considered a violation of paragraph (2) if such request, | be considered a violation of paragraph (2) if such request, | ||
requirement, or purchase is not in violation of paragraph (1). | requirement, or purchase is not in violation of paragraph (1). | ||
+ | |||
(c) APPLICATION TO GENETIC INFORMATION OF A FETUS OR | (c) APPLICATION TO GENETIC INFORMATION OF A FETUS OR | ||
EMBRYO.—Such section is further amended by adding at the end | EMBRYO.—Such section is further amended by adding at the end | ||
the following: | the following: | ||
− | ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO. | + | |
+ | ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.— | ||
+ | |||
+ | Any reference in this chapter to genetic information concerning an individual or family member of an individual shall— | ||
+ | |||
‘‘(1) with respect to such an individual or family member | ‘‘(1) with respect to such an individual or family member | ||
of an individual who is a pregnant woman, include genetic | of an individual who is a pregnant woman, include genetic | ||
information of any fetus carried by such pregnant woman; | information of any fetus carried by such pregnant woman; | ||
and | and | ||
+ | |||
‘‘(2) with respect to an individual or family member utilizing an assisted reproductive technology, include genetic | ‘‘(2) 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 | information of any embryo legally held by the individual or | ||
family member.’’. | family member.’’. | ||
+ | |||
SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY | SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY | ||
ACT RELATING TO MEDIGAP. | ACT RELATING TO MEDIGAP. | ||
+ | |||
(b) LIMITATIONS ON GENETIC TESTING AND GENETIC INFORMATION.— | (b) LIMITATIONS ON GENETIC TESTING AND GENETIC INFORMATION.— | ||
+ | |||
(1) IN GENERAL.—Section 1882 of the Social Security Act | (1) IN GENERAL.—Section 1882 of the Social Security Act | ||
(42 U.S.C. 1395ss) is amended by adding at the end the following: | (42 U.S.C. 1395ss) is amended by adding at the end the following: | ||
+ | |||
‘‘(x) LIMITATIONS ON GENETIC TESTING AND INFORMATION.— | ‘‘(x) LIMITATIONS ON GENETIC TESTING AND INFORMATION.— | ||
+ | |||
‘‘(1) GENETIC TESTING.— | ‘‘(1) GENETIC TESTING.— | ||
+ | |||
‘‘(A) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ‘‘(A) LIMITATION ON REQUESTING OR REQUIRING GENETIC | ||
TESTING.—An issuer of a medicare supplemental policy | TESTING.—An issuer of a medicare supplemental policy | ||
shall not request or require an individual or a family | shall not request or require an individual or a family | ||
member of such individual to undergo a genetic test. | member of such individual to undergo a genetic test. | ||
+ | |||
‘‘(B) RULE OF CONSTRUCTION.—Subparagraph (A) shall | ‘‘(B) RULE OF CONSTRUCTION.—Subparagraph (A) shall | ||
not be construed to limit the authority of a health care | not be construed to limit the authority of a health care | ||
Line 356: | Line 476: | ||
individual to request that such individual undergo a genetic | individual to request that such individual undergo a genetic | ||
test. | test. | ||
+ | |||
‘‘(C) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ‘‘(C) RULE OF CONSTRUCTION REGARDING PAYMENT.— | ||
+ | |||
‘‘(i) IN GENERAL.—Nothing in subparagraph (A) | ‘‘(i) IN GENERAL.—Nothing in subparagraph (A) | ||
shall be construed to preclude an issuer of a medicare | shall be construed to preclude an issuer of a medicare | ||
Line 366: | Line 488: | ||
264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to | 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to | ||
time) consistent with subsection (s)(2)(E). | time) consistent with subsection (s)(2)(E). | ||
+ | |||
‘‘(ii) LIMITATION.—For purposes of clause (i), an | ‘‘(ii) LIMITATION.—For purposes of clause (i), an | ||
issuer of a medicare supplemental policy may request | issuer of a medicare supplemental policy may request | ||
only the minimum amount of information necessary | only the minimum amount of information necessary | ||
to accomplish the intended purpose. | to accomplish the intended purpose. | ||
+ | |||
‘‘(D) RESEARCH EXCEPTION.—Notwithstanding subparagraph (A), an issuer of a medicare supplemental policy | ‘‘(D) RESEARCH EXCEPTION.—Notwithstanding subparagraph (A), an issuer of a medicare supplemental policy | ||
may request, but not require, that an individual or a family | may request, but not require, that an individual or a family | ||
member of such individual undergo a genetic test if each | member of such individual undergo a genetic test if each | ||
of the following conditions is met: | of the following conditions is met: | ||
+ | |||
‘‘(i) The request is made pursuant to research that | ‘‘(i) The request is made pursuant to research that | ||
complies with part 46 of title 45, Code of Federal | complies with part 46 of title 45, Code of Federal | ||
Line 379: | Line 504: | ||
applicable State or local law or regulations for the | applicable State or local law or regulations for the | ||
protection of human subjects in research. | protection of human subjects in research. | ||
+ | |||
‘‘(ii) The issuer clearly indicates to each individual, | ‘‘(ii) The issuer clearly indicates to each individual, | ||
or in the case of a minor child, to the legal guardian | or in the case of a minor child, to the legal guardian | ||
of such child, to whom the request is made that— | of such child, to whom the request is made that— | ||
+ | |||
‘‘(I) compliance with the request is voluntary; | ‘‘(I) compliance with the request is voluntary; | ||
and | and | ||
+ | |||
‘‘(II) non-compliance will have no effect on | ‘‘(II) non-compliance will have no effect on | ||
enrollment status or premium or contribution | enrollment status or premium or contribution | ||
amounts. | amounts. | ||
+ | |||
‘‘(iii) No genetic information collected or acquired | ‘‘(iii) 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 | 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. | coverage for health insurance or health benefits. | ||
+ | |||
‘‘(iv) The issuer notifies the Secretary in writing | ‘‘(iv) The issuer notifies the Secretary in writing | ||
that the issuer is conducting activities pursuant to | that the issuer is conducting activities pursuant to | ||
the exception provided for under this subparagraph, | the exception provided for under this subparagraph, | ||
including a description of the activities conducted. | including a description of the activities conducted. | ||
+ | |||
‘‘(v) The issuer complies with such other conditions | ‘‘(v) The issuer complies with such other conditions | ||
as the Secretary may by regulation require for activities conducted under this subparagraph. | as the Secretary may by regulation require for activities conducted under this subparagraph. | ||
− | ‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMA- TION.— ‘‘(A) IN GENERAL.—An issuer of a medicare supplemental policy shall not request, require, or purchase genetic | + | |
+ | ‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMA- TION.— | ||
+ | |||
+ | ‘‘(A) IN GENERAL.—An issuer of a medicare supplemental policy shall not request, require, or purchase genetic | ||
information for underwriting purposes (as defined in paragraph (3)). | information for underwriting purposes (as defined in paragraph (3)). | ||
− | ‘‘(B) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT. | + | |
+ | ‘‘(B) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT.— | ||
+ | |||
+ | An issuer of a medicare | ||
supplemental policy shall not request, require, or purchase | supplemental policy shall not request, require, or purchase | ||
genetic information with respect to any individual prior | genetic information with respect to any individual prior | ||
to such individual’s enrollment under the policy in connection with such enrollment. | to such individual’s enrollment under the policy in connection with such enrollment. | ||
− | ‘‘(C) INCIDENTAL COLLECTION. | + | |
+ | ‘‘(C) INCIDENTAL COLLECTION.— | ||
+ | |||
+ | 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, | information concerning any individual, such request, | ||
requirement, or purchase shall not be considered a violation | 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). | of subparagraph (B) if such request, requirement, or purchase is not in violation of subparagraph (A). | ||
+ | |||
(2) APPLICATION TO GENETIC INFORMATION OF A FETUS OR | (2) APPLICATION TO GENETIC INFORMATION OF A FETUS OR | ||
− | EMBRYO. | + | EMBRYO.— |
+ | |||
+ | Section 1882(x) of such Act, as added by paragraph | ||
(1), is further amended by adding at the end the following: | (1), is further amended by adding at the end the following: | ||
