Genetic Information Nondiscrimination Act of 2008
PL 110-233 (H.R.493), enacted 05/21/2008

122 STAT. 881 
PUBLIC LAW 110–233—MAY 21, 2008 
Public Law 110–233 
110th Congress 
An Act 
To prohibit discrimination on the basis of genetic information with respect to health 
insurance and employment. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘Genetic 
Information Nondiscrimination Act of 2008’’. 
(b) TABLE OF CONTENTS.—The table of contents of this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
TITLE I—GENETIC NONDISCRIMINATION IN HEALTH INSURANCE 
Sec. 101. Amendments to Employee Retirement Income Security Act of 1974. 
Sec. 102. Amendments to the Public Health Service Act. 
Sec. 103. Amendments to the Internal Revenue Code of 1986. 
Sec. 104. Amendments to title XVIII of the Social Security Act relating to medigap. 
Sec. 105. Privacy and confidentiality. 
Sec. 106. Assuring coordination. 
TITLE II—PROHIBITING EMPLOYMENT DISCRIMINATION ON THE BASIS OF 
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. Confidentiality of genetic information. 
Sec. 207. Remedies and enforcement. 
Sec. 208. Disparate impact. 
Sec. 209. Construction. 
Sec. 210. Medical information that is not genetic information. 
Sec. 211. Regulations. 
Sec. 212. Authorization of appropriations. 
Sec. 213. Effective date. 
TITLE III—MISCELLANEOUS PROVISIONS 
Sec. 301. Severability. 
Sec. 302. Child labor protections. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Deciphering the sequence of the human genome and 
other advances in genetics open major new opportunities for 
medical progress. New knowledge about the genetic basis of 
illness will allow for earlier detection of illnesses, often before 
symptoms have begun. Genetic testing can allow individuals 
to take steps to reduce the likelihood that they will contract 
42 USC 2000ff 
note. 
Genetic 
Information 
Non- 
discrimination 
Act of 2008. 
42 USC 2000ff 
note. 
May 21, 2008 
[H.R. 493] 
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122 STAT. 882 
PUBLIC LAW 110–233—MAY 21, 2008 
a particular disorder. New knowledge about genetics may allow 
for the development of better therapies that are more effective 
against disease or have fewer side effects than current treat-
ments. These advances give rise to the potential misuse of 
genetic information to discriminate in health insurance and 
employment. 
(2) The early science of genetics became the basis of State 
laws that provided for the sterilization of persons having pre-
sumed genetic ‘‘defects’’ such as mental retardation, mental 
disease, epilepsy, blindness, and hearing loss, among other 
conditions. The first sterilization law was enacted in the State 
of Indiana in 1907. By 1981, a majority of States adopted 
sterilization laws to ‘‘correct’’ apparent genetic traits or ten-
dencies. Many of these State laws have since been repealed, 
and many have been modified to include essential constitutional 
requirements of due process and equal protection. However, 
the current explosion in the science of genetics, and the history 
of sterilization laws by the States based on early genetic science, 
compels Congressional action in this area. 
(3) Although genes are facially neutral markers, many 
genetic conditions and disorders are associated with particular 
racial and ethnic groups and gender. Because some genetic 
traits are most prevalent in particular groups, members of 
a particular group may be stigmatized or discriminated against 
as a result of that genetic information. This form of discrimina-
tion was evident in the 1970s, which saw the advent of pro-
grams to screen and identify carriers of sickle cell anemia, 
a disease which afflicts African-Americans. Once again, State 
legislatures began to enact discriminatory laws in the area, 
and in the early 1970s began mandating genetic screening 
of all African Americans for sickle cell anemia, leading to 
discrimination and unnecessary fear. To alleviate some of this 
stigma, Congress in 1972 passed the National Sickle Cell 
Anemia Control Act, which withholds Federal funding from 
States unless sickle cell testing is voluntary. 
(4) Congress has been informed of examples of genetic 
discrimination in the workplace. These include the use of pre- 
employment genetic screening at Lawrence Berkeley Labora-
tory, which led to a court decision in favor of the employees 
in that case Norman-Bloodsaw v. Lawrence Berkeley Labora-
tory (135 F.3d 1260, 1269 (9th Cir. 1998)). Congress clearly 
has a compelling public interest in relieving the fear of discrimi-
nation and in prohibiting its actual practice in employment 
and health insurance. 
