I 
108TH CONGRESS 
1ST SESSION H. R. 1910
To prohibit discrimination on the basis of genetic information with respect 
to health insurance. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 1, 2003
Ms. SLAUGHTER (for herself, Mr. ABERCROMBIE, Mr. ACKERMAN, Mr. 
ALLEN, Ms. BERKLEY, Mr. BERMAN, Mrs. BIGGERT, Mr. BISHOP of New 
York, Ms. BORDALLO, Mr. BOSWELL, Mr. BOYD, Mr. BURTON of Indi-
ana, Mrs. CAPPS, Mr. CAPUANO, Mr. CARDIN, Ms. CARSON of Indiana, 
Mr. CASE, Mrs. CHRISTENSEN, Mr. COOPER, Mr. COSTELLO, Mr. CROW-
LEY, Mr. CUMMINGS, Mr. DAVIS of Florida, Mrs. DAVIS of California, 
Mr. DEFAZIO, Ms. DEGETTE, Ms. DELAURO, Mr. DICKS, Mr. DINGELL, 
Mr. DOYLE, Mr. ENGEL, Mr. FARR, Mr. FOLEY, Mr. FRANK of Massa-
chusetts, Mr. FRELINGHUYSEN, Mr. FROST, Mr. GILCHREST, Mr. 
GILLMOR, Mr. GORDON, Ms. GRANGER, Mr. GREEN of Texas, Mr. 
GUTIERREZ, Mr. HEFLEY, Mr. HINCHEY, Mr. HINOJOSA, Mr. HOEFFEL, 
Mr. HOLT, Mr. HYDE, Mr. INSLEE, Mr. ISRAEL, Ms. JACKSON-LEE of 
Texas, Ms. EDDIE BERNICE JOHNSON of Texas, Mrs. JONES of Ohio, 
Mr. KANJORSKI, Ms. KAPTUR, Mrs. KELLY, Mr. KENNEDY of Rhode Is-
land, Mr. KILDEE, Mr. KING of New York, Mr. KUCINICH, Mr. LANTOS, 
Mr. LATOURETTE, Mr. LEACH, Mr. LOBIONDO, Ms. LOFGREN, Mrs. 
LOWEY, Mrs. MALONEY, Mr. MARKEY, Mr. MATSUI, Mrs. MCCARTHY of 
New York, Mr. MCDERMOTT, Mr. MCHUGH, Mr. MCINTYRE, Mr. 
MCNULTY, Mr. MEEHAN, Mr. MENENDEZ, Mr. MICA, Ms. MILLENDER-
MCDONALD, Mr. GEORGE MILLER of California, Mr. MOORE, Mr. 
MORAN of Virginia, Mr. NADLER, Mr. NEY, Mrs. NORTHUP, Ms. NOR-
TON, Mr. OBEY, Mr. OWENS, Ms. PELOSI, Mr. PLATTS, Mr. RANGEL, 
Mr. ROTHMAN, Ms. ROYBAL-ALLARD, Ms. LINDA T. SA´NCHEZ of Cali-
fornia, Ms. LORETTA
SANCHEZ
of California, Mr. SANDERS, Ms. 
SCHAKOWSKY, Mr. SCHIFF, Mr. SERRANO, Mr. SHAYS, Mr. SHERMAN, 
Mr. SIMMONS, Mr. STARK, Mr. STRICKLAND, Mrs. TAUSCHER, Mr. 
TIERNEY, Mr. UDALL of New Mexico, Ms. VELA´ZQUEZ, Mr. WALSH, Mr. 
WAMP, Mr. WAXMAN, Mr. WEXLER, and Ms. WOOLSEY) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committees on Ways and Means and Edu-
cation and the Workforce, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisdiction of the committee concerned
A BILL 
To prohibit discrimination on the basis of genetic information 
with respect to health insurance.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE AND TABLE OF CONTENTS. 
(a) SHORT TITLE.—This title may be cited as the 
‘‘Genetic Nondiscrimination in Health Insurance and Em-
ployment Act’’.
(b) TABLE OF CONTENTS.—The table of contents is 
as follows:
Sec. 1. Short title and table of contents. 
TITLE I—PROHIBITION OF HEALTH INSURANCE DISCRIMINATION 
ON THE BASIS OF PROTECTED GENETIC INFORMATION 
Sec. 101. Amendments to Employee Retirement Income Security Act of 1974. 
Sec. 102. Amendments to the Public Health Service Act. 
Sec. 103. Amendments to Internal Revenue Code of 1986. 
Sec. 104. Amendments to Title XVIII of the Social Security Act relating to 
Medigap. 
TITLE II—PROHIBITION OF EMPLOYMENT DISCRIMINATION ON 
THE BASIS OF PROTECTED GENETIC INFORMATION 
Sec. 201. Definitions. 
Sec. 202. Employer practices. 
Sec. 203. Employment agency practices. 
Sec. 204. Labor organization practices. 
Sec. 205. Training programs. 
Sec. 206. Maintenance and disclosure of protected genetic information. 
Sec. 207. Civil action. 
Sec. 208. Exceptions; rules of construction. 
Sec. 209. Authorization of appropriations. 
Sec. 210. Effective date. 
TITLE III—MISCELLANEOUS PROVISIONS 
Sec. 301. Severability.
TITLE 
I—PROHIBITION 
OF 
HEALTH 
INSURANCE 
DIS-
CRIMINATION ON THE BASIS 
OF PROTECTED GENETIC IN-
FORMATION 
SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT IN-
COME SECURITY ACT OF 1974. 
(a) PROHIBITION OF HEALTH INSURANCE DISCRIMI-
NATION ON THE BASIS OF GENETIC SERVICES OR PRO-
TECTED GENETIC INFORMATION.—
(1) NO
ENROLLMENT
RESTRICTION
FOR
GE-
NETIC SERVICES.—Section 702(a)(1)(F) of the Em-
ployee Retirement Income Security Act of 1974 (29 
U.S.C. 1182(a)(1)(F)) is amended by inserting be-
fore the period ‘‘(or information about a request for 
or the receipt of genetic services by such individual 
or family member of such individual)’’. 
(2) NO DISCRIMINATION IN GROUP RATE BASED 
ON PROTECTED GENETIC INFORMATION.—
(A) IN GENERAL.—Subpart B of part 7 of 
subtitle B of title I of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185 
et seq.) is amended by adding at the end the 
following:
‘‘SEC. 
714. 
PROHIBITING 
DISCRIMINATION 
AGAINST 
GROUPS ON THE BASIS OF PROTECTED GE-
NETIC INFORMATION. 