− | ‘‘(4) GENETIC INFORMATION OF A FETUS OR EMBRYO. | + | |
+ | ‘‘(4) GENETIC INFORMATION OF A FETUS OR EMBRYO.— | ||
+ | |||
+ | Any | ||
reference in this section to genetic information concerning an | reference in this section to genetic information concerning an | ||
individual or family member of an individual shall— | individual or family member of an individual shall— | ||
+ | |||
‘‘(A) with respect to such an individual or family | ‘‘(A) with respect to such an individual or family | ||
member of an individual who is a pregnant woman, include | member of an individual who is a pregnant woman, include | ||
genetic information of any fetus carried by such pregnant | genetic information of any fetus carried by such pregnant | ||
woman; and | woman; and | ||
+ | |||
‘‘(B) with respect to an individual or family member | ‘‘(B) with respect to an individual or family member | ||
utilizing an assisted reproductive technology, include | utilizing an assisted reproductive technology, include | ||
genetic information of any embryo legally held by the individual or family member.’’. | genetic information of any embryo legally held by the individual or family member.’’. | ||
+ | |||
SEC. 105. PRIVACY AND CONFIDENTIALITY. | SEC. 105. PRIVACY AND CONFIDENTIALITY. | ||
+ | |||
(a) IN GENERAL.—Part C of title XI of the Social Security | (a) IN GENERAL.—Part C of title XI of the Social Security | ||
Act is amended by adding at the end the following new section: | Act is amended by adding at the end the following new section: | ||
+ | |||
‘‘SEC. 1180. (a) IN GENERAL.—The Secretary shall revise the | ‘‘SEC. 1180. (a) IN GENERAL.—The Secretary shall revise the | ||
HIPAA privacy regulation (as defined in subsection (b)) so it is | HIPAA privacy regulation (as defined in subsection (b)) so it is | ||
consistent with the following: | consistent with the following: | ||
+ | |||
‘‘(1) Genetic information shall be treated as health information described in section 1171(4)(B). | ‘‘(1) Genetic information shall be treated as health information described in section 1171(4)(B). | ||
+ | |||
‘‘(2) The use or disclosure by a covered entity that is a | ‘‘(2) The use or disclosure by a covered entity that is a | ||
group health plan, health insurance issuer that issues health | group health plan, health insurance issuer that issues health | ||
Line 432: | Line 585: | ||
about an individual for underwriting purposes under the group | 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. | health plan, health insurance coverage, or medicare supplemental policy shall not be a permitted use or disclosure. | ||
− | ‘‘(b) DEFINITIONS. | + | |
+ | ‘‘(b) DEFINITIONS.— | ||
+ | |||
+ | For purposes of this section: | ||
+ | |||
‘‘(1) GENETIC INFORMATION; GENETIC TEST; FAMILY | ‘‘(1) GENETIC INFORMATION; GENETIC TEST; FAMILY | ||
− | MEMBER. | + | MEMBER.— |
+ | |||
+ | The terms ‘genetic information’, ‘genetic test’, and | ||
‘family member’ have the meanings given such terms in section | ‘family member’ have the meanings given such terms in section | ||
2791 of the Public Health Service Act (42 U.S.C. 300gg–91), | 2791 of the Public Health Service Act (42 U.S.C. 300gg–91), | ||
as amended by the Genetic Information Nondiscrimination Act | as amended by the Genetic Information Nondiscrimination Act | ||
of 2007. | of 2007. | ||
+ | |||
‘‘(2) GROUP HEALTH PLAN; HEALTH INSURANCE COVERAGE; | ‘‘(2) GROUP HEALTH PLAN; HEALTH INSURANCE COVERAGE; | ||
− | MEDICARE SUPPLEMENTAL POLICY. | + | MEDICARE SUPPLEMENTAL POLICY.— |
+ | |||
+ | The terms ‘group health | ||
plan’ and ‘health insurance coverage’ have the meanings given | plan’ and ‘health insurance coverage’ have the meanings given | ||
such terms under section 2791 of the Public Health Service | such terms under section 2791 of the Public Health Service | ||
Act (42 U.S.C. 300gg–91), and the term ‘medicare supplemental | Act (42 U.S.C. 300gg–91), and the term ‘medicare supplemental | ||
policy’ has the meaning given such term in section 1882(g). | policy’ has the meaning given such term in section 1882(g). | ||
− | ‘‘(3) HIPAA PRIVACY REGULATION. | + | |
+ | ‘‘(3) HIPAA PRIVACY REGULATION.— | ||
+ | |||
+ | The term ‘HIPAA privacy regulation’ means the regulations promulgated by the | ||
Secretary under this part and section 264 of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. | Secretary under this part and section 264 of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. | ||
1320d–2 note). | 1320d–2 note). | ||
− | ‘‘(4) UNDERWRITING PURPOSES. | + | |
+ | ‘‘(4) UNDERWRITING PURPOSES.— | ||
+ | |||
+ | The term ‘underwriting | ||
purposes’ means, with respect to a group health plan, health | purposes’ means, with respect to a group health plan, health | ||
insurance coverage, or a medicare supplemental policy— | insurance coverage, or a medicare supplemental policy— | ||
+ | |||
‘‘(A) rules for, or determination of, eligibility (including | ‘‘(A) rules for, or determination of, eligibility (including | ||
enrollment and continued eligibility) for, or determination | enrollment and continued eligibility) for, or determination | ||
of, benefits under the plan, coverage, or policy; | of, benefits under the plan, coverage, or policy; | ||
+ | |||
‘‘(B) the computation of premium or contribution | ‘‘(B) the computation of premium or contribution | ||
amounts under the plan, coverage, or policy; | amounts under the plan, coverage, or policy; | ||
+ | |||
‘‘(C) the application of any pre-existing condition exclusion under the plan, coverage, or policy; and | ‘‘(C) the application of any pre-existing condition exclusion under the plan, coverage, or policy; and | ||
+ | |||
‘‘(D) other activities related to the creation, renewal, | ‘‘(D) other activities related to the creation, renewal, | ||
or replacement of a contract of health insurance or health | or replacement of a contract of health insurance or health | ||
benefits. | benefits. | ||
+ | |||
SEC. 202. EMPLOYER PRACTICES. | SEC. 202. EMPLOYER PRACTICES. | ||
− | (a) DISCRIMINATION BASED ON GENETIC INFORMATION. | + | |
+ | (a) DISCRIMINATION BASED ON GENETIC INFORMATION.— | ||
+ | |||
+ | It shall | ||
be an unlawful employment practice for an employer— | be an unlawful employment practice for an employer— | ||
+ | |||
(1) to fail or refuse to hire, or to discharge, any employee, | (1) to fail or refuse to hire, or to discharge, any employee, | ||
or otherwise to discriminate against any employee with respect | 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 | to the compensation, terms, conditions, or privileges of employment of the employee, because of genetic information with | ||
respect to the employee; or | respect to the employee; or | ||
+ | |||
(2) to limit, segregate, or classify the employees of the | (2) to limit, segregate, or classify the employees of the | ||
employer in any way that would deprive or tend to deprive | employer in any way that would deprive or tend to deprive | ||
Line 472: | Line 650: | ||
adversely affect the status of the employee as an employee, | adversely affect the status of the employee as an employee, | ||
because of genetic information with respect to the employee. | because of genetic information with respect to the employee. | ||
+ | |||
(b) ACQUISITION OF GENETIC INFORMATION.—It shall be an | (b) ACQUISITION OF GENETIC INFORMATION.—It shall be an | ||
unlawful employment practice for an employer to request, require, | unlawful employment practice for an employer to request, require, | ||
or purchase genetic information with respect to an employee or | or purchase genetic information with respect to an employee or | ||
a family member of the employee except— | a family member of the employee except— | ||
+ | |||
(1) where an employer inadvertently requests or requires | (1) where an employer inadvertently requests or requires | ||
family medical history of the employee or family member of | family medical history of the employee or family member of | ||
the employee; | the employee; | ||
+ | |||
(2) where— | (2) where— | ||
+ | |||
(A) health or genetic services are offered by the | (A) health or genetic services are offered by the | ||
employer, including such services offered as part of a | employer, including such services offered as part of a | ||
wellness program; | wellness program; | ||
+ | |||
(B) the employee provides prior, knowing, voluntary, | (B) the employee provides prior, knowing, voluntary, | ||
and written authorization; | and written authorization; | ||
+ | |||
(C) only the employee (or family member if the family | (C) only the employee (or family member if the family | ||
member is receiving genetic services) and the licensed | member is receiving genetic services) and the licensed | ||
