described in subsection (a), except to the extent re-
quired by subsection (a)(1). 
SEC. 4. PROHIBITION ON MANDATING STATE RESTRIC-
TIONS. 
(a) IN GENERAL.—No Federal funds shall be used 
by any Federal officer or employee to induce or encourage 
any State or other jurisdiction of the United States to 
enact any restriction or prohibition prohibited to the Fed-
eral Government by this Act. 
(b) PROTECTING STATE ELIGIBILITY FOR FEDERAL 
FUNDS.—No State’s eligibility for participation in any 
program operated by or funded wholly or partly by the 
Federal Government, or for receiving funds from the Fed-
eral Government shall be conditioned on that State enact-
ing any restriction or prohibition prohibited to the Federal 
Government by this Act, nor adversely affected by that 
State’s failure to enact any restriction or prohibition pro-
hibited to the Federal Government by this Act. 
SEC. 5. CLARIFICATION. 
Nothing in this Act shall be construed to permit the 
expenditure of funds otherwise prohibited by law. 
SEC. 6. CONFORMING AMENDMENT. 
Section 1802(b)(3) of the Social Security Act (42 
U.S.C. 1395(2)(B)) is hereby repealed. 
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SEC. 7. DEFINITIONS. 
For purposes of this Act: 
(1) 
HEALTH
CARE
SERVICES.—The 
term 
‘‘health care services’’ means any lawful service in-
tended to diagnose, cure, prevent, or mitigate the 
adverse effects of any disease, injury, infirmity, or 
physical or mental disability, including the provision 
of any lawful product the use of which is so in-
tended. 
(2) 
PHYSICIAN.—The 
term 
‘‘physician’’ 
means— 
(A) a doctor of medicine or osteopathy le-
gally authorized to practice medicine and sur-
gery by the State in which he performs such 
practice and surgery; 
(B) a doctor of dental surgery or of dental 
medicine who is legally authorized to practice 
dentistry by the State in which he performs 
such function and who is acting within the 
scope of his license when he performs such 
functions; 
(C) a doctor of podiatric medicine but only 
with respect to functions which he is legally au-
thorized to perform as such by the State in 
which he performs them; 
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(D) a doctor of optometry with respect to 
the provision of items or services which he is le-
gally authorized to perform as a doctor of op-
tometry by the State in which he performs 
them; or 
(E) a chiropractor who is licensed as such 
by the State (or in a State which does not li-
cense chiropractors as such, is legally author-
ized to perform the services of a chiropractor in 
the jurisdiction in which he performs such serv-
ices), but only with respect to treatment which 
he is legally authorized to perform by the State 
or jurisdiction in which such treatment is pro-
vided. 
(3) PRACTICE OF MEDICINE.—The term ‘‘prac-
tice of medicine’’ means— 
(A) health care services that are performed 
by physicians; and 
(B) services and supplies furnished as an 
incident to a physician’s professional service. 
(4) HEALTH CARE PRACTITIONER.—The term 
‘‘health care practitioner’’ means a physician assist-
ant, registered nurse, nurse practitioner, psycholo-
gist, clinical social worker, midwife, or other indi-
vidual (other than a physician) licensed or legally 
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authorized to perform health care services in the 
State in which the individual performs such services. 
(5) PRACTICE OF OTHER HEALTH CARE PRO-
FESSIONS.—The term ‘‘practice of other health care 
professions’’ means— 
(A) health care services performed by a 
health care practitioner; and 
(B) services and supplies furnished as an 
incident to a health care practitioner’s profes-
sional service. 
(6) GROUP HEALTH PLAN.—The term ‘‘group 
health plan’’ has the meaning given such term in 
section 733(a)(1) of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1191b(a)(1)). 
(7) HEALTH
INSURANCE
ISSUER.—The term 
‘‘health insurance issuer’’ has the meaning given 
such term in section 733(b)(2) of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 
1191b(b)(2)). 
(8) BUSINESS.—The term ‘‘business’’ means 
any sole proprietorship, partnership, for-profit cor-
poration, or not-for-profit corporation. 
(9) STATE.—The term ‘‘State’’ means any of 
the United States, the Commonwealth of Puerto 
Rico, the Commonwealth of the Northern Mariana 
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Islands, the United States Virgin Islands, Guam, 
American Samoa, or the District of Columbia. 
SEC. 8. EFFECTIVE DATE. 
The provisions of this Act shall apply to Federal enti-
ties, including employees and officials of such entities, be-
ginning on January 1, 2009. 
Æ 
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