‘‘A group health plan, and a health insurance issuer 
offering group health insurance coverage in connection 
with a group health plan, shall not deny eligibility to a 
group or adjust premium or contribution rates for a group 
on the basis of protected genetic information concerning 
an individual in the group (or information about a request 
for or the receipt of genetic services by such individual 
or family member of such individual).’’. 
(B) CONFORMING AMENDMENTS.—
(i) Section 702(b)(2)(A) of the Em-
ployee Retirement Income Security Act of 
1974 (29 U.S.C. 1182(b)) is amended to 
read as follows: 
‘‘(A) to restrict the amount that an em-
ployer may be charged for coverage under a 
group health plan, except as provided in section 
714; or’’.
(ii) Section 732(a) of the Employee 
Retirement Income Security Act of 1974 
(29 U.S.C. 1191a(a)) is amended by strik-
ing ‘‘section 711’’ and inserting ‘‘sub-
sections (a)(1)(F), (b) (with respect to 
cases relating to genetic information or in-
formation about a request or receipt of ge-
netic services by an individual or family 
member of such individual), (c), (d), (e), 
(f), or (g) of section 702, section 711 and 
section 714’’. 
(b) LIMITATIONS
ON GENETIC TESTING
AND
ON 
COLLECTION AND DISCLOSURE OF PROTECTED GENETIC 
INFORMATION.—Section 702 of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1182) is amended 
by adding at the end the following: 
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan, or a 
health insurance issuer offering health insurance 
coverage in connection with a group health plan, 
shall not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this part shall be construed to limit the authority of 
a health care professional, who is providing treat-
ment with respect to an individual and who is em-
ployed by a group health plan or a health insurance 
issuer, to request that such individual or family 
member of such individual undergo a genetic test. 
Such a health care professional shall not require
that such individual or family member undergo a ge-
netic test. 
‘‘(3) CERTAIN TESTS.—The conducting of met-
abolic tests that are not intended to reveal protected 
genetic information shall not be considered a viola-
tion of the preceding provisions of this subsection re-
gardless of the results of the tests. Test results that 
are protected genetic information shall be subject to 
the applicable provisions of this part. 
‘‘(d) COLLECTION OF PROTECTED GENETIC INFOR-
MATION.—Except as provided in subsections (f) and (g), 
a group health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group 
health plan, shall not request, require, collect, or purchase 
protected genetic information concerning an individual (or 
information about a request for or the receipt of genetic 
services by such individual or family member of such indi-
vidual). 
‘‘(e) DISCLOSURE OF PROTECTED GENETIC INFOR-
MATION.—A group health plan, or a health insurance 
issuer offering health insurance coverage in connection 
with a group health plan, shall not disclose protected ge-
netic information about an individual (or information 
about a request for or the receipt of genetic services by 
such individual or family member of such individual) to—
‘‘(1) any entity that is a member of the same 
controlled group as such issuer or plan sponsor of 
such group health plan; 
‘‘(2) any other group health plan or health in-
surance issuer or any insurance agent, third party 
administrator, or other person subject to regulation 
under State insurance laws;
‘‘(3) the Medical Information Bureau or any 
other person that collects, compiles, publishes, or 
otherwise disseminates insurance information; 
‘‘(4) the individual’s employer or any plan spon-
sor; or 
‘‘(5) any other person the Secretary may speci-
fy in regulations. 
‘‘(f) INFORMATION
FOR PAYMENT
FOR GENETIC 
SERVICES.—
‘‘(1) IN GENERAL.—With respect to payment 
for genetic services conducted concerning an indi-
vidual or the coordination of benefits, a group health 
plan, or a health insurance issuer offering group 
health insurance coverage in connection with a group 
health plan, may request that the individual provide 
the plan or issuer with evidence that such services 
were performed.
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to—
‘‘(A) permit a group health plan or health 
insurance issuer to request (or require) the re-
sults of the services referred to in such para-
graph; or 
‘‘(B) require that a group health plan or 
health insurance issuer make payment for serv-
ices described in such paragraph where the in-
dividual involved has refused to provide evi-
dence of the performance of such services pur-
suant to a request by the plan or issuer in ac-
cordance with such paragraph. 
‘‘(g) INFORMATION
FOR
PAYMENT
OF
OTHER 
CLAIMS.—With respect to the payment of claims for bene-
fits other than genetic services, a group health plan, or 
a health insurance issuer offering group health insurance 
coverage in connection with a group health plan, may re-
quest that an individual provide protected genetic informa-
tion so long as such information—
‘‘(1) is used solely for the payment of a claim; 
‘‘(2) is limited to information that is directly re-
lated to and necessary for the payment of such claim 
and the claim would otherwise be denied but for the 
protected genetic information; and
‘‘(3) is used only by an individual (or individ-
uals) within such plan or issuer who needs access to 
such information for purposes of payment of a 
claim. 
‘‘(h) RULES OF CONSTRUCTION.—
‘‘(1) COLLECTION OR DISCLOSURE AUTHORIZED 
BY INDIVIDUAL.—The provisions of subsections (d) 
(regarding collection) and (e) shall not apply to an 
individual if the individual (or legal representative of 
the individual) provides prior, knowing, voluntary, 
and written authorization for the collection or disclo-
sure of protected genetic information. 
‘‘(2) DISCLOSURE FOR HEALTH CARE TREAT-
MENT.—Nothing in this section shall be construed to 
limit or restrict the disclosure of protected genetic 
information from a health care provider to another 
health care provider for the purpose of providing 
health care treatment to the individual involved. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) CONTROLLED
GROUP.—The term ‘con-
trolled group’ means any group treated as a single 
employer under subsection (b), (c), (m), or (o) of 
section 414 of the Internal Revenue Code of 1986. 
‘‘(2) GROUP
HEALTH
PLAN, HEALTH
INSUR-
ANCE ISSUER.—The terms ‘group health plan’ and
‘health insurance issuer’ include a third party ad-
ministrator or other person acting for or on behalf 
of such plan or issuer.’’. 
(c) ENFORCEMENT.—Section 502 (29 U.S.C. 1132) 
is amended by adding at the end the following: 
‘‘(n) VIOLATION OF GENETIC DISCRIMINATION OR 
GENETIC DISCLOSURE PROVISIONS.—
‘‘(1) IN GENERAL.—In any action under this 
section against any administrator of a group health 
plan, or health insurance issuer offering group 
health insurance coverage in connection with a group 
health plan (including any third party administrator 
or other person acting for or on behalf of such plan 
or issuer) alleging a violation of subsection 
(a)(1)(F), (b) (with respect to cases relating to ge-
netic information or information about a request or 
receipt of genetic services by an individual or family 
member of such individual), (c), (d), (e), (f), or (g) 
of section 702, or section 714, the court may award 
any appropriate legal or equitable relief. Such relief 
may include a requirement for the payment of attor-
ney’s fees and costs, including the costs of expert 
witnesses. 
