II 

116TH CONGRESS 

1ST SESSION S. 1993 

To restrict Federal funding for health care entities that do not respect 

all human life and patient rights. 

IN THE SENATE OF THE UNITED STATES 

JUNE 26, 2019 

Mr. CRAMER (for himself, Mr. DAINES, and Mrs. BLACKBURN) introduced the 

following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To restrict Federal funding for health care entities that 

do not respect all human life and patient rights. 

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 ‘‘Patient Rights Act’’. 

5 SEC. 2. RESTRICTION ON FEDERAL FUNDING FOR HEALTH 

6 CARE ENTITIES THAT DO NOT RESPECT ALL 

7 HUMAN LIFE AND PATIENT RIGHTS. 

8 (a) IN GENERAL.—Subject to section 4, no funds ap9 propriated by Congress for the purpose of paying (directly 

10 or indirectly, in whole or in part) for the provision of 


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1 health care services shall be paid to any entity, unless the 

2 entity certifies to the Secretary of Health and Human 

3 Services (referred to in this Act as the ‘‘Secretary’’) that 

4 the entity respects all human life and patient rights by 

5 ensuring that any health care practitioner employed by, 

6 or utilizing the facilities or resources of, such entity— 

7 (1) exercises the same degree of professional 

8 skill, care, and diligence to preserve the life and 

9 health of any patient as a reasonably diligent and 

10 conscientious health care practitioner would render 

11 to a patient in a different state of functionality, de12 velopment, or degree of dependence, including a pa13 tient who is— 

14 (A) unborn; 

15 (B) newly born; 

16 (C) born prematurely; 

17 (D) pregnant; 

18 (E) elderly; 

19 (F) mentally or physically disabled; 

20 (G) terminally ill; 

21 (H) in a persistent vegetative state; 

22 (I) unresponsive or comatose; or 

23 (J) otherwise incapable of self-advocacy; 

24 (2) does not intentionally end the life of, or oth25 erwise harm, any patient, including any patient deVerDate Sep 11 2014 02:24 Jul 02, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1993.IS S1993

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1 scribed in paragraph (1), by any means or for any 

2 reason, including by the use or prescription of any 

3 instrument, medicine, drug, or any other substance 

4 or device; and 

5 (3) does not institute a do-not-resuscitate order 

6 or a similar order with respect to any patient for 

7 any reason without obtaining the prior consent of an 

8 applicable individual described in section 4(1)(A). 

9 (b) RULE OF CONSTRUCTION.—Subsection (a) de10 scribes the minimum standard of care required of entities 

11 described in such paragraph. Nothing in this subsection 

12 shall be construed as a reason for a practitioner to not 

13 help a patient who is in a worse or different condition than 

14 the cases described in paragraph (1). 

15 SEC. 3. VIOLATIONS. 

16 (a) REVIEW BY THE SECRETARY.—Beginning not 

17 later than 1 year after the date of enactment of this Act, 

18 the Secretary, not less frequently than once every 5 years, 

19 shall conduct a review of each entity that receives funds 

20 described in section 2 to determine whether such entities 

21 are in compliance with such section. 

22 (b) SUSPECTED VIOLATION REPORTS.—The Sec23 retary shall establish a process by which— 

24 (1) suspected violations of section 2 may be 

25 confidentially reported to the Director of the Office 


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1 for Civil Rights of the Department of Health and 

2 Human Services; and 

3 (2) the Secretary fully investigates each report 

4 received under paragraph (1). 

5 (c) PUBLIC DATABASE.—The Secretary shall estab6 lish and maintain a public, online, searchable database of 

7 the entities subject to this section, indicating whether each 

8 such entity is in compliance with the requirements of sec9 tion 2. 

10 (d) ENFORCEMENT.—Any entity found to violate the 

11 requirements of section 2 shall be ineligible for funding 

12 described in such subsections for a period of at least 1 

13 year. After such 1-year period, such funding shall be rein14 stated upon a review conducted by the Secretary that con15 firms that the entity is in compliance with such require16 ments. 

17 (e) CIVIL ACTION FOR CERTAIN VIOLATIONS.— 

18 (1) IN GENERAL.—The Attorney General or 

19 any person adversely affected by an actual or threat20 ened violation of section 2, including the parents, 

21 children, spouse, or legal guardian of a patient, may, 

22 in a civil action, obtain appropriate relief with re23 gard to such violation. 

24 (2) ADMINISTRATIVE REMEDIES NOT RE25 QUIRED.—An action under this subsection may be 


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1 commenced, and relief may be granted, without re2 gard to whether the party commencing the action 

3 has sought or exhausted available administrative 

4 remedies. 

5 (3) DEFENDANTS IN ACTIONS UNDER THIS

6 SECTION MAY INCLUDE GOVERNMENTAL ENTITIES

7 OR OTHERS.—An action under this subsection may 

8 be maintained against, among others, a party that 

9 is a Federal, State, or local governmental entity. Re10 lief in an action under this paragraph may include 

11 money damages even if the defendant is such a gov12 ernmental entity. An action under this paragraph 

13 may not be maintained against a woman upon whom 

14 an abortion is performed or attempted to be per15 formed in violation of section 2. 

16 (4) NATURE OF RELIEF.—In an action under 

17 this subsection, the court shall grant— 

18 (A) all necessary equitable and legal relief, 

19 including, where appropriate, declaratory relief, 

20 injunctive relief, civil penalties, and compen21 satory damages, to prevent the occurrence, con22 tinuance, or repetition of the actual or threat23 ened violation of section 2 and to compensate 

24 for losses resulting from such violation; and 


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1 (B) to a prevailing plaintiff, reasonable at2 torneys’ fees and litigation expenses as part of 

3 the costs. 