(5) Federal law addressing genetic discrimination in health 
insurance and employment is incomplete in both the scope 
and depth of its protections. Moreover, while many States have 
enacted some type of genetic non-discrimination law, these 
laws vary widely with respect to their approach, application, 
and level of protection. Congress has collected substantial evi-
dence that the American public and the medical community 
find the existing patchwork of State and Federal laws to be 
confusing and inadequate to protect them from discrimination. 
Therefore Federal legislation establishing a national and uni-
form basic standard is necessary to fully protect the public 
from discrimination and allay their concerns about the potential 
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122 STAT. 883 
PUBLIC LAW 110–233—MAY 21, 2008 
for discrimination, thereby allowing individuals to take advan-
tage of genetic testing, technologies, research, and new thera-
pies. 
TITLE 
I—GENETIC 
NONDISCRIMINA-
TION IN HEALTH INSURANCE 
SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECU-
RITY ACT OF 1974. 
(a) NO DISCRIMINATION IN GROUP PREMIUMS BASED ON GENETIC 
INFORMATION.—Section 702(b) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1182(b)) is amended— 
(1) in paragraph (2)(A), by inserting before the semicolon 
the following: ‘‘except as provided in paragraph (3)’’; and 
(2) by adding at the end the following: 
‘‘(3) NO GROUP-BASED DISCRIMINATION ON BASIS OF GENETIC 
INFORMATION.— 
‘‘(A) IN GENERAL.—For purposes of this section, a group 
health plan, and a health insurance issuer offering group 
health insurance coverage in connection with a group 
health plan, may not adjust premium or contribution 
amounts for the group covered under such plan on the 
basis of genetic information. 
‘‘(B) RULE
OF
CONSTRUCTION.—Nothing in subpara-
graph (A) or in paragraphs (1) and (2) of subsection (d) 
shall be construed to limit the ability of a health insurance 
issuer offering health insurance coverage in connection with 
a group health plan to increase the premium for an 
employer based on the manifestation of a disease or dis-
order of an individual who is enrolled in the plan. In 
such case, the manifestation of a disease or disorder in 
one individual cannot also be used as genetic information 
about other group members and to further increase the 
premium for the employer.’’. 
(b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLEC-
TION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.—Sec-
tion 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
REQUIRING
GENETIC 
TESTING.—A group health plan, and 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.—Paragraph (1) shall not be 
construed to limit the authority of a health care professional 
who is providing health care services to an individual to request 
that such individual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— 
‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be 
construed to preclude a group health plan, or a health 
insurance issuer offering health insurance coverage in 
connection with a group health plan, from obtaining and 
using the results of a genetic test in making a determina-
tion regarding payment (as such term is defined for the 
purposes of applying the regulations promulgated by the 
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122 STAT. 884 
PUBLIC LAW 110–233—MAY 21, 2008 
Secretary of Health and Human Services under part C 
of title XI of the Social Security Act and section 264 of 
the Health Insurance Portability and Accountability Act 
of 1996, as may be revised from time to time) consistent 
with subsection (a). 
‘‘(B) LIMITATION.—For purposes of subparagraph (A), 
a group health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group 
health plan, may request only the minimum amount of 
information necessary to accomplish the intended purpose. 
‘‘(4) RESEARCH
EXCEPTION.—Notwithstanding paragraph 
(1), a group health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group health 
plan, may request, but not require, that a participant or bene-
ficiary undergo a genetic test if each of the following conditions 
is met: 
‘‘(A) The request is made, in writing, pursuant to 
research that complies with part 46 of title 45, Code of 
Federal Regulations, or equivalent Federal regulations, and 
any applicable State or local law or regulations for the 
protection of human subjects in research. 
‘‘(B) The plan or issuer clearly indicates to each partici-
pant or beneficiary, or in the case of a minor child, to 
the legal guardian of such beneficiary, to whom the request 
is made that— 
‘‘(i) compliance with the request is voluntary; and 
‘‘(ii) non-compliance will have no effect on enroll-
ment status or premium or contribution amounts. 
‘‘(C) No genetic information collected or acquired under 
this paragraph shall be used for underwriting purposes. 
‘‘(D) The plan or issuer notifies the Secretary in writing 
that the plan or issuer is conducting activities pursuant 
to the exception provided for under this paragraph, 
including a description of the activities conducted. 