‘‘(2) CIVIL PENALTY.—In any action described 
in paragraph (1), the Secretary may, to vindicate
the public interest, assess a civil penalty against the 
defendant in an amount—
‘‘(A) not exceeding $50,000 for a first vio-
lation, and 
‘‘(B) not exceeding $100,000 for any sub-
sequent violation.
Any such relief awarded shall be paid into the gen-
eral fund of the Treasury.’’. 
(d) PREEMPTION.—Section 731 of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 1191) 
is amended—
(1) in subsection (a)(1), by inserting ‘‘or (e)’’ 
after ‘‘subsection (b)’’; and 
(2) by adding at the end the following: 
‘‘(e) SPECIAL RULE IN CASE OF GENETIC INFORMA-
TION.—With respect to group health insurance coverage 
offered by a health insurance issuer, the provisions of this 
part relating to genetic information (including information 
about a request for or the receipt of genetic services by 
an individual or a family member of such individual) shall 
not be construed to supersede any provision of State law 
which establishes, implements, or continues in effect a 
standard, requirement, or remedy that more completely—
‘‘(1) protects the confidentiality of genetic in-
formation (including information about a request for
or the receipt of genetic services by an individual or 
a family member of such individual) or the privacy 
of an individual or a family member of the individual 
with respect to genetic information (including infor-
mation about a request for or the receipt of genetic 
services by an individual or a family member of such 
individual) than does this part; or 
‘‘(2) prohibits discrimination on the basis of ge-
netic information than does this part.’’. 
(e) DEFINITIONS.—Section 733(d) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1191b(d)) is amended by adding at the end the following: 
‘‘(5) FAMILY
MEMBER.—The term ‘family 
member’ means with respect to an individual—
‘‘(A) the spouse of the individual; 
‘‘(B) a dependent child of the individual, 
including a child who is born to or placed for 
adoption with the individual; or 
‘‘(C) any other individuals related by blood 
to the individual or to the spouse or child de-
scribed in subparagraph (A) or (B). 
‘‘(6) GENETIC
INFORMATION.—The term ‘ge-
netic information’ means information about genes, 
gene products, or inherited characteristics that may 
derive from an individual or a family member of
such individual (including information about a re-
quest for or the receipt of genetic services by such 
individual or family member of such individual). 
‘‘(7) GENETIC
SERVICES.—The term ‘genetic 
services’ means health services, including genetic 
tests, provided to obtain, assess, or interpret genetic 
information for diagnostic and therapeutic purposes, 
and for genetic education and counseling. 
‘‘(8) GENETIC TEST.—The term ‘genetic test’ 
means the analysis of human DNA, RNA, chro-
mosomes, proteins, or metabolites that detects 
genotypes, mutations, or chromosomal changes. 
‘‘(9) PROTECTED GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘protected genetic 
information’ means—
‘‘(i) information about an individual’s 
genetic tests; 
‘‘(ii) information about genetic tests 
of family members of the individual; and 
‘‘(iii) information about the occur-
rence of a disease or disorder in family 
members. 
‘‘(B) LIMITATIONS.—The term ‘protected 
genetic information’ shall not include—
‘‘(i) information about the sex or age 
of the individual; 
‘‘(ii) 
information 
about 
chemical, 
blood, or urine analyses of the individual, 
unless these analyses are genetic tests; or 
‘‘(iii) 
information 
about 
physical 
exams of the individual, and other informa-
tion that indicates the current health sta-
tus of the individual.’’. 
(f) AMENDMENT CONCERNING SUPPLEMENTAL EX-
CEPTED BENEFITS.—Section 732(c)(3) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1191a(c)(3)) is amended by inserting ‘‘, other than the 
requirements of subsections (a)(1)(F), (b) (in cases relat-
ing 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), (c), (d), (e), (f) and 
(g) of section 702 and section 714,’’ after ‘‘The require-
ments of this part’’. 
(g) EFFECTIVE DATE.—
(1) IN GENERAL.—Except as provided in this 
section, this section and the amendments made by 
this section shall apply with respect to group health 
plans for plan years beginning after October 1, 
2005.
(2) SPECIAL
RULE
FOR
COLLECTIVE
BAR-
GAINING
AGREEMENTS.—In the case of a group 
health plan maintained pursuant to one or more col-
lective bargaining agreements between employee rep-
resentatives and one or more employers ratified be-
fore the date of the enactment of this Act, this sec-
tion and the amendments made by this section shall 
not apply to plan years beginning before the later 
of—
(A) the date on which the last of the col-
lective bargaining agreements relating to the 
plan terminates (determined without regard to 
any extension thereof agreed to after the date 
of the enactment of this Act), or 
(B) October 1, 2005. 
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining 
agreement relating to the plan which amends the 
plan solely to conform to any requirement of the 
amendments made by this section shall not be treat-
ed as a termination of such collective bargaining 
agreement.
SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) AMENDMENTS RELATING TO THE GROUP MAR-
KET.—
(1) PROHIBITION OF HEALTH INSURANCE DIS-
CRIMINATION
ON
THE
BASIS
OF
PROTECTED
GE-
NETIC INFORMATION OR GENETIC SERVICES.—
(A) NO
ENROLLMENT
RESTRICTION
FOR 
GENETIC SERVICES.—Section 2702(a)(1)(F) of 
the Public Health Service Act (42 U.S.C. 
300gg–1(a)(1)(F)) is amended by inserting be-
fore the period the following: ‘‘(or information 
about a request for or the receipt of genetic 
services by an individual or a family member of 
such individual)’’. 
(B) NO DISCRIMINATION IN GROUP RATE 
BASED
ON
PROTECTED
GENETIC
INFORMA-
TION.—
(i) IN GENERAL.—Subpart 2 of part 
A of title XXVII of the Public Health 
Service (42 U.S.C. 300gg–4 et seq.) is 
amended by adding at the end the fol-
lowing:
‘‘SEC. 
2707. 
PROHIBITING 
DISCRIMINATION 
AGAINST 
GROUPS ON THE BASIS OF PROTECTED GE-
NETIC INFORMATION. 
‘‘A group health plan, and a health insurance issuer 
offering group health insurance coverage in connection 
with a group health plan, shall not deny eligibility to a 
group or adjust premium or contribution rates for a group 
on the basis of protected genetic information concerning 
an individual in the group (or information about a request 
for or the receipt of genetic services by such individual 
or family member of such individual).’’. 
(ii) CONFORMING AMENDMENTS.—
(I) Section 2702(b)(2)(A) of the 
Public Health Service Act (42 U.S.C. 
