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42 U.S.C. § 300ff–131 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–131. Infectious diseases and circumstances relevant to notification requirements
(a) In general
Not later than 180 days after October 30, 2009, the Secretary shall complete the development of—
(1) a list of potentially life-threatening infectious diseases, including emerging infectious diseases, to which emergency response employees may be exposed in responding to emergencies;
(2) guidelines describing the circumstances in which such employees may be exposed to such diseases, taking into account the conditions under which emergency response is provided; and
(3) guidelines describing the manner in which medical facilities should make determinations for purposes of section 300ff–133(d) of this title.
(b) Specification of airborne infectious diseases
The list developed by the Secretary under subsection (a)(1) shall include a specification of those infectious diseases on the list that are routinely transmitted through airborne or aerosolized means.
(c) Dissemination
The Secretary shall—
(1) transmit to State public health officers copies of the list and guidelines developed by the Secretary under subsection (a) with the request that the officers disseminate such copies as appropriate throughout the States; and
(2) make such copies available to the public.
(July 1, 1944, ch. 373, title XXVI, § 2695, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2897.)
heading: Effective Date
text: Part effective as if enacted on Sept. 30, 2009, see section 2(a)(3)(B) of Pub. L. 111–87, set out as an Effective Date of 2009 Amendment; Revival of Section note under section 300ff–11 of this title.
42 U.S.C. § 300ff–132 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–132. Routine notifications with respect to airborne infectious diseases in victims assisted
(a) Routine notification of designated officer
(1) Determination by treating facility
If a victim of an emergency is transported by emergency response employees to a medical facility and the medical facility makes a determination that the victim has an airborne infectious disease, the medical facility shall notify the designated officer of the emergency response employees who transported the victim to the medical facility of the determination.
(2) Determination by facility ascertaining cause of death
If a victim of an emergency is transported by emergency response employees to a medical facility and the victim dies at or before reaching the medical facility, the medical facility ascertaining the cause of death shall notify the designated officer of the emergency response employees who transported the victim to the initial medical facility of any determination by the medical facility that the victim had an airborne infectious disease.
(b) Requirement of prompt notification
With respect to a determination described in paragraph (1) or (2) of subsection (a), the notification required in each of such paragraphs shall be made as soon as is practicable, but not later than 48 hours after the determination is made.
(July 1, 1944, ch. 373, title XXVI, § 2695A, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2898.)
42 U.S.C. § 300ff–134 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–134. Procedures for notification of exposure
(a) Contents of notification to officer
In making a notification required under section 300ff–132 of this title or section 300ff–133(d)(2) of this title, a medical facility shall provide—
(1) the name of the infectious disease involved; and
(2) the date on which the victim of the emergency involved was transported by emergency response employees to the medical facility involved.
(b) Manner of notification
If a notification under section 300ff–132 of this title or section 300ff–133(d)(2) of this title is mailed or otherwise indirectly made—
(1) the medical facility sending the notification shall, upon sending the notification, inform the designated officer to whom the notification is sent of the fact that the notification has been sent; and
(2) such designated officer shall, not later than 10 days after being informed by the medical facility that the notification has been sent, inform such medical facility whether the designated officer has received the notification.
(July 1, 1944, ch. 373, title XXVI, § 2695C, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2901.)
42 U.S.C. § 300ff–135 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–135. Notification of employee
(a) In general
After receiving a notification for purposes of section 300ff–132 or 300ff–133(d)(2) of this title, a designated officer of emergency response employees shall, to the extent practicable, immediately notify each of such employees who—
(1) responded to the emergency involved; and
(2) as indicated by guidelines developed by the Secretary, may have been exposed to an infectious disease.
(b) Certain contents of notification to employee
A notification under this subsection to an emergency response employee shall inform the employee of—
(1) the fact that the employee may have been exposed to an infectious disease and the name of the disease involved;
(2) any action by the employee that, as indicated by guidelines developed by the Secretary, is medically appropriate; and
(3) if medically appropriate under such criteria, the date of such emergency.
(c) Responses other than notification of exposure
After receiving a response under paragraph (3) or (4) of subsection (d) of section 300ff–133 of this title, or a response under subsection (g)(1) of such section, the designated officer for the employee shall, to the extent practicable, immediately inform the employee of the response.
(July 1, 1944, ch. 373, title XXVI, § 2695D, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2901.)
42 U.S.C. § 300ff–136 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–136. Selection of designated officers
(a) In general
For the purposes of receiving notifications and responses and making requests under this part on behalf of emergency response employees, the public health officer of each State shall designate 1 official or officer of each employer of emergency response employees in the State.