Line 490: | Line 674: | ||
involved in providing such services receive individually | involved in providing such services receive individually | ||
identifiable information concerning the results of such services; and | identifiable information concerning the results of such services; and | ||
+ | |||
(D) any individually identifiable genetic information | (D) any individually identifiable genetic information | ||
provided under subparagraph (C) in connection with the | provided under subparagraph (C) in connection with the | ||
Line 496: | Line 681: | ||
to the employer except in aggregate terms that do not | to the employer except in aggregate terms that do not | ||
disclose the identity of specific employees; | disclose the identity of specific employees; | ||
+ | |||
(3) where an employer requests or requires family medical | (3) where an employer requests or requires family medical | ||
history from the employee to comply with the certification | history from the employee to comply with the certification | ||
Line 501: | Line 687: | ||
Act of 1993 (29 U.S.C. 2613) or such requirements under State | Act of 1993 (29 U.S.C. 2613) or such requirements under State | ||
family and medical leave laws; | family and medical leave laws; | ||
+ | |||
(4) where an employer purchases documents that are | (4) where an employer purchases documents that are | ||
commercially and publicly available (including newspapers, | commercially and publicly available (including newspapers, | ||
magazines, periodicals, and books, but not including medical | magazines, periodicals, and books, but not including medical | ||
databases or court records) that include family medical history; | databases or court records) that include family medical history; | ||
+ | |||
(5) where the information involved is to be used for genetic | (5) where the information involved is to be used for genetic | ||
monitoring of the biological effects of toxic substances in the | monitoring of the biological effects of toxic substances in the | ||
workplace, but only if— | workplace, but only if— | ||
+ | |||
(A) the employer provides written notice of the genetic | (A) the employer provides written notice of the genetic | ||
monitoring to the employee; | monitoring to the employee; | ||
+ | |||
(B)(i) the employee provides prior, knowing, voluntary, | (B)(i) the employee provides prior, knowing, voluntary, | ||
and written authorization; or | and written authorization; or | ||
+ | |||
(ii) the genetic monitoring is required by Federal or | (ii) the genetic monitoring is required by Federal or | ||
State law; | State law; | ||
+ | |||
(C) the employee is informed of individual monitoring | (C) the employee is informed of individual monitoring | ||
results; | results; | ||
+ | |||
(D) the monitoring is in compliance with— | (D) the monitoring is in compliance with— | ||
+ | |||
(i) any Federal genetic monitoring regulations, | (i) any Federal genetic monitoring regulations, | ||
including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | ||
Line 523: | Line 717: | ||
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | ||
Act of 1954 (42 U.S.C. 2011 et seq.); or | Act of 1954 (42 U.S.C. 2011 et seq.); or | ||
+ | |||
(ii) State genetic monitoring regulations, in the | (ii) State genetic monitoring regulations, in the | ||
case of a State that is implementing genetic monitoring | case of a State that is implementing genetic monitoring | ||
Line 528: | Line 723: | ||
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | ||
and | and | ||
+ | |||
(E) the employer, excluding any licensed health care | (E) the employer, excluding any licensed health care | ||
professional or board certified genetic counselor that is | professional or board certified genetic counselor that is | ||
Line 533: | Line 729: | ||
results of the monitoring only in aggregate terms that | results of the monitoring only in aggregate terms that | ||
do not disclose the identity of specific employees; or | do not disclose the identity of specific employees; or | ||
+ | |||
(6) where the employer conducts DNA analysis for law | (6) where the employer conducts DNA analysis for law | ||
enforcement purposes as a forensic laboratory or for purposes | enforcement purposes as a forensic laboratory or for purposes | ||
Line 540: | Line 737: | ||
of DNA identification markers for quality control to detect | of DNA identification markers for quality control to detect | ||
sample contamination. | sample contamination. | ||
+ | |||
(c) PRESERVATION OF PROTECTIONS.—In the case of information | (c) PRESERVATION OF PROTECTIONS.—In the case of information | ||
to which any of paragraphs (1) through (6) of subsection (b) applies, | to which any of paragraphs (1) through (6) of subsection (b) applies, | ||
Line 545: | Line 743: | ||
or (2) of subsection (a) or treated or disclosed in a manner that | or (2) of subsection (a) or treated or disclosed in a manner that | ||
violates section 206. | violates section 206. | ||
+ | |||
SEC. 203. EMPLOYMENT AGENCY PRACTICES. | SEC. 203. EMPLOYMENT AGENCY PRACTICES. | ||
+ | |||
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—It shall | (a) DISCRIMINATION BASED ON GENETIC INFORMATION.—It shall | ||
be an unlawful employment practice for an employment agency— | be an unlawful employment practice for an employment agency— | ||
+ | |||
(1) to fail or refuse to refer for employment, or otherwise | (1) to fail or refuse to refer for employment, or otherwise | ||
to discriminate against, any individual because of genetic | to discriminate against, any individual because of genetic | ||
information with respect to the individual; | information with respect to the individual; | ||
+ | |||
(2) to limit, segregate, or classify individuals or fail or | (2) to limit, segregate, or classify individuals or fail or | ||
refuse to refer for employment any individual in any way | refuse to refer for employment any individual in any way | ||
Line 556: | Line 758: | ||
of the individual as an employee, because of genetic information | of the individual as an employee, because of genetic information | ||
with respect to the individual; or | with respect to the individual; or | ||
+ | |||
(3) to cause or attempt to cause an employer to discriminate | (3) to cause or attempt to cause an employer to discriminate | ||
against an individual in violation of this title. | against an individual in violation of this title. | ||
− | (b) ACQUISITION OF GENETIC INFORMATION. | + | |
+ | (b) ACQUISITION OF GENETIC INFORMATION.— | ||
+ | |||
+ | It shall be an | ||
unlawful employment practice for an employment agency to request, | 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— | require, or purchase genetic information with respect to an individual or a family member of the individual except— | ||
+ | |||
(1) where an employment agency inadvertently requests | (1) where an employment agency inadvertently requests | ||
or requires family medical history of the individual or family | or requires family medical history of the individual or family | ||
member of the individual; | member of the individual; | ||
+ | |||
(2) where— | (2) where— | ||
+ | |||
(A) health or genetic services are offered by the employment agency, including such services offered as part of | (A) health or genetic services are offered by the employment agency, including such services offered as part of | ||
a wellness program; | a wellness program; | ||
+ | |||
(B) the individual provides prior, knowing, voluntary, | (B) the individual provides prior, knowing, voluntary, | ||
and written authorization; | and written authorization; | ||
+ | |||
(C) only the individual (or family member if the family | (C) only the individual (or family member if the family | ||
member is receiving genetic services) and the licensed | member is receiving genetic services) and the licensed | ||
Line 574: | Line 785: | ||
involved in providing such services receive individually | involved in providing such services receive individually | ||
identifiable information concerning the results of such services; and | identifiable information concerning the results of such services; and | ||
+ | |||
(D) any individually identifiable genetic information | (D) any individually identifiable genetic information | ||
provided under subparagraph (C) in connection with the | provided under subparagraph (C) in connection with the | ||
Line 580: | Line 792: | ||
to the employment agency except in aggregate terms that | to the employment agency except in aggregate terms that | ||
do not disclose the identity of specific individuals; | do not disclose the identity of specific individuals; | ||
+ | |||