300gg–1(b)(2)(A)) is amended to read 
as follows:
‘‘(A) to restrict the amount that an em-
ployer may be charged for coverage under a 
group health plan, except as provided in section 
2707; or’’.
(II) Section 2721(a) of the Pub-
lic Health Service Act (42 U.S.C. 
300gg–21(a)) is amended by inserting 
‘‘(other than subsections (a)(1)(F), 
(b) (with respect to cases relating to 
genetic information or information
about a request or receipt of genetic 
services by an individual or family 
member of such individual), (c), (d), 
(e), (f), or (g) of section 2702 and 
section 2707)’’ after ‘‘subparts 1 and 
3’’. 
(2) LIMITATIONS ON GENETIC TESTING AND ON 
COLLECTION AND DISCLOSURE OF PROTECTED GE-
NETIC INFORMATION.—Section 2702 of the Public 
Health Service Act (42 U.S.C. 300gg–1) is amended 
by adding at the end the following: 
‘‘(c) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan, or a 
health insurance issuer offering health insurance 
coverage in connection with a group health plan, 
shall not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this title shall be construed to limit the authority of 
a health care professional, who is providing treat-
ment with respect to an individual and who is em-
ployed by a group health plan or a health insurance 
issuer, to request that such individual or family 
member of such individual undergo a genetic test.
Such a health care professional shall not require 
that such individual or family member undergo a ge-
netic test. 
‘‘(3) CERTAIN TESTS.—The conducting of met-
abolic tests that are not intended to reveal protected 
genetic information shall not be considered a viola-
tion of the preceding provisions of this subsection re-
gardless of the results of the tests. Test results that 
are protected genetic information shall be subject to 
the applicable provisions of this title. 
‘‘(d) COLLECTION OF PROTECTED GENETIC INFOR-
MATION.—Except as provided in subsections (f) and (g), 
a group health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group 
health plan, shall not request, require, collect, or purchase 
protected genetic information concerning an individual (or 
information about a request for or the receipt of genetic 
services by such individual or family member of such indi-
vidual). 
‘‘(e) DISCLOSURE OF PROTECTED GENETIC INFOR-
MATION.—A group health plan, or a health insurance 
issuer offering health insurance coverage in connection 
with a group health plan, shall not disclose protected ge-
netic information about an individual (or information
about a request for or the receipt of genetic services by 
such individual or family member of such individual) to—
‘‘(1) any entity that is a member of the same 
controlled group as such issuer or plan sponsor of 
such group health plan; 
‘‘(2) any other group health plan or health in-
surance issuer or any insurance agent, third party 
administrator, or other person subject to regulation 
under State insurance laws;
‘‘(3) the Medical Information Bureau or any 
other person that collects, compiles, publishes, or 
otherwise disseminates insurance information; 
‘‘(4) the individual’s employer or any plan spon-
sor; or 
‘‘(5) any other person the Secretary may speci-
fy in regulations. 
‘‘(f) INFORMATION
FOR PAYMENT
FOR GENETIC 
SERVICES.—
‘‘(1) IN GENERAL.—With respect to payment 
for genetic services conducted concerning an indi-
vidual or the coordination of benefits, a group health 
plan, or a health insurance issuer offering group 
health insurance coverage in connection with a group 
health plan, may request that the individual provide
the plan or issuer with evidence that such services 
were performed. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to—
‘‘(A) permit a group health plan or health 
insurance issuer to request (or require) the re-
sults of the services referred to in such para-
graph; or 
‘‘(B) require that a group health plan or 
health insurance issuer make payment for serv-
ices described in such paragraph where the in-
dividual involved has refused to provide evi-
dence of the performance of such services pur-
suant to a request by the plan or issuer in ac-
cordance with such paragraph. 
‘‘(g) INFORMATION
FOR
PAYMENT
OF
OTHER 
CLAIMS.—With respect to the payment of claims for bene-
fits other than genetic services, a group health plan, or 
a health insurance issuer offering group health insurance 
coverage in connection with a group health plan, may re-
quest that an individual provide protected genetic informa-
tion so long as such information—
‘‘(1) is used solely for the payment of a claim; 
‘‘(2) is limited to information that is directly re-
lated to and necessary for the payment of such claim
and the claim would otherwise be denied but for the 
protected genetic information; and 
‘‘(3) is used only by an individual (or individ-
uals) within such plan or issuer who needs access to 
such information for purposes of payment of a 
claim. 
‘‘(h) RULES OF CONSTRUCTION.—
‘‘(1) COLLECTION OR DISCLOSURE AUTHORIZED 
BY INDIVIDUAL.—The provisions of subsections (d) 
(regarding collection) and (e) shall not apply to an 
individual if the individual (or legal representative of 
the individual) provides prior, knowing, voluntary, 
and written authorization for the collection or disclo-
sure of protected genetic information. 
‘‘(2) DISCLOSURE FOR HEALTH CARE TREAT-
MENT.—Nothing in this section shall be construed to 
limit or restrict the disclosure of protected genetic 
information from a health care provider to another 
health care provider for the purpose of providing 
health care treatment to the individual involved. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) CONTROLLED
GROUP.—The term ‘con-
trolled group’ means any group treated as a single 
employer under subsection (b), (c), (m), or (o) of 
section 414 of the Internal Revenue Code of 1986.
‘‘(2) GROUP
HEALTH
PLAN, HEALTH
INSUR-
ANCE ISSUER.—The terms ‘group health plan’ and 
‘health insurance issuer’ include a third party ad-
ministrator or other person acting for or on behalf 
of such plan or issuer.’’. 
(3) DEFINITIONS.—Section 2791(d) of the Pub-
lic Health Service Act (42 U.S.C. 300gg–91(d)) is 
amended by adding at the end the following new 
paragraphs: 
‘‘(15) FAMILY
MEMBER.—The term ‘family 
member’ means with respect to an individual—
‘‘(A) the spouse of the individual; 
‘‘(B) a dependent child of the individual, 
including a child who is born to or placed for 
adoption with the individual; and 
‘‘(C) all other individuals related by blood 
to the individual or the spouse or child de-
scribed in subparagraph (A) or (B). 
‘‘(16) GENETIC INFORMATION.—The term ‘ge-
netic information’ means information about genes, 
gene products, or inherited characteristics that may 
derive from an individual or a family member of 
such individual (including information about a re-
quest for or the receipt of genetic services by such 
individual or family member of such individual).
‘‘(17) GENETIC SERVICES.—The term ‘genetic 
services’ means health services, including genetic 
tests, provided to obtain, assess, or interpret genetic 
information for diagnostic and therapeutic purposes, 
and for genetic education and counselling. 
