I
106TH CONGRESS
1ST SESSION
H. R. 2021
To amend title I of the Employee Retirement Income Security Act of 1974
and title XXVII of the Public Health Service Act to require group
health plans and health insurance issuers to provide coverage for human
leukocyte antigen testing.
IN THE HOUSE OF REPRESENTATIVES
JUNE 7, 1999
Mr. KENNEDY of Rhode Island (for himself and Mr. BROWN of California)
introduced the following bill; which was referred to the Committee on
Commerce, and in addition to the Committee on Education and the
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned
A BILL
To amend title I of the Employee Retirement Income Secu-
rity Act of 1974 and title XXVII of the Public Health
Service Act to require group health plans and health
insurance issuers to provide coverage for human leu-
kocyte antigen testing.
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 ‘‘Bone Marrow Blood
Testing Coverage Act of 1999’’.
SEC. 2. COVERAGE OF HUMAN ANTIGEN TESTING.
(a) AMENDMENTS TO THE EMPLOYEE RETIREMENT
INCOME SECURITY ACT OF 1974.—
(1) IN GENERAL.—Subpart B of part 7 of sub-
title 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. COVERAGE OF HUMAN ANTIGEN TESTING.
‘‘(a) REQUIREMENT.—A group health plan, and a
health insurance issuer offering group health insurance
coverage, may not deny coverage and payment for human
antigen testing if—
‘‘(1) the testing is provided by an entity that is
licensed under the Clinical Laboratory Improvement
Act of 1967 (42 U.S.C. 263a) and accredited by the
American Association of Blood Banks; and
‘‘(2) the participant or beneficiary undergoing
such testing signs an informed consent which allows
the results of the test to be used for participation in
the National Marrow Donor Registry established
under section 274k of title 42, United States Code.
‘‘(b) DEFINITION.—For purposes of this section, the
term ‘‘human antigen testing’’ means human leukocyte
antigen testing for A,B, and DR antigens for utilization
in bone marrow transplantation.’’.
(2) 
CONFORMING
AMENDMENT.—Section
732(a) of such Act (29 U.S.C. 1191a(a)) is amended
by striking ‘‘section 711’’ and inserting ‘‘sections
711 and 714’’.
(3) CLERICAL 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. Coverage of human antigen testing.’’.
(b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE
ACT.—
(1) GROUP HEALTH INSURANCE COVERAGE.—
Subpart 2 of part A of title XXVII of the Public
Health Service Act is amended by adding at the end
the following new section:
‘‘SEC. 2707. COVERAGE OF HUMAN ANTIGEN TESTING.
‘‘(a) REQUIREMENT.—A group health plan, and a
health insurance issuer offering group health insurance
coverage, may not deny coverage and payment for human
antigen testing if—
‘‘(1) the testing is provided by an entity that is
licensed under the Clinical Laboratory Improvement
Act of 1967 (42 U.S.C. 263a) and accredited by the
American Association of Blood Banks; and
‘‘(2) the participant or beneficiary undergoing
such testing signs an informed consent which allows
the results of the test to be used for participation in
the National Marrow Donor Program.
‘‘(b) DEFINITION.—For purposes of this section, the
term ‘‘human antigen testing’’ means human leukocyte
antigen testing for A,B, and DR antigens for utilization
in bone marrow transplantation.’’.
(2) INDIVIDUAL
HEALTH
INSURANCE
COV-
ERAGE.—Part B of title XXVII of such Act is
amended by inserting after section 2752 the fol-
lowing new section:
‘‘SEC. 2753. COVERAGE OF HUMAN ANTIGEN TESTING.
‘‘The provisions of section 2707 shall apply to health
insurance coverage offered by a health insurance issuer
in the individual market in the same manner as they apply
to health insurance coverage offered by a health insurance
issuer in connection with a group health plan in the small
or large group market.’’.
(c) EFFECTIVE DATES AND RELATED RULES.—
(1) 
GROUP
HEALTH
PLANS
AND
GROUP
HEALTH INSURANCE COVERAGE.—
(A) IN
GENERAL.—Subject to subpara-
graph (B), the amendments made by sub-
sections (a) and (b)(1) apply with respect to
group health plans for plan years beginning on
or after the first day of the first month that be-
gins more than 1 year after the date of the en-
actment of this Act.
(B) 
COLLECTIVE
BARGAINING
EXCEP-
TION.—In the case of a group health plan
maintained pursuant to 1 or more collective
bargaining agreements between employee rep-
resentatives and 1 or more employers ratified
before the date of enactment of this Act, the
amendments made subsections (a) and (b)(1)
shall not apply to plan years beginning before
the later of—
(i) the date on which the last collec-
tive bargaining agreements relating to the
plan terminates (determined without re-
gard to any extension thereof agreed to
after the date of enactment of this Act), or
(ii) the first day described in subpara-
graph (A).
For purposes of clause (i), any plan amendment
made pursuant to a collective bargaining agree-
ment relating to the plan which amends the
plan solely to conform to any requirement
added by subsection (a) or (b)(1) shall not be
treated as a termination of such collective bar-
gaining agreement.
(2) INDIVIDUAL
HEALTH
INSURANCE
COV-
ERAGE.—The amendment made by subsection (b)(2)
applies with respect to health insurance coverage of-
fered, sold, issued, renewed, in effect, or operated in
the individual market on or after the first day of the
first month that begins more than 1 year after the
date of the enactment of this Act.
(3) LIMITATION ON ENFORCEMENT ACTIONS.—
No enforcement action shall be taken, pursuant to
the amendments made by this section, against a
group health plan or health insurance issuer with re-
spect to a violation of a requirement imposed by
such amendments, and no penalty shall be imposed
on any failure by such plan to comply with any re-
quirement imposed by such amendments, to the ex-
tent that violation or failure occurs before the date
of issuance of final regulations issued in connection
with such requirement, if the plan or issuer has
sought to comply in good faith with such require-
ment.
SEC. 3. COORDINATION OF ADMINISTRATION.
The Secretary of Labor and the Secretary of Health
and Human Services shall ensure, through the execution
of an interagency memorandum of understanding among
such Secretaries, that—
(1) regulations, rulings, and interpretations
issued by such Secretaries relating to the same mat-
ter over which both such Secretaries have responsi-
bility under the provisions of this Act (and the
amendments made thereby) are administered so as
to have the same effect at all times; and
(2) coordination of policies relating to enforcing
the same requirements through such Secretaries in
order to have a coordinated enforcement strategy
that avoids duplication of enforcement efforts and
assigns priorities in enforcement.
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