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‘‘SEC. 
716. 
PROHIBITING 
PREMIUM 
DISCRIMINATION
AGAINST GROUPS ON THE BASIS OF PRE-
DICTIVE GENETIC INFORMATION.
‘‘A group health plan, or a health insurance issuer of-
fering group health insurance coverage in connection with
a group health plan, shall not adjust premium or contribu-
tion amounts for a group on the basis of predictive genetic
information concerning any individual (including a de-
pendent) or family member of the individual (including in-
formation about a request for or receipt of genetic serv-
ices).’’.
(3) CONFORMING AMENDMENTS.—
(A) IN
GENERAL.—Section 702(b) of the
Employee Retirement Income Security Act of
1974 (29 U.S.C. 1182(b)) is amended by adding
at the end the following:
‘‘(3) REFERENCE TO RELATED PROVISION.—For
a provision prohibiting the adjustment of premium or
contribution amounts for a group under a group
health plan on the basis of predictive genetic informa-
tion (including information about a request for or re-
ceipt of genetic services), see section 716.’’.
(B) TABLE
OF
CONTENTS.—The table of
contents in section 1 of the Employee Retirement
Income Security Act of 1974, as amended by sec-
tion 2301, is further amended by inserting after
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the item relating to section 715 the following new
item:
‘‘Sec. 716. Prohibiting premium discrimination against groups on the basis of
predictive genetic information.’’.
(b) LIMITATION ON COLLECTION OF PREDICTIVE GE-
NETIC INFORMATION.—Section 702 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 1182) is
amended by adding at the end the following:
‘‘(c) COLLECTION OF PREDICTIVE GENETIC INFORMA-
TION.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING
PREDICTIVE GENETIC INFORMATION.—Except as pro-
vided in paragraph (2), a group health plan, or a
health insurance issuer offering health insurance cov-
erage in connection with a group health plan, shall
not request or require predictive genetic information
concerning any individual (including a dependent) or
family member of the individual (including informa-
tion about a request for or receipt of genetic services).
‘‘(2) INFORMATION
NEEDED
FOR
DIAGNOSIS,
TREATMENT, OR PAYMENT.—
‘‘(A) IN GENERAL.—Notwithstanding para-
graph (1), a group health plan, or a health in-
surance issuer offering health insurance coverage
in connection with a group health plan, that
provides health care items and services to an in-
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dividual or dependent may request (but may not
require) that such individual or dependent dis-
close, or authorize the collection or disclosure of,
predictive genetic information for purposes of di-
agnosis, treatment, or payment relating to the
provision of health care items and services to
such individual or dependent.
‘‘(B) NOTICE
OF
CONFIDENTIALITY
PRAC-
TICES AND DESCRIPTION OF SAFEGUARDS.—As a
part of a request under subparagraph (A), the
group health plan, or a health insurance issuer
offering health insurance coverage in connection
with a group health plan, shall provide to the in-
dividual or dependent a description of the proce-
dures in place to safeguard the confidentiality,
as described in subsection (d), of such predictive
genetic information.
‘‘(d) CONFIDENTIALITY
WITH
RESPECT
TO
PRE-
DICTIVE GENETIC INFORMATION.—
‘‘(1) NOTICE OF CONFIDENTIALITY PRACTICES.—
‘‘(A) PREPARATION OF WRITTEN NOTICE.—
A group health plan, or a health insurance
issuer offering health insurance coverage in con-
nection with a group health plan, shall post or
provide, in writing and in a clear and con-
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spicuous manner, notice of the plan or issuer’s
confidentiality practices, that shall include—
‘‘(i) a description of an individual’s
rights with respect to predictive genetic in-
formation;
‘‘(ii) the procedures established by the
plan or issuer for the exercise of the individ-
ual’s rights; and
‘‘(iii) the right to obtain a copy of the
notice of the confidentiality practices re-
quired under this subsection.
‘‘(B) MODEL
NOTICE.—The Secretary, in
consultation with the National Committee on
Vital and Health Statistics and the National As-
sociation of Insurance Commissioners, and after
notice and opportunity for public comment, shall
develop and disseminate model notices of con-
fidentiality practices. Use of the model notice
shall serve as a defense against claims of receiv-
ing inappropriate notice.
‘‘(2) 
ESTABLISHMENT
OF
SAFEGUARDS.—A
group health plan, or a health insurance issuer offer-
ing health insurance coverage in connection with a
group health plan, shall establish and maintain ap-
propriate administrative, technical, and physical
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safeguards to protect the confidentiality, security, ac-
curacy, and integrity of predictive genetic informa-
tion created, received, obtained, maintained, used,
transmitted, or disposed of by such plan or issuer.’’.