‘‘(18) GENETIC TEST.—The term ‘genetic test’ 
means the analysis of human DNA, RNA, chro-
mosomes, proteins, or metabolites that detects 
genotypes, mutations, or chromosomal changes.
‘‘(19) PROTECTED GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘protected genetic 
information’ means—
‘‘(i) information about an individual’s 
genetic tests; 
‘‘(ii) information about genetic tests 
of family members of the individual; and 
‘‘(iii) information about the occur-
rence of a disease or disorder in family 
members.’’. 
‘‘(B) LIMITATIONS.—The term ‘protected 
genetic information’ shall not include—
‘‘(i) information about the sex or age 
of the individual;
‘‘(ii) 
information 
about 
chemical, 
blood, or urine analyses of the individual, 
unless these analyses are genetic tests; or 
‘‘(iii) 
information 
about 
physical 
exams of the individual, and other informa-
tion that indicates the current health sta-
tus of the individual.’’. 
(b) AMENDMENT RELATING
TO
THE INDIVIDUAL 
MARKET.—The first subpart 3 of part B of title XXVII 
of the Public Health Service Act (42 U.S.C. 300gg–51 et 
seq.) is amended—
(1) by redesignating such subpart as subpart 2; 
and 
(2) by adding at the end the following: 
‘‘SEC. 2753. PROHIBITION OF HEALTH INSURANCE DIS-
CRIMINATION AGAINST INDIVIDUALS ON THE 
BASIS OF PROTECTED GENETIC INFORMA-
TION. 
‘‘(a) INELIGIBILITY TO ENROLL.—A health insur-
ance issuer offering health insurance coverage in the indi-
vidual market shall not establish rules for eligibility to en-
roll in individual health insurance coverage that are based 
on protected genetic information concerning the individual 
(or information about a request for or the receipt of ge-
netic services by such individual or family member of such 
individual). 
‘‘(b) IN PREMIUM RATES.—A health insurance issuer 
offering health insurance coverage in the individual mar-
ket shall not adjust premium rates on the basis of pro-
tected genetic information concerning an individual (or in-
formation about a request for or the receipt of genetic 
services by such individual or family member of such indi-
vidual). 
‘‘SEC. 2754. LIMITATIONS ON GENETIC TESTING AND ON 
COLLECTION 
AND 
DISCLOSURE 
OF 
PRO-
TECTED GENETIC INFORMATION. 
‘‘(a) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A health insurance issuer 
offering health insurance coverage in the individual 
market shall not request or require an individual or 
a family member of such individual to undergo a ge-
netic test. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this title shall be construed to limit the authority of 
a health care professional, who is providing treat-
ment with respect to an individual and who is em-
ployed by a group health plan or a health insurance 
issuer, to request that such individual or family
member of such individual undergo a genetic test. 
Such a health care professional shall not require 
that such individual or family member undergo a ge-
netic test. 
‘‘(3) CERTAIN TESTS.—The conducting of met-
abolic tests that are not intended to reveal protected 
genetic information shall not be considered a viola-
tion of the preceding provisions of this subsection re-
gardless of the results of the tests. Test results that 
are protected genetic information shall be subject to 
the applicable provisions of this title. 
‘‘(b) COLLECTION OF PROTECTED GENETIC INFOR-
MATION.—Except as provided in subsections (d) and (e), 
a health insurance issuer offering health insurance cov-
erage in the individual market shall not request, require, 
collect, or purchase protected genetic information con-
cerning an individual (or information about a request for 
or the receipt of genetic services by such individual or fam-
ily member of such individual). 
‘‘(c) DISCLOSURE OF PROTECTED GENETIC INFOR-
MATION.—A health insurance issuer offering health insur-
ance coverage in the individual market shall not disclose 
protected genetic information about an individual (or in-
formation about a request for or the receipt of genetic
services by such individual or family member of such indi-
vidual) to—
‘‘(1) any entity that is a member of the same 
controlled group as such issuer or plan sponsor of 
such group health plan;
‘‘(2) any other group health plan or health in-
surance issuer or any insurance agent, third party 
administrator, or other person subject to regulation 
under State insurance laws;
‘‘(3) the Medical Information Bureau or any 
other person that collects, compiles, publishes, or 
otherwise disseminates insurance information; 
‘‘(4) the individual’s employer or any plan spon-
sor; or 
‘‘(5) any other person the Secretary may speci-
fy in regulations. 
‘‘(d) INFORMATION
FOR PAYMENT
FOR GENETIC 
SERVICES.—
‘‘(1) IN GENERAL.—With respect to payment 
for genetic services conducted concerning an indi-
vidual or the coordination of benefits, a health insur-
ance issuer offering health insurance coverage in the 
individual market may request that the individual 
provide the plan or issuer with evidence that such 
services were performed.
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to—
‘‘(A) permit a health insurance issuer to 
request (or require) the results of the services 
referred to in such paragraph; or 
‘‘(B) require that a health insurance issuer 
make payment for services described in such 
paragraph where the individual involved has re-
fused to provide evidence of the performance of 
such services pursuant to a request by the plan 
or issuer in accordance with such paragraph. 
‘‘(e) INFORMATION
FOR
PAYMENT
OF
OTHER 
CLAIMS.—With respect to the payment of claims for bene-
fits other than genetic services, a health insurance issuer 
offering health insurance coverage in the individual mar-
ket may request that an individual provide protected ge-
netic information so long as such information—
‘‘(1) is used solely for the payment of a claim; 
‘‘(2) is limited to information that is directly re-
lated to and necessary for the payment of such claim 
and the claim would otherwise be denied but for the 
protected genetic information; and
‘‘(3) is used only by an individual (or individ-
uals) within such plan or issuer who needs access to
such information for purposes of payment of a 
claim. 
‘‘(f) RULES OF CONSTRUCTION.—
‘‘(1) COLLECTION OR DISCLOSURE AUTHORIZED 
BY INDIVIDUAL.—The provisions of subsections (c) 
(regarding collection) and (d) shall not apply to an 
individual if the individual (or legal representative of 
the individual) provides prior, knowing, voluntary, 
and written authorization for the collection or disclo-
sure of protected genetic information. 
‘‘(2) DISCLOSURE FOR HEALTH CARE TREAT-
MENT.—Nothing in this section shall be construed to 
limit or restrict the disclosure of protected genetic 
information from a health care provider to another 
health care provider for the purpose of providing 
health care treatment to the individual involved. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) CONTROLLED
GROUP.—The term ‘con-
trolled group’ means any group treated as a single 
employer under subsection (b), (c), (m), or (o) of 
section 414 of the Internal Revenue Code of 1986. 