4 SEC. 4. CONSTRUCTION AND TREATMENT OF CERTAIN 

5 SERVICES. 

6 Nothing in this Act shall be construed to apply to 

7 or to affect any limitation relating to— 

8 (1) the withholding or withdrawing of life-sav9 ing or life-sustaining medical treatment or medical 

10 care if— 

11 (A)(i) such withholding or withdrawing is 

12 after informed consent has been provided by— 

13 (I) the patient; 

14 (II) in the case where the patient is 

15 incapable of decision making, an individual 

16 authorized to make health care decisions 

17 on behalf of, and in the best interests of, 

18 the patient; or 

19 (III) in the case where the patient is 

20 a minor, the patient and the patient’s par21 ent or legal guardian, or another individual 

22 authorized to make health care decisions 

23 on behalf of, and in the best interests of, 

24 the patient; or 


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1 (ii) in the case where an individual de2 scribed in clause (i) is not available to provide 

3 informed consent, as described in such clause, 

4 the entity provides sufficient opportunity for an 

5 individual described in clause (i)(II) to present 

6 and provide informed consent for such with7 holding or withdrawing; and 

8 (B) any individual providing informed con9 sent as described in subparagraph (A) is af10 forded sufficient opportunity to arrange for the 

11 patient’s transfer to another health care pro12 vider willing to provide life-saving or life-sus13 taining medical treatment or medical care that 

14 is not available in the entity; 

15 (2) the withholding or withdrawing of nutrition 

16 or hydration if— 

17 (A) such withholding or withdrawing is not 

18 for the purpose of causing, or the purpose of 

19 assisting in causing, death, for any reason; and 

20 (B) the conditions of paragraph (1) are 

21 met; 

22 (3) the use of an item, good, benefit, or service 

23 furnished for the purpose of alleviating pain or dis24 comfort, even if such use may increase the risk of 

25 death, so long as such item, good, benefit, or service 


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1 is not also furnished for the purpose of causing, or 

2 the purpose of assisting in causing, death, for any 

3 reason; or 

4 (4) any medical procedure required to prevent 

5 the death of a pregnant woman or her unborn child, 

6 so long as every reasonable effort is made to pre7 serve the life of all patients. 

8 SEC. 5. LIST OF PROGRAMS TO WHICH RESTRICTIONS 

9 APPLY. 

10 (a) FEDERAL HEALTH CARE FUNDING PRO11 GRAMS.—Section 2 applies to funds appropriated under 

12 or to carry out the following: 

13 (1) The Medicare program under title XVIII of 

14 the Social Security Act (42 U.S.C. 1395 et seq.). 

15 (2) The Medicaid program under title XIX of 

16 the Social Security Act (42 U.S.C. 1396 et seq.). 

17 (3) Title XX of the Social Security Act (42 

18 U.S.C. 1397 et seq.). 

19 (4) Title V of the Social Security Act (42 

20 U.S.C. 701 et seq.). 

21 (5) The Public Health Service Act (42 U.S.C. 

22 201 et seq.). 

23 (6) The Indian Health Care Improvement Act 

24 (25 U.S.C. 1601 et seq.). 


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1 (7) The Federal Employees Health Benefits 

2 program under chapter 89 of title 5, United States 

3 Code. 

4 (8) The Military health care system (including 

5 TRICARE and CHAMPUS programs) under chap6 ter 55 of title 10, United States Code. 

7 (9) Veterans medical care under chapter 17 of 

8 title 38, United States Code. 

9 (10) Health services for Peace Corps volunteers 

10 under section 5(e) of the Peace Corps Act (22 

11 U.S.C. 2504(e)). 

12 (11) Medical services for Federal prisoners 

13 under section 4005(a) of title 18, United States 

14 Code. 

15 (12) The Patient Protection and Affordable 

16 Care Act (Public Law 111–148). 

17 (b) FEDERAL FACILITIES AND PERSONNEL.—The 

18 provisions of section 2 apply to facilities and personnel of 

19 the following: 

20 (1) The Department of Defense operating 

21 under chapter 55 of title 10, United States Code. 

22 (2) The Veterans Health Administration of the 

23 Department of Veterans Affairs. 

24 (3) The Public Health Service. 


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1 (c) NONEXCLUSIVE LIST.—Nothing in this section 

2 shall be construed as limiting the application of section 

3 2 to the programs specified in subsection (a) or the facili4 ties and personnel specified in subsection (b). 

5 SEC. 6. RELATION TO OTHER LAWS. 

6 The provisions of this Act supersede other Federal 

7 laws (including laws enacted after the date of the enact8 ment of this Act) except to the extent such laws specifi9 cally supersede the provisions of this Act. 

10 SEC. 7. EFFECTIVE DATE. 

11 (a) IN GENERAL.—The provisions of this Act take 

12 effect on the dates of enactment of this Act and apply 

13 to Federal payments made pursuant to obligations in14 curred after the date of the enactment of this Act. 

15 (b) APPLICATION TO CONTRACTS.—Such provisions 

16 shall apply with respect to contracts entered into, renewed, 

17 or extended after the date of the enactment of this Act 

18 and shall also apply to a contract entered into before such 

19 date to the extent permitted under such contract. 

Æ 


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