I
106TH CONGRESS
1ST SESSION
H. R. 2043
To amend title I of the Employee Retirement Income Security Act of 1974
to provide to participants and beneficiaries of group health plans access
to unrestricted medical advice.
IN THE HOUSE OF REPRESENTATIVES
JUNE 8, 1999
Mrs. KELLY introduced the following bill; which was referred to the
Committee on Education and the Workforce
A BILL
To amend title I of the Employee Retirement Income Secu-
rity Act of 1974 to provide to participants and bene-
ficiaries of group health plans access to unrestricted
medical advice.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Patient Right to Unre-
stricted Medical Advice Act of 1999’’.
SEC. 2. PATIENT ACCESS TO UNRESTRICTED MEDICAL AD-
VICE.
(a) IN GENERAL.—Subpart B of part 7 of subtitle
B of title I of the Employee Retirement Income Security
Act of 1974 is amended by adding at the end the following
new section:
‘‘SEC. 714. PATIENT ACCESS TO UNRESTRICTED MEDICAL
ADVICE.
‘‘(a) IN GENERAL.—In the case of any health care
professional acting within the lawful scope of practice in
the course of carrying out a contractual employment ar-
rangement or other direct contractual arrangement be-
tween such professional and a group health plan or a
health insurance issuer offering health insurance coverage
in connection with a group health plan, the plan or issuer
with which such contractual employment arrangement or
other direct contractual arrangement is maintained by the
professional may not impose on such professional under
such arrangement any prohibition or restriction with re-
spect to advice, provided to a participant or beneficiary
under the plan who is a patient, about the health status
of the participant or beneficiary or the medical care or
treatment for the condition or disease of the participant
or beneficiary, regardless of whether benefits for such care
or treatment are provided under the plan or health insur-
ance coverage offered in connection with the plan.
‘‘(b) HEALTH CARE PROFESSIONAL DEFINED.—For
purposes of this section, the term ‘health care professional’
means a physician (as defined in section 1861(r) of the
Social Security Act) or other health care professional if
coverage for the professional’s services is provided under
the group health plan for the services of the professional.
Such term includes a podiatrist, optometrist, chiropractor,
psychologist, dentist, physician assistant, physical or occu-
pational therapist and therapy assistant, speech-language
pathologist, audiologist, registered or licensed practical
nurse (including nurse practitioner, clinical nurse spe-
cialist, certified registered nurse anesthetist, and certified
nurse-midwife), licensed certified social worker, registered
respiratory therapist, and certified respiratory therapy
technician.’’.
(b) CONFORMING AMENDMENT.—The table of con-
tents in section 1 of such Act is amended by adding at
the end of the items relating to subpart B of part 7 of
subtitle B of title I of such Act the following new item:
‘‘Sec. 714. Patient access to unrestricted medical advice.’’.
SEC. 3. EFFECTIVE DATE AND RELATED RULES.
(a) IN GENERAL.—The amendments made by this
Act shall apply with respect to plan years beginning on
or after January 1 of the second calendar year following
the date of the enactment of this Act, except that the Sec-
retary of Labor may issue regulations before such date
under such amendments. The Secretary shall first issue
regulations necessary to carry out the amendments made
by this Act before the effective date thereof.
(b) LIMITATION ON ENFORCEMENT ACTIONS.—No
enforcement action shall be taken, pursuant to the amend-
ments made by this Act, against a group health plan or
health insurance issuer with respect to a violation of a re-
quirement imposed by such amendments before the date
of issuance of regulations issued in connection with such
requirement, if the plan or issuer has sought to comply
in good faith with such requirement.
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