‘‘(2) GROUP
HEALTH
PLAN, HEALTH
INSUR-
ANCE ISSUER.—The terms ‘group health plan’ and 
‘health insurance issuer’ include a third party ad-
ministrator or other person acting for or on behalf 
of such plan or issuer.’’. 
(c) ENFORCEMENT.—
(1) GROUP PLANS.—Section 2722 of the Public 
Health Service Act (42 U.S.C. 300gg–22) is amend-
ed by adding at the end the following: 
‘‘(c) VIOLATION OF GENETIC DISCRIMINATION OR 
GENETIC DISCLOSURE PROVISIONS.—
‘‘(1) IN GENERAL.—In any action under this 
section against any administrator of a group health 
plan, or health insurance issuer offering group 
health insurance coverage in connection with a group 
health plan (including any third party administrator 
or other person acting for or on behalf of such plan 
or issuer) alleging a violation of subsections 
(a)(1)(F), (b) (with respect to cases relating to ge-
netic information or information about a request or 
receipt of genetic services by an individual or family 
member of such individual), (c), (d), (e), (f), or (g) 
of section 2702 and section 2707 the court may 
award any appropriate legal or equitable relief. Such 
relief may include a requirement for the payment of 
attorney’s fees and costs, including the costs of ex-
pert witnesses.
‘‘(2) CIVIL PENALTY.—In any action described 
in paragraph (1), the Secretary may, to vindicate 
the public interest, assess a civil penalty against the 
defendant in an amount—
‘‘(A) not exceeding $50,000 for a first vio-
lation, and 
‘‘(B) not exceeding $100,000 for any sub-
sequent violation. 
Any such relief awarded shall be paid into the gen-
eral fund of the Treasury.’’.
(2) INDIVIDUAL PLANS.—Section 2761 of the 
Public Health Service Act (42 U.S.C. 300gg–45) is 
amended by adding at the end the following: 
‘‘(c) VIOLATION OF GENETIC DISCRIMINATION OR 
GENETIC DISCLOSURE PROVISIONS.—
‘‘(1) IN GENERAL.—In any action under this 
section against any health insurance issuer offering 
health insurance coverage in the individual market 
(including any other person acting for or on behalf 
of such issuer) alleging a violation of sections 2753 
and 2754 the court in which the action is com-
menced may award any appropriate legal or equi-
table relief. Such relief may include a requirement 
for the payment of attorney’s fees and costs, includ-
ing the costs of expert witnesses.
‘‘(2) CIVIL PENALTY.—In any action described 
in paragraph (1), the Secretary may, to vindicate 
the public interest, assess a civil penalty against the 
defendant in an amount—
‘‘(A) not exceeding $50,000 for a first vio-
lation, and 
‘‘(B) not exceeding $100,000 for any sub-
sequent violation. 
Any such relief awarded shall be paid into the gen-
eral fund of the Treasury.’’. 
(d) PREEMPTION.—
(1) GROUP MARKET.—Section 2723 of the Pub-
lic Health Service Act (42 U.S.C. 300gg–23) is 
amended—
(A) in subsection (a)(1), by inserting ‘‘or 
(e)’’ after ‘‘subsection (b)’’; and 
(B) by adding at the end the following: 
‘‘(e) SPECIAL RULE IN CASE OF GENETIC INFORMA-
TION.—With respect to group health insurance coverage 
offered by a health insurance issuer, the provisions of this 
part relating to genetic information (including information 
about a request for or the receipt of genetic services by 
an individual or a family member of such individual) shall 
not be construed to supersede any provision of State law
which establishes, implements, or continues in effect a 
standard, requirement, or remedy that more completely—
‘‘(1) protects the confidentiality of genetic in-
formation (including information about a request for 
or the receipt of genetic services by an individual or 
a family member of such individual) or the privacy 
of an individual or a family member of the individual 
with respect to genetic information (including infor-
mation about a request for or the receipt of genetic 
services by an individual or a family member of such 
individual) than does this part; or 
‘‘(2) prohibits discrimination on the basis of ge-
netic information than does this part.’’. 
(2) INDIVIDUAL MARKET.—Section 2762 of the 
Public Health Service Act (42 U.S.C. 300gg–46) is 
amended—
(A) in subsection (a), by inserting ‘‘and ex-
cept as provided in subsection (c),’’ after ‘‘Sub-
ject to subsection (b),’’; and 
(B) by adding at the end the following: 
‘‘(c) SPECIAL RULE IN CASE OF GENETIC INFORMA-
TION.—With respect to individual health insurance cov-
erage offered by a health insurance issuer, the provisions 
of this part (or part C insofar as it applies to this part) 
relating to genetic information (including information
about a request for or the receipt of genetic services by 
an individual or a family member of such individual) shall 
not be construed to supersede any provision of State law 
(as defined in section 2723(d)) which establishes, imple-
ments, or continues in effect a standard, requirement, or 
remedy that more completely—
‘‘(1) protects the confidentiality of genetic in-
formation (including information about a request for 
or the receipt of genetic services of an individual or 
a family member of such individual) or the privacy 
of an individual or a family member of the individual 
with respect to genetic information (including infor-
mation about a request for or the receipt of genetic 
services by an individual or a family member of such 
individual) than does this part (or part C insofar as 
it applies to this part); or 
‘‘(2) prohibits discrimination on the basis of ge-
netic information than does this part (or part C in-
sofar as it applies to this part).’’. 
(e) 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), (c), (d), (e), 
(f), and (g) of section 2702 and section 2707, 
and the provisions of section 2702(b) to the ex-
tent that they 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).’’. 
(f) AMENDMENT CONCERNING SUPPLEMENTAL EX-
CEPTED BENEFITS.—
(1) GROUP
MARKET.—Section 2721(d)(3) of 
the Public Health Service Act (42 U.S.C. 300gg–
23(d)(3)) is amended by inserting ‘‘, other than the 
requirements of subsections (a)(1)(F), (b) (in cases 
relating 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)),
(c), (d), (e), (f) and (g) of section 2702 and section 
2707,’’ after ‘‘The requirements of this part’’. 
(2) INDIVIDUAL MARKET.—Section 2763(b) of 
the Public Health Service Act (42 U.S.C. 300gg–
47(b)) is amended—
(A) by striking ‘‘The requirements of this 
part’’ and inserting the following: 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the requirements of this part’’; and 
(B) by adding at the end the following: 
‘‘(2) LIMITATION.—The requirements of sec-
tions 2753 and 2754 shall apply to excepted benefits 
described in section 2791(c)(4).’’.
(g) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendments made by 
this section shall apply with respect to—
(A) group health plans, and health insur-
ance coverage offered in connection with group 
health plans, for plan years beginning; and 
(B) health insurance coverage offered, 
sold, issued, renewed, in effect, or operated in 
the individual market, after; 
October 1, 2005. 