(3) where an employment agency requests or requires | (3) where an employment agency requests or requires | ||
family medical history from the individual to comply with the | family medical history from the individual to comply with the | ||
Line 585: | Line 798: | ||
Leave Act of 1993 (29 U.S.C. 2613) or such requirements under | Leave Act of 1993 (29 U.S.C. 2613) or such requirements under | ||
State family and medical leave laws; | State family and medical leave laws; | ||
+ | |||
(4) where an employment agency purchases documents that | (4) where an employment agency purchases documents that | ||
are commercially and publicly available (including newspapers, | are commercially and publicly available (including newspapers, | ||
Line 590: | Line 804: | ||
databases or court records) that include family medical history; | databases or court records) that include family medical history; | ||
or | or | ||
+ | |||
(5) where the information involved is to be used for genetic | (5) where the information involved is to be used for genetic | ||
monitoring of the biological effects of toxic substances in the | monitoring of the biological effects of toxic substances in the | ||
workplace, but only if— | workplace, but only if— | ||
+ | |||
(A) the employment agency provides written notice | (A) the employment agency provides written notice | ||
of the genetic monitoring to the individual; | of the genetic monitoring to the individual; | ||
+ | |||
(B)(i) the individual provides prior, knowing, voluntary, | (B)(i) the individual provides prior, knowing, voluntary, | ||
and written authorization; or | and written authorization; or | ||
+ | |||
(ii) the genetic monitoring is required by Federal or | (ii) the genetic monitoring is required by Federal or | ||
State law; | State law; | ||
+ | |||
(C) the individual is informed of individual monitoring | (C) the individual is informed of individual monitoring | ||
results; | results; | ||
+ | |||
(D) the monitoring is in compliance with— | (D) the monitoring is in compliance with— | ||
+ | |||
(i) any Federal genetic monitoring regulations, | (i) any Federal genetic monitoring regulations, | ||
including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | ||
Line 608: | Line 829: | ||
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | ||
Act of 1954 (42 U.S.C. 2011 et seq.); or | Act of 1954 (42 U.S.C. 2011 et seq.); or | ||
+ | |||
(ii) State genetic monitoring regulations, in the | (ii) State genetic monitoring regulations, in the | ||
case of a State that is implementing genetic monitoring | case of a State that is implementing genetic monitoring | ||
Line 613: | Line 835: | ||
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | ||
and | and | ||
+ | |||
(E) the employment agency, excluding any licensed | (E) the employment agency, excluding any licensed | ||
health care professional or board certified genetic counselor | health care professional or board certified genetic counselor | ||
Line 618: | Line 841: | ||
the results of the monitoring only in aggregate terms that | the results of the monitoring only in aggregate terms that | ||
do not disclose the identity of specific individuals. | do not disclose the identity of specific individuals. | ||
+ | |||
(c) PRESERVATION OF PROTECTIONS.—In the case of information | (c) PRESERVATION OF PROTECTIONS.—In the case of information | ||
to which any of paragraphs (1) through (5) of subsection (b) applies, | to which any of paragraphs (1) through (5) of subsection (b) applies, | ||
Line 623: | Line 847: | ||
(2), or (3) of subsection (a) or treated or disclosed in a manner | (2), or (3) of subsection (a) or treated or disclosed in a manner | ||
that violates section 206. | that violates section 206. | ||
+ | |||
SEC. 204. LABOR ORGANIZATION PRACTICES. | SEC. 204. LABOR ORGANIZATION PRACTICES. | ||
− | (a) DISCRIMINATION BASED ON GENETIC INFORMATION. | + | |
+ | (a) DISCRIMINATION BASED ON GENETIC INFORMATION.— | ||
+ | |||
+ | It shall | ||
be an unlawful employment practice for a labor organization— | be an unlawful employment practice for a labor organization— | ||
+ | |||
(1) to exclude or to expel from the membership of the | (1) to exclude or to expel from the membership of the | ||
organization, or otherwise to discriminate against, any member | organization, or otherwise to discriminate against, any member | ||
because of genetic information with respect to the member; | because of genetic information with respect to the member; | ||
+ | |||
(2) to limit, segregate, or classify the members of the | (2) to limit, segregate, or classify the members of the | ||
organization, or fail or refuse to refer for employment any | organization, or fail or refuse to refer for employment any | ||
Line 636: | Line 866: | ||
because of genetic information with respect to the member; | because of genetic information with respect to the member; | ||
or | or | ||
+ | |||
(3) to cause or attempt to cause an employer to discriminate | (3) to cause or attempt to cause an employer to discriminate | ||
against a member in violation of this title. | against a member in violation of this title. | ||
− | (b) ACQUISITION OF GENETIC INFORMATION. | + | |
+ | (b) ACQUISITION OF GENETIC INFORMATION.— | ||
+ | |||
+ | It shall be an | ||
unlawful employment practice for a labor organization to request, | unlawful employment practice for a labor organization to request, | ||
require, or purchase genetic information with respect to a member | require, or purchase genetic information with respect to a member | ||
or a family member of the member except— | or a family member of the member except— | ||
+ | |||
(1) where a labor organization inadvertently requests or | (1) where a labor organization inadvertently requests or | ||
requires family medical history of the member or family | requires family medical history of the member or family | ||
member of the member; | member of the member; | ||
+ | |||
(2) where— | (2) where— | ||
+ | |||
(A) health or genetic services are offered by the labor | (A) health or genetic services are offered by the labor | ||
organization, including such services offered as part of | organization, including such services offered as part of | ||
a wellness program; | a wellness program; | ||
+ | |||
(B) the member provides prior, knowing, voluntary, | (B) the member provides prior, knowing, voluntary, | ||
and written authorization; | and written authorization; | ||
+ | |||
(C) only the member (or family member if the family | (C) only the member (or family member if the family | ||
member is receiving genetic services) and the licensed | member is receiving genetic services) and the licensed | ||
Line 656: | Line 895: | ||
involved in providing such services receive individually | involved in providing such services receive individually | ||
identifiable information concerning the results of such services; and | identifiable information concerning the results of such services; and | ||
+ | |||
(D) any individually identifiable genetic information | (D) any individually identifiable genetic information | ||
provided under subparagraph (C) in connection with the | provided under subparagraph (C) in connection with the | ||
Line 662: | Line 902: | ||
to the labor organization except in aggregate terms that | to the labor organization except in aggregate terms that | ||
do not disclose the identity of specific members; | do not disclose the identity of specific members; | ||
+ | |||
(3) where a labor organization requests or requires family | (3) 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 | medical history from the members to comply with the certification provisions of section 103 of the Family and Medical | ||
Leave Act of 1993 (29 U.S.C. 2613) or such requirements under | Leave Act of 1993 (29 U.S.C. 2613) or such requirements under | ||
State family and medical leave laws; | State family and medical leave laws; | ||
+ | |||
(4) where a labor organization purchases documents that | (4) where a labor organization purchases documents that | ||
are commercially and publicly available (including newspapers, | are commercially and publicly available (including newspapers, | ||
Line 671: | Line 913: | ||
databases or court records) that include family medical history; | databases or court records) that include family medical history; | ||
or | or | ||
+ | |||
(5) where the information involved is to be used for genetic | (5) where the information involved is to be used for genetic | ||
monitoring of the biological effects of toxic substances in the | monitoring of the biological effects of toxic substances in the | ||
workplace, but only if— | workplace, but only if— | ||
+ | |||