(c) DEFINITIONS.—Section 733(d) of the Employee Re-
tirement 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 mem-
ber’ 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 described
in subparagraph (A) or (B).
‘‘(6) GENETIC INFORMATION.—The term ‘genetic
information’ means information about genes, gene
products, or inherited characteristics that may derive
from an individual or a family member (including
information about a request for or receipt of genetic
services).
‘‘(7) GENETIC
SERVICES.—The term ‘genetic
services’ means health services provided to obtain, as-
sess, or interpret genetic information for diagnostic
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and therapeutic purposes, and for genetic education
and counseling.
‘‘(8) PREDICTIVE GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—The term ‘predictive ge-
netic information’ means, in the absence of
symptoms, clinical signs, or a diagnosis of the
condition related to such information—
‘‘(i) information about an individual’s
genetic tests;
‘‘(ii) information about genetic tests of
family members of the individual; or
‘‘(iii) information about the occurrence
of a disease or disorder in family members.
‘‘(B) EXCEPTIONS.—The term ‘predictive
genetic information’ shall not include—
‘‘(i) information about the sex or age of
the individual;
‘‘(ii) information derived from phys-
ical tests, such as the chemical, blood, or
urine analyses of the individual including
cholesterol tests; and
‘‘(iii) 
information 
about 
physical
exams of the individual.
‘‘(9) GENETIC
TEST.—The term ‘genetic test’
means the analysis of human DNA, RNA, chro-
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mosomes, proteins, and certain metabolites, including
analysis of genotypes, mutations, phenotypes, or
karyotypes, for the purpose of predicting risk of dis-
ease in asymptomatic or undiagnosed individuals.
Such term does not include physical tests, such as the
chemical, blood, or urine analyses of the individual
including cholesterol tests, and physical exams of the
individual, in order to detect symptoms, clinical
signs, or a diagnosis of disease.’’.
(d) EFFECTIVE DATE.—Except as provided in this sec-
tion, this section and the amendments made by this section
shall apply with respect to group health plans for plan
years beginning 1 year after the date of the enactment of
this Act.
SEC. 2403. AMENDMENTS TO THE PUBLIC HEALTH SERVICE
ACT.
(a) AMENDMENTS RELATING TO THE GROUP MAR-
KET.—
(1) PROHIBITION
OF
HEALTH
DISCRIMINATION
ON
THE
BASIS
OF
GENETIC
INFORMATION
IN
THE
GROUP MARKET.—
(A) NO ENROLLMENT RESTRICTION FOR GE-
NETIC 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 before the
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period the following: ‘‘(including information
about a request for or receipt of genetic serv-
ices)’’.
(B) NO
DISCRIMINATION
IN
PREMIUMS
BASED ON PREDICTIVE GENETIC INFORMATION.—
Subpart 2 of part A of title XXVII of the Public
Health Service Act (42 U.S.C. 300gg–4 et seq.),
as amended by section 2301(d), is amended by
adding at the end the following new section:
‘‘SEC. 
2708. 
PROHIBITING 
PREMIUM 
DISCRIMINATION
AGAINST GROUPS ON THE BASIS OF PRE-
DICTIVE 
GENETIC 
INFORMATION 
IN 
THE
GROUP MARKET.
‘‘A group health plan, or a health insurance issuer of-
fering group health insurance coverage in connection with
a group health plan shall not adjust premium or contribu-
tion amounts for a group on the basis of predictive genetic
information concerning any individual (including a de-
pendent) or family member of the individual (including in-
formation about a request for or receipt of genetic serv-
ices).’’.
(C) 
CONFORMING
AMENDMENT.—Section
2702(b) of the Public Health Service Act (42
U.S.C. 300gg–1(b)) is amended by adding at the
end the following:
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‘‘(3) REFERENCE TO RELATED PROVISION.—For
a provision prohibiting the adjustment of premium or
contribution amounts for a group under a group
health plan on the basis of predictive genetic informa-
tion (including information about a request for or re-
ceipt of genetic services), see section 2708.’’.
(D) LIMITATION ON COLLECTION AND DIS-
CLOSURE
OF
PREDICTIVE
GENETIC
INFORMA-
TION.—Section 2702 of the Public Health Service
Act (42 U.S.C. 300gg–1) is amended by adding
at the end the following:
‘‘(c) COLLECTION OF PREDICTIVE GENETIC INFORMA-
TION.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING
PREDICTIVE GENETIC INFORMATION.—Except as pro-
vided in paragraph (2), a group health plan, or a
health insurance issuer offering health insurance cov-
erage in connection with a group health plan, shall
not request or require predictive genetic information
concerning any individual (including a dependent) or
a family member of the individual (including infor-
mation about a request for or receipt of genetic serv-
ices).