(2) SPECIAL
RULE
FOR
COLLECTIVE
BAR-
GAINING
AGREEMENTS.—In the case of a group
health plan maintained pursuant to one or more col-
lective bargaining agreements between employee rep-
resentatives and one or more employers ratified be-
fore the date of the enactment of this Act, the 
amendments made by this section shall not apply to 
plan years beginning before the later of—
(A) the date on which the last of the col-
lective bargaining agreements relating to the 
plan terminates (determined without regard to 
any extension thereof agreed to after the date 
of the enactment of this Act); or 
(B) October 1, 2005. 
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining 
agreement relating to the plan which amends the 
plan solely to conform to any requirement of the 
amendments made by this section shall not be treat-
ed as a termination of such collective bargaining 
agreement.
SEC. 103. AMENDMENTS TO INTERNAL REVENUE CODE OF 
1986. 
(a) PROHIBITION OF HEALTH INSURANCE DISCRIMI-
NATION ON THE BASIS OF GENETIC SERVICES OR PRO-
TECTED GENETIC INFORMATION.—
(1) NO
ENROLLMENT
RESTRICTION
FOR
GE-
NETIC SERVICES.—Section 9802(a)(1)(F) of the In-
ternal Revenue Code of 1986 is amended by insert-
ing before the period ‘‘(or information about a re-
quest for or the receipt of genetic services by such 
individual or family member of such individual)’’. 
(2) NO DISCRIMINATION IN GROUP RATE BASED 
ON PROTECTED GENETIC INFORMATION.—
(A) IN GENERAL.—Subchapter B of chap-
ter 100 of the Internal Revenue Code of 1986 
is amended by adding at the end the following: 
‘‘SEC. 
9813. 
PROHIBITING 
DISCRIMINATION 
AGAINST 
GROUPS ON THE BASIS OF PROTECTED GE-
NETIC INFORMATION. 
‘‘A group health plan shall not deny eligibility to a 
group or adjust premium or contribution rates for a group 
on the basis of protected genetic information concerning 
an individual in the group (or information about a request 
for or the receipt of genetic services by such individual 
or family member of such individual).’’. 
(B) CONFORMING AMENDMENTS.—
(i) Section 9802(b)(2)(A) of the Inter-
nal Revenue Code of 1986 is amended to 
read as follows:
‘‘(A) to restrict the amount that an em-
ployer may be charged for coverage under a 
group health plan, except as provided in section 
9813; or’’. 
(ii) Section 9831(a) of the Internal 
Revenue Code of 1986 is amended by in-
serting ‘‘(other than subsections (a)(1)(F), 
(b) (with respect to cases relating to ge-
netic information or information about a 
request or receipt of genetic services by an 
individual or family member of such indi-
vidual), (d), (e), (f), (g), or (h) of section 
9802 or section 9813) after ‘‘chapter’’. 
(b) LIMITATIONS
ON GENETIC TESTING
AND
ON 
COLLECTION AND DISCLOSURE OF PROTECTED GENETIC 
INFORMATION.—Section 9802 of the Internal Revenue 
Code of 1986 is amended by adding at the end the fol-
lowing: 
‘‘(d) GENETIC TESTING.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIR-
ING GENETIC TESTING.—A group health plan may 
not request or require an individual or a family 
member of such individual to undergo a genetic test. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this chapter shall be construed to limit the authority
of a health care professional, who is providing treat-
ment with respect to an individual and who is em-
ployed by a group health plan, to request that such 
individual or family member of such individual un-
dergo a genetic test. Such a health care professional 
shall not require that such individual or family mem-
ber undergo a genetic test. 
‘‘(3) CERTAIN TESTS.—The conducting of met-
abolic tests that are not intended to reveal protected 
genetic information shall not be considered a viola-
tion of the preceding provisions of this subsection re-
gardless of the results of the tests. Test results that 
are protected genetic information shall be subject to 
the applicable provisions of this chapter. 
‘‘(e) COLLECTION OF PROTECTED GENETIC INFOR-
MATION.—Except as provided in subsections (g) and (h), 
a group health plan shall not request, require, collect, or 
purchase protected genetic information concerning an in-
dividual (or information about a request for or the receipt 
of genetic services by such individual or family member 
of such individual). 
‘‘(f) DISCLOSURE OF PROTECTED GENETIC INFOR-
MATION.—A group health plan shall not disclose protected 
genetic information about an individual (or information
about a request for or the receipt of genetic services by 
such individual or family member of such individual) to—
‘‘(1) any entity that is a member of the same 
controlled group as such issuer or plan sponsor of 
such group health plan; 
‘‘(2) any other group health plan or health in-
surance issuer or any insurance agent, third party 
administrator, or other person subject to regulation 
under State insurance laws; 
‘‘(3) the Medical Information Bureau or any 
other person that collects, compiles, publishes, or 
otherwise disseminates insurance information;
‘‘(4) the individual’s employer or any plan spon-
sor; or 
‘‘(5) any other person the Secretary may speci-
fy in regulations. 
‘‘(g) INFORMATION
FOR PAYMENT
FOR GENETIC 
SERVICES.—
‘‘(1) IN GENERAL.—With respect to payment 
for genetic services conducted concerning an indi-
vidual or the coordination of benefits, a group health 
plan may request that the individual provide the 
plan with evidence that such services were per-
formed.
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to—
‘‘(A) permit a group health plan to request 
(or require) the results of the services referred 
to in such paragraph; or 
‘‘(B) require that a group health plan 
make payment for services described in such 
paragraph where the individual involved has re-
fused to provide evidence of the performance of 
such services pursuant to a request by the plan 
in accordance with such paragraph. 
‘‘(h) INFORMATION
FOR
PAYMENT
OF
OTHER 
CLAIMS.—With respect to the payment of claims for bene-
fits other than genetic services, a group health plan may 
request that an individual provide protected genetic infor-
mation so long as such information—
‘‘(1) is used solely for the payment of a claim; 
‘‘(2) is limited to information that is directly re-
lated to and necessary for the payment of such claim 
and the claim would otherwise be denied but for the 
protected genetic information; and 
‘‘(3) is used only by an individual (or individ-
uals) within such plan or issuer who needs access to 
such information for purposes of payment of a 
claim.
‘‘(i) RULES OF CONSTRUCTION.—
‘‘(1) COLLECTION OR DISCLOSURE AUTHORIZED 
BY INDIVIDUAL.—The provisions of subsections (e) 
(regarding collection) and (f) shall not apply to an 
individual if the individual (or legal representative 
of, the individual) provides prior, knowing, vol-
untary, and written authorization for the collection 
or disclosure of protected genetic information.