(A) the labor organization provides written notice of | (A) the labor organization provides written notice of | ||
the genetic monitoring to the member; | the genetic monitoring to the member; | ||
+ | |||
(B)(i) the member provides prior, knowing, voluntary, | (B)(i) the member provides prior, knowing, voluntary, | ||
and written authorization; or | and written authorization; or | ||
+ | |||
(ii) the genetic monitoring is required by Federal or | (ii) the genetic monitoring is required by Federal or | ||
State law; | State law; | ||
+ | |||
(C) the member is informed of individual monitoring | (C) the member is informed of individual monitoring | ||
results; | results; | ||
+ | |||
(D) the monitoring is in compliance with— | (D) the monitoring is in compliance with— | ||
+ | |||
(i) any Federal genetic monitoring regulations, | (i) any Federal genetic monitoring regulations, | ||
including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | ||
Line 689: | Line 938: | ||
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | ||
Act of 1954 (42 U.S.C. 2011 et seq.); or | Act of 1954 (42 U.S.C. 2011 et seq.); or | ||
+ | |||
(ii) State genetic monitoring regulations, in the | (ii) State genetic monitoring regulations, in the | ||
case of a State that is implementing genetic monitoring | case of a State that is implementing genetic monitoring | ||
Line 694: | Line 944: | ||
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | ||
and | and | ||
+ | |||
(E) the labor organization, excluding any licensed | (E) the labor organization, excluding any licensed | ||
health care professional or board certified genetic counselor | health care professional or board certified genetic counselor | ||
Line 699: | Line 950: | ||
the results of the monitoring only in aggregate terms that | the results of the monitoring only in aggregate terms that | ||
do not disclose the identity of specific members. | do not disclose the identity of specific members. | ||
+ | |||
(c) PRESERVATION OF PROTECTIONS.—In the case of information | (c) PRESERVATION OF PROTECTIONS.—In the case of information | ||
to which any of paragraphs (1) through (5) of subsection (b) applies, | to which any of paragraphs (1) through (5) of subsection (b) applies, | ||
Line 704: | Line 956: | ||
(2), or (3) of subsection (a) or treated or disclosed in a manner | (2), or (3) of subsection (a) or treated or disclosed in a manner | ||
that violates section 206. | that violates section 206. | ||
+ | |||
SEC. 205. TRAINING PROGRAMS. | SEC. 205. TRAINING PROGRAMS. | ||
− | (a) DISCRIMINATION BASED ON GENETIC INFORMATION. | + | |
+ | (a) DISCRIMINATION BASED ON GENETIC INFORMATION.— | ||
+ | |||
+ | It shall | ||
be an unlawful employment practice for any employer, labor | be an unlawful employment practice for any employer, labor | ||
organization, or joint labor-management committee controlling | organization, or joint labor-management committee controlling | ||
apprenticeship or other training or retraining, including on-thejob training programs— | apprenticeship or other training or retraining, including on-thejob training programs— | ||
+ | |||
(1) to discriminate against any individual because of genetic | (1) to discriminate against any individual because of genetic | ||
information with respect to the individual in admission to, | information with respect to the individual in admission to, | ||
or employment in, any program established to provide | or employment in, any program established to provide | ||
apprenticeship or other training or retraining; | apprenticeship or other training or retraining; | ||
+ | |||
(2) to limit, segregate, or classify the applicants for or | (2) to limit, segregate, or classify the applicants for or | ||
participants in such apprenticeship or other training or | participants in such apprenticeship or other training or | ||
Line 720: | Line 978: | ||
because of genetic information with respect to the individual; | because of genetic information with respect to the individual; | ||
or | or | ||
+ | |||
(3) to cause or attempt to cause an employer to discriminate | (3) to cause or attempt to cause an employer to discriminate | ||
against an applicant for or a participant in such apprenticeship | against an applicant for or a participant in such apprenticeship | ||
or other training or retraining in violation of this title. | or other training or retraining in violation of this title. | ||
+ | |||
(b) ACQUISITION OF GENETIC INFORMATION.—It shall be an | (b) ACQUISITION OF GENETIC INFORMATION.—It shall be an | ||
unlawful employment practice for an employer, labor organization, | unlawful employment practice for an employer, labor organization, | ||
Line 728: | Line 988: | ||
to request, require, or purchase genetic information with respect | to request, require, or purchase genetic information with respect | ||
to an individual or a family member of the individual except— | to an individual or a family member of the individual except— | ||
− | (1) where the employer, labor organization, or joint | + | |
− | family medical history of the individual or family member of | + | (1) 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; | the individual; | ||
+ | |||
(2) where— | (2) where— | ||
+ | |||
(A) health or genetic services are offered by the | (A) health or genetic services are offered by the | ||
employer, labor organization, or joint labor-management | employer, labor organization, or joint labor-management | ||
committee, including such services offered as part of a | committee, including such services offered as part of a | ||
wellness program; | wellness program; | ||
+ | |||
(B) the individual provides prior, knowing, voluntary, | (B) the individual provides prior, knowing, voluntary, | ||
and written authorization; | and written authorization; | ||
+ | |||
(C) only the individual (or family member if the family | (C) only the individual (or family member if the family | ||
member is receiving genetic services) and the licensed | member is receiving genetic services) and the licensed | ||
Line 743: | Line 1,007: | ||
involved in providing such services receive individually | involved in providing such services receive individually | ||
identifiable information concerning the results of such services; and | identifiable information concerning the results of such services; and | ||
+ | |||
(D) any individually identifiable genetic information | (D) any individually identifiable genetic information | ||
provided under subparagraph (C) in connection with the | provided under subparagraph (C) in connection with the | ||
Line 749: | Line 1,014: | ||
to the employer, labor organization, or joint labor-management committee except in aggregate terms that do not | to the employer, labor organization, or joint labor-management committee except in aggregate terms that do not | ||
disclose the identity of specific individuals; | disclose the identity of specific individuals; | ||
− | (3) where the employer, labor organization, or joint labormanagement committee requests or requires family medical | + | |
− | history from the individual to comply with the certification | + | (3) where the employer, labor organization, or joint labormanagement 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 | provisions of section 103 of the Family and Medical Leave | ||
Act of 1993 (29 U.S.C. 2613) or such requirements under State | Act of 1993 (29 U.S.C. 2613) or such requirements under State | ||
family and medical leave laws; | family and medical leave laws; | ||
+ | |||
(4) where the employer, labor organization, or joint labormanagement committee purchases documents that are commercially and publicly available (including newspapers, magazines, | (4) where the employer, labor organization, or joint labormanagement committee purchases documents that are commercially and publicly available (including newspapers, magazines, | ||
periodicals, and books, but not including medical databases | periodicals, and books, but not including medical databases | ||
or court records) that include family medical history; | or court records) that include family medical history; | ||
+ | |||
(5) where the information involved is to be used for genetic | (5) where the information involved is to be used for genetic | ||
monitoring of the biological effects of toxic substances in the | monitoring of the biological effects of toxic substances in the | ||
workplace, but only if— | workplace, but only if— | ||
+ | |||
(A) the employer, labor organization, or joint labormanagement committee provides written notice of the | (A) the employer, labor organization, or joint labormanagement committee provides written notice of the | ||
genetic monitoring to the individual; | genetic monitoring to the individual; | ||