‘‘(2) INFORMATION
NEEDED
FOR
DIAGNOSIS,
TREATMENT, OR PAYMENT.—
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‘‘(A) IN GENERAL.—Notwithstanding para-
graph (1), a group health plan, or a health in-
surance issuer offering health insurance coverage
in connection with a group health plan, that
provides health care items and services to an in-
dividual or dependent may request (but may not
require) that such individual or dependent dis-
close, or authorize the collection or disclosure of,
predictive genetic information for purposes of di-
agnosis, treatment, or payment relating to the
provision of health care items and services to
such individual or dependent.
‘‘(B) NOTICE
OF
CONFIDENTIALITY
PRAC-
TICES AND DESCRIPTION OF SAFEGUARDS.—As a
part of a request under subparagraph (A), the
group health plan, or a health insurance issuer
offering health insurance coverage in connection
with a group health plan, shall provide to the in-
dividual or dependent a description of the proce-
dures in place to safeguard the confidentiality,
as described in subsection (d), of such predictive
genetic information.
‘‘(d) CONFIDENTIALITY
WITH
RESPECT
TO
PRE-
DICTIVE GENETIC INFORMATION.—
‘‘(1) NOTICE OF CONFIDENTIALITY PRACTICES.—
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‘‘(A) PREPARATION OF WRITTEN NOTICE.—
A group health plan, or a health insurance
issuer offering health insurance coverage in con-
nection with a group health plan, shall post or
provide, in writing and in a clear and con-
spicuous manner, notice of the plan or issuer’s
confidentiality practices, that shall include—
‘‘(i) a description of an individual’s
rights with respect to predictive genetic in-
formation;
‘‘(ii) the procedures established by the
plan or issuer for the exercise of the individ-
ual’s rights; and
‘‘(iii) the right to obtain a copy of the
notice of the confidentiality practices re-
quired under this subsection.
‘‘(B) MODEL
NOTICE.—The Secretary, in
consultation with the National Committee on
Vital and Health Statistics and the National As-
sociation of Insurance Commissioners, and after
notice and opportunity for public comment, shall
develop and disseminate model notices of con-
fidentiality practices. Use of the model notice
shall serve as a defense against claims of receiv-
ing inappropriate notice.
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‘‘(2) 
ESTABLISHMENT
OF
SAFEGUARDS.—A
group health plan, or a health insurance issuer offer-
ing health insurance coverage in connection with a
group health plan, shall establish and maintain ap-
propriate administrative, technical, and physical
safeguards to protect the confidentiality, security, ac-
curacy, and integrity of predictive genetic informa-
tion created, received, obtained, maintained, used,
transmitted, or disposed of by such plan or issuer.’’.
(2) DEFINITIONS.—Section 2791(d) of the Public
Health Service Act (42 U.S.C. 300gg–91(d)) is
amended by adding at the end the following:
‘‘(15) FAMILY MEMBER.—The term ‘family mem-
ber’ 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 described
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 (in-
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HR 4577 EAS
cluding information about a request for or receipt of
genetic services).
‘‘(17) GENETIC
SERVICES.—The term ‘genetic
services’ means health services provided to obtain, as-
sess, or interpret genetic information for diagnostic
and therapeutic purposes, and for genetic education
and counseling.
‘‘(18) PREDICTIVE GENETIC INFORMATION.—
‘‘(A) IN GENERAL.—The term ‘predictive ge-
netic information’ means, in the absence of
symptoms, clinical signs, or a diagnosis of the
condition related to such information—
‘‘(i) information about an individual’s
genetic tests;
‘‘(ii) information about genetic tests of
family members of the individual; or
‘‘(iii) information about the occurrence
of a disease or disorder in family members.
‘‘(B) EXCEPTIONS.—The term ‘predictive
genetic information’ shall not include—
‘‘(i) information about the sex or age of
the individual;
‘‘(ii) information derived from phys-
ical tests, such as the chemical, blood, or
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urine analyses of the individual including
cholesterol tests; and
‘‘(iii) 
information 
about 
physical
exams of the individual.
‘‘(19) GENETIC TEST.—The term ‘genetic test’
means the analysis of human DNA, RNA, chro-
mosomes, proteins, and certain metabolites, including
analysis of genotypes, mutations, phenotypes, or
karyotypes, for the purpose of predicting risk of dis-
ease in asymptomatic or undiagnosed individuals.
Such term does not include physical tests, such as the
chemical, blood, or urine analyses of the individual
including cholesterol tests, and physical exams of the
individual, in order to detect symptoms, clinical
signs, or a diagnosis of disease.’’.
(e) AMENDMENTS TO PHSA RELATING TO THE INDI-
VIDUAL 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.) (relating to other requirements) (42 U.S.C.