‘‘(E) The plan or issuer complies with such other condi-
tions as the Secretary may by regulation require for activi-
ties conducted under this paragraph. 
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— 
‘‘(1) IN GENERAL.—A group health plan, and a health insur-
ance issuer offering health insurance coverage in connection 
with a group health plan, shall not request, require, or purchase 
genetic information for underwriting purposes (as defined in 
section 733). 
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION 
PRIOR TO ENROLLMENT.—A group health plan, and a health 
insurance issuer offering health insurance coverage in connec-
tion with a group health plan, shall not request, require, or 
purchase genetic information with respect to any individual 
prior to such individual’s enrollment under the plan or coverage 
in connection with such enrollment. 
‘‘(3) INCIDENTAL COLLECTION.—If a group health plan, or 
a health insurance issuer offering health insurance coverage 
in connection with a group health plan, obtains genetic informa-
tion incidental to the requesting, requiring, or purchasing of 
other information concerning any individual, such request, 
requirement, or purchase shall not be considered a violation 
Notification. 
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122 STAT. 885 
PUBLIC LAW 110–233—MAY 21, 2008 
of paragraph (2) if such request, requirement, or purchase 
is not in violation of paragraph (1). 
‘‘(e) APPLICATION TO ALL PLANS.—The provisions of subsections 
(a)(1)(F), (b)(3), (c), and (d), and subsection (b)(1) and section 701 
with respect to genetic information, shall apply to group health 
plans and health insurance issuers without regard to section 
732(a).’’. 
(c) APPLICATION
TO GENETIC INFORMATION
OF
A FETUS
OR 
EMBRYO.—Such section is further amended by adding at the end 
the following: 
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any ref-
erence in this part to genetic information concerning an individual 
or family member of an individual shall— 
‘‘(1) with respect to such an individual or family member 
of an individual who is a pregnant woman, include genetic 
information of any fetus carried by such pregnant woman; 
and 
‘‘(2) with respect to an individual or family member uti-
lizing an assisted reproductive technology, include genetic 
information of any embryo legally held by the individual or 
family member.’’. 
(d) 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) a dependent (as such term is used for purposes 
of section 701(f)(2)) of such individual, and 
‘‘(B) any other individual who is a first-degree, second- 
degree, third-degree, or fourth-degree relative of such indi-
vidual or of an individual described in subparagraph (A). 
‘‘(6) GENETIC INFORMATION.— 
‘‘(A) IN
GENERAL.—The term ‘genetic information’ 
means, with respect to any individual, information about— 
‘‘(i) such individual’s genetic tests, 
‘‘(ii) the genetic tests of family members of such 
individual, and 
‘‘(iii) the manifestation of a disease or disorder 
in family members of such individual. 
‘‘(B) INCLUSION OF GENETIC SERVICES AND PARTICIPA-
TION
IN
GENETIC
RESEARCH.—Such term includes, with 
respect to any individual, any request for, or receipt of, 
genetic services, or participation in clinical research which 
includes genetic services, by such individual or any family 
member of such individual. 
‘‘(C) EXCLUSIONS.—The term ‘genetic information’ shall 
not include information about the sex or age of any indi-
vidual. 
‘‘(7) GENETIC TEST.— 
‘‘(A) IN GENERAL.—The term ‘genetic test’ means an 
analysis of human DNA, RNA, chromosomes, proteins, or 
metabolites, that detects genotypes, mutations, or chromo-
somal changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic test’ does not 
mean— 
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122 STAT. 886 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(i) an analysis of proteins or metabolites that 
does not detect genotypes, mutations, or chromosomal 
changes; or 
‘‘(ii) an analysis of proteins or metabolites that 
is directly related to a manifested disease, disorder, 
or pathological condition that could reasonably be 
detected by a health care professional with appropriate 
training and expertise in the field of medicine involved. 
‘‘(8) GENETIC
SERVICES.—The term ‘genetic services’ 
means— 
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (including obtaining, inter-
preting, or assessing genetic information); or 
‘‘(C) genetic education. 