+ | |||
(B)(i) the individual provides prior, knowing, voluntary, | (B)(i) the individual provides prior, knowing, voluntary, | ||
and written authorization; or | and written authorization; or | ||
+ | |||
(ii) the genetic monitoring is required by Federal or | (ii) the genetic monitoring is required by Federal or | ||
State law; | State law; | ||
+ | |||
(C) the individual is informed of individual monitoring | (C) the individual is informed of individual monitoring | ||
results; | results; | ||
+ | |||
(D) the monitoring is in compliance with— | (D) the monitoring is in compliance with— | ||
+ | |||
(i) any Federal genetic monitoring regulations, | (i) any Federal genetic monitoring regulations, | ||
including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | including any such regulations that may be promulgated by the Secretary of Labor pursuant to the | ||
Line 775: | Line 1,048: | ||
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy | ||
Act of 1954 (42 U.S.C. 2011 et seq.); or | Act of 1954 (42 U.S.C. 2011 et seq.); or | ||
+ | |||
(ii) State genetic monitoring regulations, in the | (ii) State genetic monitoring regulations, in the | ||
case of a State that is implementing genetic monitoring | case of a State that is implementing genetic monitoring | ||
Line 780: | Line 1,054: | ||
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); | ||
and | and | ||
+ | |||
(E) the employer, labor organization, or joint labormanagement committee, excluding any licensed health care | (E) the employer, labor organization, or joint labormanagement committee, excluding any licensed health care | ||
professional or board certified genetic counselor that is | professional or board certified genetic counselor that is | ||
Line 785: | Line 1,060: | ||
results of the monitoring only in aggregate terms that | results of the monitoring only in aggregate terms that | ||
do not disclose the identity of specific individuals; or | do not disclose the identity of specific individuals; or | ||
+ | |||
(6) where the employer conducts DNA analysis for law | (6) where the employer conducts DNA analysis for law | ||
enforcement purposes as a forensic laboratory or for purposes | enforcement purposes as a forensic laboratory or for purposes | ||
Line 792: | Line 1,068: | ||
for analysis of DNA identification markers for quality control | for analysis of DNA identification markers for quality control | ||
to detect sample contamination. | to detect sample contamination. | ||
+ | |||
(c) PRESERVATION OF PROTECTIONS.—In the case of information | (c) PRESERVATION OF PROTECTIONS.—In the case of information | ||
to which any of paragraphs (1) through (6) of subsection (b) applies, | to which any of paragraphs (1) through (6) of subsection (b) applies, | ||
Line 797: | Line 1,074: | ||
(2), or (3) of subsection (a) or treated or disclosed in a manner | (2), or (3) of subsection (a) or treated or disclosed in a manner | ||
that violates section 206. | that violates section 206. | ||
+ | |||
SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION. | SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION. | ||
+ | |||
(a) TREATMENT OF INFORMATION AS PART OF CONFIDENTIAL | (a) TREATMENT OF INFORMATION AS PART OF CONFIDENTIAL | ||
− | MEDICAL RECORD. | + | MEDICAL RECORD.— |
+ | |||
+ | If an employer, employment agency, labor | ||
organization, or joint labor-management committee possesses | organization, or joint labor-management committee possesses | ||
genetic information about an employee or member, such information | genetic information about an employee or member, such information | ||
Line 811: | Line 1,092: | ||
medical record under section 102(d)(3)(B) of the Americans With | medical record under section 102(d)(3)(B) of the Americans With | ||
Disabilities Act (42 U.S.C. 12112(d)(3)(B)). | Disabilities Act (42 U.S.C. 12112(d)(3)(B)). | ||
− | (b) LIMITATION ON DISCLOSURE. | + | |
+ | (b) LIMITATION ON DISCLOSURE.— | ||
+ | |||
+ | An employer, employment | ||
agency, labor organization, or joint labor-management committee | agency, labor organization, or joint labor-management committee | ||
shall not disclose genetic information concerning an employee or | shall not disclose genetic information concerning an employee or | ||
member except— | member except— | ||
+ | |||
(1) to the employee or member of a labor organization | (1) to the employee or member of a labor organization | ||
(or family member if the family member is receiving the genetic | (or family member if the family member is receiving the genetic | ||
services) at the written request of the employee or member | services) at the written request of the employee or member | ||
of such organization; | of such organization; | ||
+ | |||
(2) to an occupational or other health researcher if the | (2) to an occupational or other health researcher if the | ||
research is conducted in compliance with the regulations and | research is conducted in compliance with the regulations and | ||
protections provided for under part 46 of title 45, Code of | protections provided for under part 46 of title 45, Code of | ||
Federal Regulations; | Federal Regulations; | ||
+ | |||
(3) in response to an order of a court, except that— | (3) in response to an order of a court, except that— | ||
+ | |||
(A) the employer, employment agency, labor organization, or joint labor-management committee may disclose | (A) the employer, employment agency, labor organization, or joint labor-management committee may disclose | ||
only the genetic information expressly authorized by such | only the genetic information expressly authorized by such | ||
order; and | order; and | ||
+ | |||
(B) if the court order was secured without the knowledge of the employee or member to whom the information | (B) 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 | 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 | the employee or member of the court order and any genetic | ||
information that was disclosed pursuant to such order; | information that was disclosed pursuant to such order; | ||
+ | |||
(4) to government officials who are investigating compliance | (4) to government officials who are investigating compliance | ||
with this title if the information is relevant to the investigation; | with this title if the information is relevant to the investigation; | ||
+ | |||
(5) to the extent that such disclosure is made in connection | (5) to the extent that such disclosure is made in connection | ||
with the employee’s compliance with the certification provisions | with the employee’s compliance with the certification provisions | ||
Line 838: | Line 1,129: | ||
(29 U.S.C. 2613) or such requirements under State family and | (29 U.S.C. 2613) or such requirements under State family and | ||
medical leave laws; or | medical leave laws; or | ||
+ | |||
(6) to a Federal, State, or local public health agency only | (6) to a Federal, State, or local public health agency only | ||
with regard to information that is described in section | with regard to information that is described in section | ||
Line 844: | Line 1,136: | ||
is or are the subject of a disclosure under this paragraph | is or are the subject of a disclosure under this paragraph | ||
is notified of such disclosure. | is notified of such disclosure. | ||
− | (c) RELATIONSHIP TO HIPAA REGULATIONS. | + | |
+ | (c) RELATIONSHIP TO HIPAA REGULATIONS.— | ||
+ | |||
+ | With respect to | ||
the regulations promulgated by the Secretary of Health and Human | the regulations promulgated by the Secretary of Health and Human | ||
Services under part C of title XI of the Social Security Act (42 | Services under part C of title XI of the Social Security Act (42 | ||
Line 854: | Line 1,149: | ||
does not affect the authority of such Secretary to modify such | does not affect the authority of such Secretary to modify such | ||
regulations. | regulations. | ||
+ | |Categories of personal information covered=Identifying, Medical and Health, Ethnicity | ||
}} | }} |
Latest revision as of 23:51, 26 October 2020
Genetic Information Nondiscrimination Act of 2008 | |
---|---|
Short Title | GINA |
Official Text | Genetic Information Nondiscrimination Act of 2008 |
Country/Jurisdiction | United States |
State or Province | |
Regulatory Bodies | |
Date Enacted | 2008/05/21 |
Scope of the Law | Individuals, Employers, Health Care Providers, Health Insurance Issuer |
Information | |
Taxonomy | Decisional Interference, Disclosure, Exclusion, Interrogation, Secondary Use, Surveillance |
Strategies |
Genetic Information Nondiscrimination Act of 2008 limits the genetic testing procedures and prohibits collecting genetic information for other purposes from individuals.