300gg–51 et seq.), as amended by section 2301(e), is further
amended by adding at the end the following:
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HR 4577 EAS
‘‘SEC. 2754. PROHIBITION OF HEALTH DISCRIMINATION ON
THE BASIS OF PREDICTIVE GENETIC INFOR-
MATION.
‘‘(a) PROHIBITION ON PREDICTIVE GENETIC INFORMA-
TION AS A CONDITION OF ELIGIBILITY.—A health insurance
issuer offering health insurance coverage in the individual
market may not use predictive genetic information as a
condition of eligibility of an individual to enroll in indi-
vidual health insurance coverage (including information
about a request for or receipt of genetic services).
‘‘(b) PROHIBITION ON PREDICTIVE GENETIC INFORMA-
TION IN SETTING PREMIUM RATES.—A health insurance
issuer offering health insurance coverage in the individual
market shall not adjust premium rates for individuals on
the basis of predictive genetic information concerning such
an individual (including a dependent) or a family member
of the individual (including information about a request
for or receipt of genetic services).
‘‘(c) COLLECTION OF PREDICTIVE GENETIC INFORMA-
TION.—
‘‘(1) LIMITATION ON REQUESTING OR REQUIRING
PREDICTIVE GENETIC INFORMATION.—Except as pro-
vided in paragraph (2), a health insurance issuer of-
fering health insurance coverage in the individual
market shall not request or require predictive genetic
information concerning any individual (including a
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dependent) or a family member of the individual (in-
cluding information about a request for or receipt of
genetic services).
‘‘(2) INFORMATION
NEEDED
FOR
DIAGNOSIS,
TREATMENT, OR PAYMENT.—
‘‘(A) IN GENERAL.—Notwithstanding para-
graph (1), a health insurance issuer offering
health insurance coverage in the individual mar-
ket that provides health care items and services
to an individual or dependent may request (but
may not require) that such individual or de-
pendent disclose, or authorize the collection or
disclosure of, predictive genetic information for
purposes of diagnosis, treatment, or payment re-
lating to the provision of health care items and
services to such individual or dependent.
‘‘(B) NOTICE
OF
CONFIDENTIALITY
PRAC-
TICES AND DESCRIPTION OF SAFEGUARDS.—As a
part of a request under subparagraph (A), the
health insurance issuer offering health insurance
coverage in the individual market shall provide
to the individual or dependent a description of
the procedures in place to safeguard the con-
fidentiality, as described in subsection (d), of
such predictive genetic information.
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‘‘(d) CONFIDENTIALITY
WITH
RESPECT
TO
PRE-
DICTIVE GENETIC INFORMATION.—
‘‘(1) NOTICE OF CONFIDENTIALITY PRACTICES.—
‘‘(A) PREPARATION OF WRITTEN NOTICE.—
A health insurance issuer offering health insur-
ance coverage in the individual market shall post
or provide, in writing and in a clear and con-
spicuous manner, notice of the issuer’s confiden-
tiality practices, that shall include—
‘‘(i) a description of an individual’s
rights with respect to predictive genetic in-
formation;
‘‘(ii) the procedures established by the
issuer for the exercise of the individual’s
rights; and
‘‘(iii) the right to obtain a copy of the
notice of the confidentiality practices re-
quired under this subsection.
‘‘(B) MODEL
NOTICE.—The Secretary, in
consultation with the National Committee on
Vital and Health Statistics and the National As-
sociation of Insurance Commissioners, and after
notice and opportunity for public comment, shall
develop and disseminate model notices of con-
fidentiality practices. Use of the model notice
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HR 4577 EAS
shall serve as a defense against claims of receiv-
ing inappropriate notice.
‘‘(2) 
ESTABLISHMENT
OF
SAFEGUARDS.—A
health insurance issuer offering health insurance cov-
erage in the individual market shall establish and
maintain appropriate administrative, technical, and
physical safeguards to protect the confidentiality, se-
curity, accuracy, and integrity of predictive genetic
information created, received, obtained, maintained,
used, transmitted, or disposed of by such issuer.’’.
(c) EFFECTIVE DATE.—The amendments made by this
section shall apply with respect to—
(1) group health plans, and health insurance
coverage offered in connection with group health
plans, for plan years beginning after 1 year after the
date of enactment of this Act; and
(2) health insurance coverage offered, sold,
issued, renewed, in effect, or operated in the indi-
vidual market after 1 year after the date of enactment
of this Act.
SEC. 2404. AMENDMENTS TO THE INTERNAL REVENUE
CODE OF 1986.
(a) PROHIBITION OF HEALTH DISCRIMINATION ON
THE BASIS OF GENETIC INFORMATION OR GENETIC SERV-
ICES.—