‘‘(2) DISCLOSURE FOR HEALTH CARE TREAT-
MENT.—Nothing in this section shall be construed to 
limit or restrict the disclosure of protected genetic 
information from a health care provider to another 
health care provider for the purpose of providing 
health care treatment to the individual involved. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) CONTROLLED
GROUP.—The term ‘con-
trolled group’ means any group treated as a single 
employer under subsections (b), (c), (m), or (o) of 
section 414. 
‘‘(2) GROUP
HEALTH
PLAN, HEALTH
INSUR-
ANCE ISSUER.—The terms ‘group health plan’ and 
‘health insurance issuer’ include a third party ad-
ministrator or other person acting for or on behalf 
of such plan or issuer.’’.
(c) DEFINITIONS.—Section 9832(d) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following: 
‘‘(6) FAMILY
MEMBER.—The term ‘family 
member’ means with respect to an individual—
‘‘(A) the spouse of the individual; 
‘‘(B) a dependent child of the individual, 
including a child who is born to or placed for 
adoption with the individual; and 
‘‘(C) all other individuals related by blood 
to the individual or the spouse or child de-
scribed in subparagraph (A) or (B). 
‘‘(7) GENETIC
INFORMATION.—The term ‘ge-
netic information’ means information about genes, 
gene products, or inherited characteristics that may 
derive from an individual or a family member of 
such individual (including information about a re-
quest for or the receipt of genetic services by such 
individual or family member of such individual). 
‘‘(8) GENETIC
SERVICES.—The term ‘genetic 
services’ means health services, including genetic 
tests, provided to obtain, assess, or interpret genetic 
information for diagnostic and therapeutic purposes, 
and for genetic education and counseling.
‘‘(9) GENETIC TEST.—The term ‘genetic test’ 
means the analysis of human DNA, RNA, chro-
mosomes, proteins, or metabolites that detects 
genotypes, mutations, or chromosomal changes. 
‘‘(10) PROTECTED GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘protected genetic 
information’ means—
‘‘(i) information about an individual’s 
genetic tests; 
‘‘(ii) information about genetic tests 
of family members of the individual; and
‘‘(iii) information about the occur-
rence of a disease or disorder in family 
members. 
‘‘(B) LIMITATIONS.—The term ‘protected 
genetic information’ shall not include—
‘‘(i) information about the sex or age 
of the individual; 
‘‘(ii) 
information 
about 
chemical, 
blood, or urine analyses of the individual, 
unless these analyses are genetic tests; or 
‘‘(iii) 
information 
about 
physical 
exams of the individual, and other informa-
tion that indicates the current health sta-
tus of the individual.’’. 
(d) EFFECTIVE DATE.—
(1) IN GENERAL.—Except as provided in this 
section, this section and the amendments made by 
this section shall apply with respect to group health 
plans for plan years beginning after October 1, 
2005. 
(2) SPECIAL
RULE
FOR
COLLECTIVE
BAR-
GAINING
AGREEMENTS.—In the case of a group 
health plan maintained pursuant to one or more col-
lective bargaining agreements between employee rep-
resentatives and one or more employers ratified be-
fore the date of the enactment of this Act, this sec-
tion and the amendments made by this section shall 
not apply to plan years beginning before the later 
of—
(A) the date on which the last of the col-
lective bargaining agreements relating to the 
plan terminates (determined without regard to 
any extension thereof agreed to after the date 
of the enactment of this Act), or 
(B) October 1, 2005. 
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining
agreement relating to the plan which amends the 
plan solely to conform to any requirement of the 
amendments made by this section shall not be treat-
ed as a termination of such collective bargaining 
agreement. 
SEC. 104. 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: 
‘‘(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 protected ge-
netic information concerning the individual (or 
information about a request for, or the receipt 
of, genetic services by such individual or family 
member of such individual). 
‘‘(ii) For purposes of clause (i), the terms 
‘family member’, ‘genetic services’, and ‘pro-
tected genetic information’ shall have the mean-
ings given such terms in subsection (v).’’.
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply with respect to a policy 
for policy years beginning after October 1, 2005. 
(b) LIMITATIONS
ON GENETIC TESTING
AND
ON 
COLLECTION AND DISCLOSURE OF PROTECTED GENETIC 
INFORMATION.—
(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:
‘‘(v) LIMITATIONS ON GENETIC TESTING AND ON 
COLLECTION AND DISCLOSURE OF PROTECTED GENETIC 
INFORMATION.—
‘‘(1) GENETIC TESTING.—
‘‘(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 limit the au-
thority of a health care professional, who is pro-
viding treatment with respect to an individual 
and who is employed by an issuer of a medicare 
supplemental policy, to request that such indi-
vidual or family member of such individual un-
dergo a genetic test. Such a health care profes-
sional shall not require that such individual or 
family member undergo a genetic test. 
‘‘(C) CERTAIN TESTS.—The conducting of 
metabolic tests that are not intended to reveal 
protected genetic information shall not be con-
sidered a violation of the preceding provisions 
of this paragraph regardless of the results of 
the tests. Test results that are protected genetic 
information shall be subject to the applicable 
provisions of this subsection. 
‘‘(2) COLLECTION OF PROTECTED GENETIC IN-
FORMATION.—Except as provided in paragraphs (4) 
and (5), an issuer of a medicare supplemental policy 
shall not request, require, collect, or purchase pro-
tected genetic information concerning an individual 
(or information about a request for or the receipt of 
genetic services by such individual or family member 
of such individual). 
‘‘(3) DISCLOSURE OF PROTECTED GENETIC IN-
FORMATION.—An issuer of a medicare supplemental 
policy shall not disclose protected genetic informa-
tion about an individual (or information about a re-
quest for or the receipt of genetic services by such 
individual or family member of such individual) to—
‘‘(A) any entity that is a member of the 
same controlled group as such issuer; 
‘‘(B) any issuer of a medicare supple-
mental policy, group health plan or health in-
surance issuer, or any insurance agent, third 
party administrator, or other person subject to 
regulation under State insurance laws; 
‘‘(C) the Medical Information Bureau or 
any other person that collects, compiles, pub-
lishes, or otherwise disseminates insurance in-
formation; 
‘‘(D) the individual’s employer or any plan 
sponsor; or
‘‘(E) any other person the Secretary may 
specify in regulations. 
‘‘(4) INFORMATION
FOR
PAYMENT
FOR
GE-
NETIC SERVICES.—
‘‘(A) IN GENERAL.—With respect to pay-
ment for genetic services conducted concerning 
an individual or the coordination of benefits, an 
issuer of a medicare supplemental policy may 
request that the individual provide the issuer 
with evidence that such services were per-
formed.