Text of the law
SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974. Exclusion, Decisional Interference, Interrogation, Disclosure
(b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLECTION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.—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, 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. Medical and Health, Preference "Personal#list" contains a listed "#" character as part of the property label and has therefore been classified as invalid.
‘‘(2) RULE OF CONSTRUCTION.—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.
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.—
‘‘(1) IN GENERAL.—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). Credit "Personal#list" contains a listed "#" character as part of the property label and has therefore been classified as invalid.
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT.—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.
‘‘(3) INCIDENTAL COLLECTION.—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).
(c) APPLICATION TO GENETIC INFORMATION OF A FETUS OR EMBRYO.—Such section is further amended by adding at the end the following:
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any reference in this part to genetic information concerning an individual or family member of an individual shall—
‘‘(1) 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 Medical and Health, Ethnicity, Family "Personal#list" contains a listed "#" character as part of the property label and has therefore been classified as invalid.
‘‘(2) 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.’’.
SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC TESTING.—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.
‘‘(2) RULE OF CONSTRUCTION.—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.
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.—
‘‘(A) IN GENERAL.—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 Social Security Act and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) consistent with subsection (a).
‘‘(B) LIMITATION.—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.
‘‘(4) RESEARCH EXCEPTION.—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 undergo a genetic test if each of the following conditions is met:
‘‘(A) 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.
‘‘(B) The plan or issuer 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—
‘‘(i) compliance with the request is voluntary; and
‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts.
‘‘(C) No genetic information collected or acquired under this paragraph shall be used for underwriting purposes. Surveillance, Secondary Use
‘‘(D) 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.
‘‘(E) The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.—
‘‘(1) IN GENERAL.—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).
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT.—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.
‘‘(3) INCIDENTAL COLLECTION.—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).
(3) APPLICATION TO GENETIC INFORMATION OF A FETUS OR EMBRYO.—Such section is further amended by adding at the end the following:
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any reference in this part to genetic information concerning an individual or family member of an individual shall—
‘‘(1) 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
‘‘(2) 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.’’.
‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS OF GENETIC INFORMATION.
‘‘(a) PROHIBITION ON GENETIC INFORMATION AS A CONDITION OF ELIGIBILITY.—
‘‘(1) IN GENERAL.—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.
‘‘(2) RULE OF CONSTRUCTION.—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.
‘‘(b) PROHIBITION ON GENETIC INFORMATION IN SETTING PREMIUM RATES.—
‘‘(1) IN GENERAL.—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.
‘‘(2) RULE OF CONSTRUCTION.—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.
‘‘(c) PROHIBITION ON GENETIC INFORMATION AS PREEXISTING CONDITION.—
‘‘(1) IN GENERAL.—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.
‘‘(2) RULE OF CONSTRUCTION.—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.
‘‘(d) 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.—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.
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.—
‘‘(A) IN GENERAL.—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 Social Security Act and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) consistent with subsection (a) and (c).
‘‘(B) LIMITATION.—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.
‘‘(4) RESEARCH EXCEPTION.—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:
‘‘(A) 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.
in the case of a minor child, to the legal guardian of such child, to whom the request is made that—
‘‘(i) compliance with the request is voluntary; and
‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts.
‘‘(C) No genetic information collected or acquired under this paragraph shall be used for underwriting purposes.
‘‘(D) 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.
‘‘(E) The issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.
‘‘(e) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.—
‘‘(1) IN GENERAL.—
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).
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT.—
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.
‘‘(3) INCIDENTAL COLLECTION.—
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). ‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—
Any reference in this part to genetic information concerning an individual or family member of an individual shall—
‘‘(1) 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
‘‘(2) 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.’’.
SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986.
(a) NO DISCRIMINATION IN GROUP PREMIUMS BASED ON GENETIC INFORMATION.—
Subsection (b) of section 9802 of the Internal Revenue Code of 1986 is amended—
(1) in paragraph (2)(A), by inserting before the semicolon the following: ‘‘except as provided in paragraph (3)’’; and
(2) by adding at the end the following:
‘‘(3) NO GROUP-BASED DISCRIMINATION ON BASIS OF GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—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.
‘‘(B) RULE OF CONSTRUCTION.—
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.’’.
(b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLECTION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.—
Section 9802 of such Code is amended by redesignating subsection (c) as subsection (f) and by inserting after subsection (b) the following new subsections:
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING GENETIC TESTING.—
A group health plan may not request or require an individual or a family member of such individual to undergo a genetic test.
‘‘(2) RULE OF CONSTRUCTION.—
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.
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.—
‘‘(A) IN GENERAL.—
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 Social Security Act and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) consistent with subsection (a).
‘‘(B) LIMITATION.—
For purposes of subparagraph (A), a group health plan may request only the minimum amount of information necessary to accomplish the intended purpose.
‘‘(4) RESEARCH EXCEPTION.—
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:
‘‘(A) 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.
‘‘(B) 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—
‘‘(i) compliance with the request is voluntary; and
‘‘(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts.
‘‘(C) No genetic information collected or acquired under this paragraph shall be used for underwriting purposes.
‘‘(D) 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.
‘‘(E) The plan complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.—
‘‘(1) IN GENERAL.—A group health plan shall not request, require, or purchase genetic information for underwriting purposes (as defined in section 9832).
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT.—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.
‘‘(3) INCIDENTAL COLLECTION.—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).
(c) APPLICATION TO GENETIC INFORMATION OF A FETUS OR EMBRYO.—Such section is further amended by adding at the end the following:
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—
Any reference in this chapter to genetic information concerning an individual or family member of an individual shall—
‘‘(1) 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
‘‘(2) 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.’’.
SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY ACT RELATING TO MEDIGAP.
(b) LIMITATIONS ON GENETIC TESTING AND 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:
‘‘(x) LIMITATIONS ON GENETIC TESTING AND 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.—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.
‘‘(C) RULE OF CONSTRUCTION REGARDING PAYMENT.—
‘‘(i) IN GENERAL.—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 Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) consistent with subsection (s)(2)(E).
‘‘(ii) LIMITATION.—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.
‘‘(D) RESEARCH EXCEPTION.—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:
‘‘(i) 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.
‘‘(ii) 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—
‘‘(I) compliance with the request is voluntary; and
‘‘(II) non-compliance will have no effect on enrollment status or premium or contribution amounts.
‘‘(iii) 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.
‘‘(iv) 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.
‘‘(v) The issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this subparagraph.
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMA- TION.—
‘‘(A) IN GENERAL.—An issuer of a medicare supplemental policy shall not request, require, or purchase genetic information for underwriting purposes (as defined in paragraph (3)).
‘‘(B) PROHIBITION ON COLLECTION OF GENETIC INFORMATION PRIOR TO ENROLLMENT.—
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.
‘‘(C) INCIDENTAL COLLECTION.—
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).
(2) APPLICATION TO GENETIC INFORMATION OF A FETUS OR EMBRYO.—
Section 1882(x) of such Act, as added by paragraph (1), is further amended by adding at the end the following:
‘‘(4) GENETIC INFORMATION OF A FETUS OR EMBRYO.—
Any reference in this section to genetic information concerning an individual or family member of an individual shall—
‘‘(A) 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
‘‘(B) 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.’’.
