157 
for Patients and Providers Act of 2008 (Public Law 110– 
275), as amended by section 3205(d) of the Patient Pro-
tection and Affordable Care Act (Public Law 111–148), 
is amended by striking ‘‘December 31, 2012’’ and insert-
ing ‘‘December 31, 2015’’. 
SEC. 318. CONSCIENCE PROTECTIONS. 
Part F of title XVIII of the Social Security Act, as 
redesignated by section 101(a)(1) and amended by section 
313, is further amended by adding at the end the following 
new sections: 
‘‘SEC. 1899C. CONSCIENCE PROTECTIONS; PROHIBITION 
AGAINST DISCRIMINATION ON ASSISTED SUI-
CIDE AND ABORTION SERVICES. 
‘‘(a) PROHIBITION ON FUNDING FOR ABORTIONS.— 
No payment may be made under this title for any expenses 
incurred for any abortion. 
‘‘(b) PROHIBITION ON FUNDING FOR HEALTH BENE-
FITS PLANS THAT COVER ABORTION.—No payment may 
be made under this title for any expenses for coverage 
under an MA plan or prescription drug plan that includes 
coverage of any abortion. 
‘‘(c) TREATMENT OF ABORTIONS RELATED TO RAPE, 
INCEST, OR PRESERVING THE LIFE OF THE MOTHER.— 
The limitations established in the previous subsections 
shall not apply to an abortion— 
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158 
‘‘(1) if the pregnancy is the result of an act of 
rape or incest; or 
‘‘(2) in the case where a woman suffers from a 
physical disorder, physical injury, or physical illness 
that would, as certified by a physician, place the 
woman in danger of death unless an abortion is per-
formed, including a life-endangering physical condi-
tion caused by or arising from the pregnancy itself. 
‘‘SEC. 1899D. PROHIBITION AGAINST DISCRIMINATION ON 
ASSISTED SUICIDE AND ABORTIONS. 
‘‘(a) IN GENERAL.—The Federal Government, any 
MA plan or prescription drug plan that receives payment 
under this title, and any provider of services or supplier 
that receives payment under this title with respect to 
Medicare fee-for-service (as defined in section 1860E– 
61(b)) may not subject an individual or institutional 
health care entity to discrimination on the basis that the 
entity does not provide— 
‘‘(1) any health care item or service furnished 
for the purpose of causing, or for the purpose of as-
sisting in causing, the death of any individual, such 
as by assisted suicide, euthanasia, or mercy killing; 
or 
‘‘(2) abortions. 
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159 
‘‘(b) DEFINITION.—In this section, the term ‘health 
care entity’ includes an individual physician or other 
health care professional, a hospital, a provider-sponsored 
organization, a health maintenance organization, a health 
insurance plan, or any other kind of health care facility, 
organization, or plan. 
‘‘(c) CONSTRUCTION AND TREATMENT OF CERTAIN 
SERVICES IN THE CASE OF ASSISTED SUICIDE.—Nothing 
in subsection (a)(1) shall be construed to apply to, or to 
affect, any limitation relating to— 
‘‘(1) the withholding or withdrawing of medical 
treatment or medical care; 
‘‘(2) the withholding or withdrawing of nutri-
tion or hydration; or 
‘‘(3) the use of an item, good, benefit, or service 
furnished for the purpose of alleviating pain or dis-
comfort, even if such use may increase the risk of 
death, so long as such item, good, benefit, or service 
is not also furnished for the purpose of causing, or 
the purpose of assisting in causing, death, for any 
reason. 
‘‘(d) ADMINISTRATION.—The Office for Civil Rights 
of the Department of Health and Human Services is des-
ignated to receive complaints of discrimination based on 
this section. Any such complaint shall, by not later than 
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160 
180 days after receipt by the Office of such complaint, 
be reviewed by the Office and, as appropriate, referred to 
the Medicare Choices Commission or Centers for Medicare 
& Medicaid Services for purposes of subsection (e). 
‘‘(e) ENFORCEMENT.— 
‘‘(1) MA PLANS
AND
PRESCRIPTION
DRUG 
PLANS.—In the case of an MA plan or prescription 
drug plan that is in violation of subsection (a), the 
Medicare Choices Commission may, as determined 
appropriate by the Commission— 
‘‘(A) apply against the MA organization of-
fering the MA plan or the PDP sponsor offer-
ing the prescription drug plan a civil monetary 
penalty or assessment in the same manner as 
such a penalty or assessment is authorized 
under section 1128A(a); 
‘‘(B) exclude the plan from participation 
under this title, in accordance with the proce-
dures of subsections (c), (f), and (g) of section 
1128; or 
‘‘(C) apply both subparagraphs (A) and 
(B) with respect to the plan. 
‘‘(2) MEDICARE FEE-FOR-SERVICE PROVIDERS 
OF SERVICES AND SUPPLIERS.—In the case of a pro-
vider of services or supplier described in subsection 
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161 
(a) that is in violation of such subsection, the Sec-
retary, through the Administrator of the Centers for 
Medicare & Medicaid Services, may, as determined 
appropriate by the Secretary— 
‘‘(A) apply against the provider of services 
or supplier a civil monetary penalty or assess-
ment in the same manner as such a penalty or 
assessment 
is 
authorized 
under 
section 
1128A(a); 
‘‘(B) exclude the provider of services or 
supplier from participation under this title, in 
accordance with the procedures of subsections 
(c), (f), and (g) of section 1128; or 
‘‘(C) apply both subparagraphs (A) and 
(B) with respect to the provider of services or 
supplier. 
‘‘(3) ADMINISTRATION.—The provisions of sec-
tion 1128A (other than the first 2 sentences of sub-
section (a) and other than subsection (b)) shall 
apply to a civil money penalty and assessment under 
paragraph (1) or (2) in the same manner as such 
provisions apply to a penalty, assessment, or pro-
ceeding under section 1128A(a), except to the extent 
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162 
such provisions are inconsistent with paragraph 
(1)(B) or (2)(B), respectively.’’. 
Æ 
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