(b) Preference in making designations
In making the designations required in subsection (a), a public health officer shall give preference to individuals who are trained in the provision of health care or in the control of infectious diseases.
(July 1, 1944, ch. 373, title XXVI, § 2695E, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2901.)
42 U.S.C. § 300ff–137 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–137. Limitation with respect to duties of medical facilities
The duties established in this part for a medical facility—
(1) shall apply only to medical information possessed by the facility during the period in which the facility is treating the victim for conditions arising from the emergency, or during the 60-day period beginning on the date on which the victim is transported by emergency response employees to the facility, whichever period expires first; and
(2) shall not apply to any extent after the expiration of the 30-day period beginning on the expiration of the applicable period referred to in paragraph (1), except that such duties shall apply with respect to any request under section 300ff–133(c) of this title received by a medical facility before the expiration of such 30-day period.
(July 1, 1944, ch. 373, title XXVI, § 2695F, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2901.)
42 U.S.C. § 300ff–138 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–138. Miscellaneous provisions
(a) Liability of medical facilities, designated officers, public health officers, and governing entities
This part may not be construed to authorize any cause of action for damages or any civil penalty against any medical facility, any designated officer, any other public health officer, or any governing entity of such facility or officer for failure to comply with the duties established in this part.
(b) Testing
This part may not, with respect to victims of emergencies, be construed to authorize or require a medical facility to test any such victim for any infectious disease.
(c) Confidentiality
This part may not be construed to authorize or require any medical facility, any designated officer of emergency response employees, or any such employee, to disclose identifying information with respect to a victim of an emergency or with respect to an emergency response employee.
(d) Failure to provide emergency services
This part may not be construed to authorize any emergency response employee to fail to respond, or to deny services, to any victim of an emergency.
(e) Notification and reporting deadlines
In any case in which the Secretary determines that, wholly or partially as a result of a public health emergency that has been determined pursuant to section 247d(a) of this title, individuals or public or private entities are unable to comply with the requirements of this part, the Secretary may, notwithstanding any other provision of law, temporarily suspend, in whole or in part, the requirements of this part as the circumstances reasonably require. Before or promptly after such a suspension, the Secretary shall notify the Congress of such action and publish in the Federal Register a notice of the suspension.
(f) Continued application of State and local law
Nothing in this part shall be construed to limit the application of State or local laws that require the provision of data to public health authorities.
(July 1, 1944, ch. 373, title XXVI, § 2695G, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2902.)
42 U.S.C. § 300ff–139 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–139. Injunctions regarding violation of prohibition
(a) In general
The Secretary may, in any court of competent jurisdiction, commence a civil action for the purpose of obtaining temporary or permanent injunctive relief with respect to any violation of this part.
(b) Facilitation of information on violations
The Secretary shall establish an administrative process for encouraging emergency response employees to provide information to the Secretary regarding violations of this part. As appropriate, the Secretary shall investigate alleged such 1 violations and seek appropriate injunctive relief.
(July 1, 1944, ch. 373, title XXVI, § 2695H, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2902.)
42 U.S.C. § 300ff–140 (THE PUBLIC HEALTH AND WELFARE)
§ 300ff–140. Applicability of part
This part shall not apply in a State if the chief executive officer of the State certifies to the Secretary that the law of the State is substantially consistent with this part.
(July 1, 1944, ch. 373, title XXVI, § 2695I, as added Pub. L. 111–87, § 13, Oct. 30, 2009, 123 Stat. 2903.)
42 U.S.C. § 300gg–5 (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–5. Non-discrimination in health care
(a) Providers
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.
(b) Individuals
The provisions of section 218c 1 of title 29 (relating to non-discrimination) shall apply with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage.
(July 1, 1944, ch. 373, title XXVII, § 2706, as added Pub. L. 111–148, title I, § 1201(4), Mar. 23, 2010, 124 Stat. 160.)
heading: Enactment of Section
text: For delayed effective date of section, see Effective Date note below.
heading: References in Text
text: Section 218c of title 29, referred to in subsec. (b), was in the original “section 1558 of the Patient Protection and Affordable Care Act”, meaning section 1558 of Pub. L. 111–148, and was translated as meaning section 18C of act June 25, 1938, ch. 676, which was added by section 1558 of Pub. L. 111–148, to reflect the probable intent of Congress.
heading: Prior Provisions
text: A prior section 300gg–5, act July 1, 1944, ch. 373, title XXVII, § 2705, as added Pub. L. 104–204, title VII, § 703(a), Sept. 26, 1996, 110 Stat. 2947, and amended, which related to parity in mental health and substance use disorder benefits, was renumbered section 2726 of act July 1, 1944, and transferred to section 300gg–26 of this title.
