tions of genetic nondiscrimination provisions, in relation 
to the enforcement of the provisions of part A with respect 
to issuers of health insurance coverage in the small group 
market in the State.’’. 
(c) ELIMINATION
OF OPTION
OF NON-FEDERAL 
GOVERNMENTAL PLANS TO BE EXCEPTED FROM RE-
QUIREMENTS CONCERNING GENETIC INFORMATION.— 
Section 2721(b)(2) of the Public Health Service Act (42 
U.S.C. 300gg–21(b)(2)) is amended— 
(1) in subparagraph (A), by striking ‘‘If the 
plan sponsor’’ and inserting ‘‘Except as provided in 
subparagraph (D), if the plan sponsor’’; and 
(2) by adding at the end the following: 
‘‘(D) ELECTION NOT APPLICABLE TO RE-
QUIREMENTS CONCERNING GENETIC INFORMA-
TION.—The election described in subparagraph 
(A) shall not be available with respect to the 
provisions of subsections (a)(1)(F) and (c) of 
section 2702 and the provisions of section 
2702(b) to the extent that such provisions 
apply to genetic information (or information 
about a request for or the receipt of genetic 
services by an individual or a family member of 
such individual).’’. 
(d) REGULATIONS AND EFFECTIVE DATE.— 
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(1) REGULATIONS.—Not later than 1 year after 
the date of enactment of this title, the Secretary of 
Labor and the Secretary of Health and Human 
Services (as the case may be) shall issue final regu-
lations in an accessible format to carry out the 
amendments made by this section. 
(2) EFFECTIVE DATE.—The amendments made 
by this section shall apply— 
(A) with respect to group health plans, and 
health insurance coverage offered in connection 
with group health plans, for plan years begin-
ning after the date that is 18 months after the 
date of enactment of this title; and 
(B) with respect to health insurance cov-
erage offered, sold, issued, renewed, in effect, or 
operated in the individual market after the date 
that is 18 months after the date of enactment 
of this title. 
SEC. 103. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SE-
CURITY ACT RELATING TO MEDIGAP. 
(a) NONDISCRIMINATION.— 
(1) IN
GENERAL.—Section 1882(s)(2) of the 
Social Security Act (42 U.S.C. 1395ss(s)(2)) is 
amended by adding at the end the following: 
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‘‘(E)(i) An issuer of a medicare supple-
mental policy shall not deny or condition the 
issuance or effectiveness of the policy, and shall 
not discriminate in the pricing of the policy (in-
cluding the adjustment of premium rates) of an 
eligible individual on the basis of genetic infor-
mation concerning the individual (or informa-
tion about a request for, or the receipt of, ge-
netic services by such individual or family mem-
ber of such individual). 
‘‘(ii) For purposes of clause (i), the terms 
‘family member’, ‘genetic services’, and ‘genetic 
information’ shall have the meanings given such 
terms in subsection (x).’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply with respect to a policy 
for policy years beginning after the date that is 18 
months after the date of enactment of this Act. 
(b) LIMITATIONS ON GENETIC TESTING.— 
(1) IN GENERAL.—Section 1882 of the Social 
Security Act (42 U.S.C. 1395ss) is amended by add-
ing at the end the following: 
‘‘(x) LIMITATIONS ON GENETIC TESTING.— 
‘‘(1) GENETIC TESTING.— 
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‘‘(A) LIMITATION ON REQUESTING OR RE-
QUIRING
GENETIC
TESTING.—An issuer of a 
medicare supplemental policy shall not request 
or require an individual or a family member of 
such individual to undergo a genetic test. 
‘‘(B) RULE OF CONSTRUCTION.—Nothing 
in this title shall be construed to— 
‘‘(i) limit the authority of a health 
care professional who is providing health 
care services with respect to an individual 
to request that such individual or a family 
member of such individual undergo a ge-
netic test; 
‘‘(ii) limit the authority of a health 
care professional who is employed by or af-
filiated with an issuer of a medicare sup-
plemental policy and who is providing 
health care services to an individual as 
part of a bona fide wellness program to no-
tify such individual of the availability of a 
genetic test or to provide information to 
such individual regarding such genetic test; 
or 
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‘‘(iii) authorize or permit a health 
care professional to require that an indi-
vidual undergo a genetic test. 
‘‘(2) DEFINITIONS.—In this subsection: 
‘‘(A) FAMILY MEMBER.—The term ‘family 
member’ means with respect to an individual— 
‘‘(i) the spouse of the individual; 
‘‘(ii) a dependent child of the indi-
vidual, including a child who is born to or 
placed for adoption with the individual; or 
‘‘(iii) any other individuals related by 
blood to the individual or to the spouse or 
child described in clause (i) or (ii). 
‘‘(B) GENETIC INFORMATION.— 
‘‘(i) IN
GENERAL.—Except as pro-
vided in clause (ii), the term ‘genetic infor-
mation’ means information about— 
‘‘(I) an individual’s genetic tests; 
‘‘(II) the genetic tests of family 
members of the individual; or 
‘‘(III) the occurrence of a disease 
or disorder in family members of the 
individual. 
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‘‘(ii) EXCLUSIONS.—The term ‘genetic 
information’ shall not include information 
about the sex or age of an individual. 
‘‘(C) GENETIC TEST.— 
‘‘(i) IN GENERAL.—The term ‘genetic 
test’ means an analysis of human DNA, 
RNA, chromosomes, proteins, or metabo-
lites, that detects genotypes, mutations, or 
chromosomal changes. 
‘‘(ii) EXCEPTIONS.—The term ‘genetic 
test’ does not mean— 
‘‘(I) an analysis of proteins or 
metabolites that does not detect 
genotypes, mutations, or chromosomal 
changes; or 
‘‘(II) an analysis of proteins or 
metabolites that is directly related to 
a manifested disease, disorder, or 
pathological condition that could rea-
sonably be detected by a health care 
professional with appropriate training 
and expertise in the field of medicine 
involved. 
‘‘(D) GENETIC SERVICES.—The term ‘ge-
netic services’ means— 
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