I

106TH CONGRESS

1ST SESSION H. R. 2021

To amend title I of the Employee Retirement Income Security Act of 1974

and title XXVII of the Public Health Service Act to require group

health plans and health insurance issuers to provide coverage for human

leukocyte antigen testing.

IN THE HOUSE OF REPRESENTATIVES

JUNE 7, 1999

Mr. KENNEDY of Rhode Island (for himself and Mr. BROWN of California)

introduced the following bill; which was referred to the Committee on

Commerce, and in addition to the Committee on Education and the

Workforce, for a period to be subsequently determined by the Speaker,

in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title I of the Employee Retirement Income Security Act of 1974 and title XXVII of the Public Health

Service Act to require group health plans and health

insurance issuers to provide coverage for human leukocyte antigen testing.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Bone Marrow Blood

5 Testing Coverage Act of 1999’’.
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1 SEC. 2. COVERAGE OF HUMAN ANTIGEN TESTING.

2 (a) AMENDMENTS TO THE EMPLOYEE RETIREMENT

3 INCOME SECURITY ACT OF 1974.—

4 (1) IN GENERAL.—Subpart B of part 7 of sub5 title B of title I of the Employee Retirement Income

6 Security Act of 1974 is amended by adding at the

7 end the following new section:

8 ‘‘SEC. 714. COVERAGE OF HUMAN ANTIGEN TESTING.

9 ‘‘(a) REQUIREMENT.—A group health plan, and a

10 health insurance issuer offering group health insurance

11 coverage, may not deny coverage and payment for human

12 antigen testing if—

13 ‘‘(1) the testing is provided by an entity that is

14 licensed under the Clinical Laboratory Improvement

15 Act of 1967 (42 U.S.C. 263a) and accredited by the

16 American Association of Blood Banks; and

17 ‘‘(2) the participant or beneficiary undergoing

18 such testing signs an informed consent which allows

19 the results of the test to be used for participation in

20 the National Marrow Donor Registry established

21 under section 274k of title 42, United States Code.

22 ‘‘(b) DEFINITION.—For purposes of this section, the

23 term ‘‘human antigen testing’’ means human leukocyte

24 antigen testing for A,B, and DR antigens for utilization

25 in bone marrow transplantation.’’.
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1 (2) CONFORMING AMENDMENT.—Section

2 732(a) of such Act (29 U.S.C. 1191a(a)) is amended

3 by striking ‘‘section 711’’ and inserting ‘‘sections

4 711 and 714’’.

5 (3) CLERICAL AMENDMENT.—The table of con6 tents in section 1 of such Act is amended by adding

7 at the end of the items relating to subpart B of part

8 7 of subtitle B of title I of such Act the following

9 new item:

‘‘Sec. 714. Coverage of human antigen testing.’’.

10 (b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE

11 ACT.—

12 (1) GROUP HEALTH INSURANCE COVERAGE.—

13 Subpart 2 of part A of title XXVII of the Public

14 Health Service Act is amended by adding at the end

15 the following new section:

16 ‘‘SEC. 2707. COVERAGE OF HUMAN ANTIGEN TESTING.

17 ‘‘(a) REQUIREMENT.—A group health plan, and a

18 health insurance issuer offering group health insurance

19 coverage, may not deny coverage and payment for human

20 antigen testing if—

21 ‘‘(1) the testing is provided by an entity that is

22 licensed under the Clinical Laboratory Improvement

23 Act of 1967 (42 U.S.C. 263a) and accredited by the

24 American Association of Blood Banks; and
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1 ‘‘(2) the participant or beneficiary undergoing

2 such testing signs an informed consent which allows

3 the results of the test to be used for participation in

4 the National Marrow Donor Program.

5 ‘‘(b) DEFINITION.—For purposes of this section, the

6 term ‘‘human antigen testing’’ means human leukocyte

7 antigen testing for A,B, and DR antigens for utilization

8 in bone marrow transplantation.’’.

9 (2) INDIVIDUAL HEALTH INSURANCE COV10 ERAGE.—Part B of title XXVII of such Act is

11 amended by inserting after section 2752 the fol12 lowing new section:

13 ‘‘SEC. 2753. COVERAGE OF HUMAN ANTIGEN TESTING.

14 ‘‘The provisions of section 2707 shall apply to health

15 insurance coverage offered by a health insurance issuer

16 in the individual market in the same manner as they apply

17 to health insurance coverage offered by a health insurance

18 issuer in connection with a group health plan in the small

19 or large group market.’’.

20 (c) EFFECTIVE DATES AND RELATED RULES.—

21 (1) GROUP HEALTH PLANS AND GROUP

22 HEALTH INSURANCE COVERAGE.—

23 (A) IN GENERAL.—Subject to subpara24 graph (B), the amendments made by sub25 sections (a) and (b)(1) apply with respect to
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1 group health plans for plan years beginning on

2 or after the first day of the first month that be3 gins more than 1 year after the date of the en4 actment of this Act.

5 (B) COLLECTIVE BARGAINING EXCEP6 TION.—In the case of a group health plan

7 maintained pursuant to 1 or more collective

8 bargaining agreements between employee rep9 resentatives and 1 or more employers ratified

10 before the date of enactment of this Act, the

11 amendments made subsections (a) and (b)(1)

12 shall not apply to plan years beginning before

13 the later of—

14 (i) the date on which the last collec15 tive bargaining agreements relating to the

16 plan terminates (determined without re17 gard to any extension thereof agreed to

18 after the date of enactment of this Act), or

19 (ii) the first day described in subpara20 graph (A).

21 For purposes of clause (i), any plan amendment

22 made pursuant to a collective bargaining agree23 ment relating to the plan which amends the

24 plan solely to conform to any requirement

25 added by subsection (a) or (b)(1) shall not be
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1 treated as a termination of such collective bar2 gaining agreement.

3 (2) INDIVIDUAL HEALTH INSURANCE COV4 ERAGE.—The amendment made by subsection (b)(2)

5 applies with respect to health insurance coverage of6 fered, sold, issued, renewed, in effect, or operated in

7 the individual market on or after the first day of the

8 first month that begins more than 1 year after the

9 date of the enactment of this Act.

10 (3) LIMITATION ON ENFORCEMENT ACTIONS.—

11 No enforcement action shall be taken, pursuant to

12 the amendments made by this section, against a

13 group health plan or health insurance issuer with re14 spect to a violation of a requirement imposed by

15 such amendments, and no penalty shall be imposed

16 on any failure by such plan to comply with any re17 quirement imposed by such amendments, to the ex18 tent that violation or failure occurs before the date

19 of issuance of final regulations issued in connection

20 with such requirement, if the plan or issuer has

21 sought to comply in good faith with such require22 ment.

23 SEC. 3. COORDINATION OF ADMINISTRATION.

24 The Secretary of Labor and the Secretary of Health

25 and Human Services shall ensure, through the execution
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1 of an interagency memorandum of understanding among

2 such Secretaries, that—

3 (1) regulations, rulings, and interpretations

4 issued by such Secretaries relating to the same mat5 ter over which both such Secretaries have responsi6 bility under the provisions of this Act (and the

7 amendments made thereby) are administered so as

8 to have the same effect at all times; and

9 (2) coordination of policies relating to enforcing

10 the same requirements through such Secretaries in

11 order to have a coordinated enforcement strategy

12 that avoids duplication of enforcement efforts and

13 assigns priorities in enforcement.

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