A prior section 2706 of act July 1, 1944, was renumbered section 2727 and is classified to section 300gg–27 of this title.
Another prior section 2706 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see section 238e of this title.
heading: Effective Date
text: Section effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111–148, set out as a note under section 300gg of this title.
42 U.S.C. § 300gg–6 (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–6. Comprehensive health insurance coverage
(a) Coverage for essential health benefits package
A health insurance issuer that offers health insurance coverage in the individual or small group market shall ensure that such coverage includes the essential health benefits package required under section 18022(a) of this title.
(b) Cost-sharing under group health plans
A group health plan shall ensure that any annual cost-sharing imposed under the plan does not exceed the limitations provided for under paragraphs (1) and (2) of section 18022(c) 1 of this title.
(c) Child-only plans
If a health insurance issuer offers health insurance coverage in any level of coverage specified under section 18022(d) of this title, the issuer shall also offer such coverage in that level as a plan in which the only enrollees are individuals who, as of the beginning of a plan year, have not attained the age of 21.
(d) Dental only
This section shall not apply to a plan described in section 18031(d)(2)(B)(ii) 1 of this title.
(July 1, 1944, ch. 373, title XXVII, § 2707, as added Pub. L. 111–148, title I, § 1201(4), Mar. 23, 2010, 124 Stat. 161.)
heading: Enactment of Section
text: For delayed effective date of section, see Effective Date note below.
heading: References in Text
text: Section 18022(c) of this title, referred to in subsec. (b), was in the original “section 1302(c)”, and was translated as meaning section 1302(c) of Pub. L. 111–148, pars. (1) and (2) of which relate to annual limitations on cost-sharing and deductibles, to reflect the probable intent of Congress.
Section 18031(d)(2)(B)(ii) of this title, referred to in subsec. (d), was in the original “section 1302(d)(2)(B)(ii)(I)”, and was translated as meaning section 1311(d)(2)(B)(ii) of Pub. L. 111–148, which relates to offering of stand-alone dental benefits, to reflect the probable intent of Congress.
heading: Prior Provisions
text: A prior section 300gg–6, act July 1, 1944, ch. 373, title XXVII, § 2706, as added Pub. L. 105–277, div. A, § 101(f) [title IX, § 903(a)], Oct. 21, 1998, 112 Stat. 2681–337, 2681–438, which related to required coverage for reconstructive surgery following mastectomies, was renumbered section 2727 of act July 1, 1944, and transferred to section 300gg–27 of this title.
A prior section 2707 of act July 1, 1944, was renumbered section 2728 and is classified to section 300gg–28 of this title.
Another prior section 2707 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see section 238f of this title.
heading: Effective Date
text: Section effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111–148, set out as a note under section 300gg of this title.
42 U.S.C. § 300gg–7 (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–7. Prohibition on excessive waiting periods
A group health plan and a health insurance issuer offering group health insurance coverage shall not apply any waiting period (as defined in section 300gg–3(b)(4) of this title) that exceeds 90 days.
(July 1, 1944, ch. 373, title XXVII, § 2708, as added and amended Pub. L. 111–148, title I, § 1201(4), title X, § 10103(b), Mar. 23, 2010, 124 Stat. 161, 892.)
heading: Enactment of Section
text: For delayed effective date of section, see Effective Date note below.
heading: Prior Provisions
text: A prior section 300gg–7, act July 1, 1944, ch. 373, title XXVII, § 2707, as added Pub. L. 110–381, § 2(b)(1), Oct. 9, 2008, 122 Stat. 4083, which related to coverage of dependent students on medically necessary leave of absence, was renumbered section 2728 of act July 1, 1944, and transferred to section 300gg–28 of this title.
A prior section 2708 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see section 238g of this title.
heading: Amendments
text: 2010—Pub. L. 111–148, § 10103(b), struck out “or individual” after “offering group”.
heading: Effective Date
text: Section effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111–148, set out as a note under section 300gg of this title.
42 U.S.C. § 300gg–14 (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–14. Extension of dependent coverage
(a) In general
A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child until the child turns 26 years of age. Nothing in this section shall require a health plan or a health insurance issuer described in the preceding sentence to make coverage available for a child of a child receiving dependent coverage.
(b) Regulations
The Secretary shall promulgate regulations to define the dependents to which coverage shall be made available under subsection (a).
(c) Rule of construction
Nothing in this section shall be construed to modify the definition of “dependent” as used in title 26 with respect to the tax treatment of the cost of coverage.