SEC. 105. PRIVACY AND CONFIDENTIALITY.
(a) IN GENERAL.—Part C of title XI of the Social Security Act is amended by adding at the end the following new section:
‘‘SEC. 1180. (a) IN GENERAL.—The Secretary shall revise the HIPAA privacy regulation (as defined in subsection (b)) so it is consistent with the following:
‘‘(1) Genetic information shall be treated as health information described in section 1171(4)(B).
‘‘(2) 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.
‘‘(b) DEFINITIONS.—
For purposes of this section:
‘‘(1) GENETIC INFORMATION; GENETIC TEST; FAMILY MEMBER.—
The terms ‘genetic information’, ‘genetic test’, and ‘family member’ have the meanings given such terms in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91), as amended by the Genetic Information Nondiscrimination Act of 2007.
‘‘(2) GROUP HEALTH PLAN; HEALTH INSURANCE COVERAGE; MEDICARE SUPPLEMENTAL POLICY.—
The terms ‘group health plan’ and ‘health insurance coverage’ have the meanings given such terms under section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91), and the term ‘medicare supplemental policy’ has the meaning given such term in section 1882(g).
‘‘(3) HIPAA PRIVACY REGULATION.—
The term ‘HIPAA privacy regulation’ means the regulations promulgated by the Secretary under this part and section 264 of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 note).
‘‘(4) UNDERWRITING PURPOSES.—
The term ‘underwriting purposes’ means, with respect to a group health plan, health insurance coverage, or a medicare supplemental policy—
‘‘(A) rules for, or determination of, eligibility (including enrollment and continued eligibility) for, or determination of, benefits under the plan, coverage, or policy;
‘‘(B) the computation of premium or contribution amounts under the plan, coverage, or policy;
‘‘(C) the application of any pre-existing condition exclusion under the plan, coverage, or policy; and
‘‘(D) other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.
SEC. 202. EMPLOYER PRACTICES.
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—
It shall be an unlawful employment practice for an employer—
(1) 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
(2) 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.
(b) ACQUISITION OF GENETIC INFORMATION.—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—
(1) where an employer inadvertently requests or requires family medical history of the employee or family member of the employee;
(2) where—
(A) health or genetic services are offered by the employer, including such services offered as part of a wellness program;
(B) the employee provides prior, knowing, voluntary, and written authorization;
(C) 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
(D) 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;
(3) 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 (29 U.S.C. 2613) or such requirements under State family and medical leave laws;
(4) 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;
(5) where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—
(A) the employer provides written notice of the genetic monitoring to the employee;
(B)(i) the employee provides prior, knowing, voluntary, and written authorization; or
(ii) the genetic monitoring is required by Federal or State law;
(C) the employee is informed of individual monitoring results;
(D) the monitoring is in compliance with—
(i) 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 (29 U.S.C. 651 et seq.), the Federal Mine Safety and Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) 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 (29 U.S.C. 651 et seq.); and
(E) 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
(6) 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.
(c) PRESERVATION OF PROTECTIONS.—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.
SEC. 203. EMPLOYMENT AGENCY PRACTICES.
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—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 genetic information with respect to the 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 otherwise adversely affect the status of the individual as an employee, because of genetic information with respect to the individual; or
(3) to cause or attempt to cause an employer to discriminate against an individual in violation of this title.
(b) ACQUISITION OF GENETIC INFORMATION.—
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—
(1) where an employment agency inadvertently requests or requires family medical history of the individual or family member of the individual;
(2) where—
(A) health or genetic services are offered by the employment agency, including such services offered as part of a wellness program;
(B) the individual provides prior, knowing, voluntary, and written authorization;
(C) 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
(D) 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;
(3) 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 (29 U.S.C. 2613) or such requirements under State family and medical leave laws;
(4) 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
(5) where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—
(A) the employment agency provides written notice of the genetic monitoring to the individual;
(B)(i) the individual provides prior, knowing, voluntary, and written authorization; or
(ii) the genetic monitoring is required by Federal or State law;
(C) the individual is informed of individual monitoring results;
(D) the monitoring is in compliance with—
(i) 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 (29 U.S.C. 651 et seq.), the Federal Mine Safety and Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) 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 (29 U.S.C. 651 et seq.); and
(E) 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.
(c) PRESERVATION OF PROTECTIONS.—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.
SEC. 204. LABOR ORGANIZATION PRACTICES.
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—
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 member because of genetic information with respect to the member;
(2) 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
(3) to cause or attempt to cause an employer to discriminate against a member in violation of this title.
(b) ACQUISITION OF GENETIC INFORMATION.—
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—
(1) where a labor organization inadvertently requests or requires family medical history of the member or family member of the member;
(2) where—
(A) health or genetic services are offered by the labor organization, including such services offered as part of a wellness program;
(B) the member provides prior, knowing, voluntary, and written authorization;
(C) 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
(D) 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;
(3) 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 (29 U.S.C. 2613) or such requirements under State family and medical leave laws;
(4) 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
(5) where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—
(A) the labor organization provides written notice of the genetic monitoring to the member;
(B)(i) the member provides prior, knowing, voluntary, and written authorization; or
(ii) the genetic monitoring is required by Federal or State law;
(C) the member is informed of individual monitoring results;
(D) the monitoring is in compliance with—
(i) 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 (29 U.S.C. 651 et seq.), the Federal Mine Safety and Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) 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 (29 U.S.C. 651 et seq.); and
(E) 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.
(c) PRESERVATION OF PROTECTIONS.—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.
SEC. 205. TRAINING PROGRAMS.
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—
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-thejob training programs—
(1) 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;
(2) 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
(3) 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.
(b) ACQUISITION OF GENETIC INFORMATION.—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—
(1) 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;
(2) where—
(A) 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;
(B) the individual provides prior, knowing, voluntary, and written authorization;
(C) 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
(D) 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;
(3) where the employer, labor organization, or joint labormanagement 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 (29 U.S.C. 2613) or such requirements under State family and medical leave laws;
(4) where the employer, labor organization, or joint labormanagement 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;
(5) where the information involved is to be used for genetic monitoring of the biological effects of toxic substances in the workplace, but only if—
(A) the employer, labor organization, or joint labormanagement committee provides written notice of the genetic monitoring to the individual;
(B)(i) the individual provides prior, knowing, voluntary, and written authorization; or
(ii) the genetic monitoring is required by Federal or State law;
(C) the individual is informed of individual monitoring results;
(D) the monitoring is in compliance with—
(i) 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 (29 U.S.C. 651 et seq.), the Federal Mine Safety and Health Act of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy Act of 1954 (42 U.S.C. 2011 et seq.); or
(ii) 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 (29 U.S.C. 651 et seq.); and
(E) the employer, labor organization, or joint labormanagement 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
(6) 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.
(c) PRESERVATION OF PROTECTIONS.—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.
SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION.
(a) TREATMENT OF INFORMATION AS PART OF CONFIDENTIAL MEDICAL RECORD.—
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 (42 U.S.C. 12112(d)(3)(B)).
(b) LIMITATION ON DISCLOSURE.—
An employer, employment agency, labor organization, or joint labor-management committee shall not disclose genetic information concerning an employee or member except—
(1) 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;
(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) in response to an order of a court, except that—
(A) the employer, employment agency, labor organization, or joint labor-management committee may disclose only the genetic information expressly authorized by such order; and
(B) 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;
(4) to government officials who are investigating compliance with this title if the information is relevant to the investigation;
(5) 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 (29 U.S.C. 2613) or such requirements under State family and medical leave laws; or
(6) 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.
(c) RELATIONSHIP TO HIPAA REGULATIONS.—
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 (42 U.S.C. 1320d et seq.) and section 264 of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 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.
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