(July 1, 1944, ch. 373, title XXVII, § 2714, as added Pub. L. 111–148, title I, § 1001(5), Mar. 23, 2010, 124 Stat. 132; amended Pub. L. 111–152, title II, § 2301(b), Mar. 30, 2010, 124 Stat. 1082.)
heading: Prior Provisions
text: A prior section 2714 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see section 238m of this title.
heading: Amendments
text: 2010—Subsec. (a). Pub. L. 111–152 struck out “(who is not married)” after “adult child”.
heading: Effective Date
text: Section effective for plan years beginning on or after the date that is 6 months after Mar. 23, 2010, see section 1004 of Pub. L. 111–148, set out as a note under section 300gg–11 of this title.
42 U.S.C. § 300gg–15a (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–15a. Provision of additional information
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall comply with the provisions of section 18031(e)(3) of this title, except that a plan or coverage that is not offered through an Exchange shall only be required to submit the information required to the Secretary and the State insurance commissioner, and make such information available to the public.
(July 1, 1944, ch. 373, title XXVII, § 2715A, as added Pub. L. 111–148, title X, § 10101(c), Mar. 23, 2010, 124 Stat. 884.)
42 U.S.C. § 300gg–16 (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–16. Prohibition on discrimination in favor of highly compensated individuals
(a) In general
A group health plan (other than a self-insured plan) shall satisfy the requirements of section 105(h)(2) of title 26 (relating to prohibition on discrimination in favor of highly compensated individuals).
(b) Rules and definitions
For purposes of this section—
(1) Certain rules to apply
Rules similar to the rules contained in paragraphs (3), (4), and (8) of section 105(h) of title 26 shall apply.
(2) Highly compensated individual
The term “highly compensated individual” has the meaning given such term by section 105(h)(5) of title 26.
(July 1, 1944, ch. 373, title XXVII, § 2716, as added and amended Pub. L. 111–148, title I, § 1001(5), title X, § 10101(d), Mar. 23, 2010, 124 Stat. 135, 884.)
heading: Amendments
text: 2010—Pub. L. 111–148, § 10101(d), amended section generally. Prior to amendment, text read as follows:
“(a) In General.—The plan sponsor of a group health plan (other than a self-insured plan) may not establish rules relating to the health insurance coverage eligibility (including continued eligibility) of any full-time employee under the terms of the plan that are based on the total hourly or annual salary of the employee or otherwise establish eligibility rules that have the effect of discriminating in favor of higher wage employees.
“(b) Limitation.—Subsection (a) shall not be construed to prohibit a plan sponsor from establishing contribution requirements for enrollment in the plan or coverage that provide for the payment by employees with lower hourly or annual compensation of a lower dollar or percentage contribution than the payment required of similarly situated employees with a higher hourly or annual compensation.”
heading: Effective Date
text: Section effective for plan years beginning on or after the date that is 6 months after Mar. 23, 2010, see section 1004 of Pub. L. 111–148, set out as a note under section 300gg–11 of this title.
42 U.S.C. § 300gg–27 (THE PUBLIC HEALTH AND WELFARE)
§ 300gg–27. Required coverage for reconstructive surgery following mastectomies
The provisions of section 1185b of title 29 shall apply to group health plans, and and 1 health insurance issuers offering group or individual health insurance coverage, as if included in this subpart.
(July 1, 1944, ch. 373, title XXVII, § 2727, formerly § 2706, as added Pub. L. 105–277, div. A, § 101(f) [title IX, § 903(a)], Oct. 21, 1998, 112 Stat. 2681–337, 2681–438; renumbered § 2727 and amended Pub. L. 111–148, title I, §§ 1001(2), 1563(c)(5), formerly § 1562(c)(5), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 266, 911.)
heading: Codification
text: Section was formerly classified to section 300gg–6 of this title prior to renumbering by Pub. L. 111–148.
heading: Amendments
text: 2010—Pub. L. 111–148, § 1563(c)(5), formerly § 1562(c)(5), as renumbered by Pub. L. 111–148, § 10107(b)(1), substituted “and health insurance issuers offering group or individual health insurance coverage” for “health insurance issuers providing health insurance coverage in connection with group health plans”.
heading: Effective Date
text: Pub. L. 105–277, div. A, § 101(f) [title IX, § 903(c)(1)], Oct. 21, 1998, 112 Stat. 2681–337, 2681–438, provided that:
“(A) In general.—
The amendment made by subsection (a) [enacting this section] shall apply to group health plans for plan years beginning on or after the date of enactment of this Act [Oct. 21, 1998].
“(B) Special rule for collective bargaining agreements.—
In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers, any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement added by the amendment made by subsection (a) shall not be treated as a termination of such collective bargaining agreement.”