‘‘(9) UNDERWRITING
PURPOSES.—The term ‘underwriting 
purposes’ means, with respect to any group health plan, or 
health insurance coverage offered in connection with a group 
health plan— 
‘‘(A) rules for, or determination of, eligibility (including 
enrollment and continued eligibility) for benefits under the 
plan or coverage; 
‘‘(B) the computation of premium or contribution 
amounts under the plan or coverage; 
‘‘(C) the application of any pre-existing condition exclu-
sion under the plan or coverage; and 
‘‘(D) other activities related to the creation, renewal, 
or replacement of a contract of health insurance or health 
benefits.’’. 
(e) ERISA ENFORCEMENT.—Section 502 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 1132) is amended— 
(1) in subsection (a)(6), by striking ‘‘(7), or (8)’’ and inserting 
‘‘(7), (8), or (9)’’; 
(2) in subsection (b)(3), by striking ‘‘The Secretary’’ and 
inserting ‘‘Except as provided in subsections (c)(9) and (a)(6) 
(with respect to collecting civil penalties under subsection 
(c)(9)), the Secretary’’; and 
(3) in subsection (c), by redesignating paragraph (9) as 
paragraph (10), and by inserting after paragraph (8) the fol-
lowing new paragraph: 
‘‘(9) SECRETARIAL ENFORCEMENT AUTHORITY RELATING TO 
USE OF GENETIC INFORMATION.— 
‘‘(A) GENERAL RULE.—The Secretary may impose a pen-
alty against any plan sponsor of a group health plan, 
or any health insurance issuer offering health insurance 
coverage in connection with the plan, for any failure by 
such sponsor or issuer to meet the requirements of sub-
section (a)(1)(F), (b)(3), (c), or (d) of section 702 or section 
701 or 702(b)(1) with respect to genetic information, in 
connection with the plan. 
‘‘(B) AMOUNT.— 
‘‘(i) IN
GENERAL.—The amount of the penalty 
imposed by subparagraph (A) shall be $100 for each 
day in the noncompliance period with respect to each 
participant or beneficiary to whom such failure relates. 
‘‘(ii) NONCOMPLIANCE PERIOD.—For purposes of this 
paragraph, the term ‘noncompliance period’ means, 
with respect to any failure, the period— 
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122 STAT. 887 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(I) beginning on the date such failure first 
occurs; and 
‘‘(II) ending on the date the failure is corrected. 
‘‘(C) MINIMUM
PENALTIES
WHERE
FAILURE
DISCOV-
ERED.—Notwithstanding clauses (i) and (ii) of subpara-
graph (D): 
‘‘(i) IN GENERAL.—In the case of 1 or more failures 
with respect to a participant or beneficiary— 
‘‘(I) which are not corrected before the date 
on which the plan receives a notice from the Sec-
retary of such violation; and 
‘‘(II) which occurred or continued during the 
period involved; 
the amount of penalty imposed by subparagraph (A) 
by reason of such failures with respect to such partici-
pant or beneficiary shall not be less than $2,500. 
‘‘(ii) HIGHER MINIMUM PENALTY WHERE VIOLATIONS 
ARE MORE THAN DE MINIMIS.—To the extent violations 
for which any person is liable under this paragraph 
for any year are more than de minimis, clause (i) 
shall be applied by substituting ‘$15,000’ for ‘$2,500’ 
with respect to such person. 
‘‘(D) LIMITATIONS.— 
‘‘(i) PENALTY NOT TO APPLY WHERE FAILURE NOT 
DISCOVERED EXERCISING REASONABLE DILIGENCE.—No 
penalty shall be imposed by subparagraph (A) on any 
failure during any period for which it is established 
to the satisfaction of the Secretary that the person 
otherwise liable for such penalty did not know, and 
exercising reasonable diligence would not have known, 
that such failure existed. 
‘‘(ii) PENALTY
NOT
TO
APPLY
TO
FAILURES
COR-
RECTED WITHIN CERTAIN PERIODS.—No penalty shall 
be imposed by subparagraph (A) on any failure if— 
‘‘(I) such failure was due to reasonable cause 
and not to willful neglect; and 
‘‘(II) such failure is corrected during the 30- 
day period beginning on the first date the person 
otherwise liable for such penalty knew, or exer-
cising reasonable diligence would have known, that 
such failure existed. 
‘‘(iii) OVERALL
LIMITATION
FOR
UNINTENTIONAL 
FAILURES.—In the case of failures which are due to 
reasonable cause and not to willful neglect, the penalty 
imposed by subparagraph (A) for failures shall not 
exceed the amount equal to the lesser of— 
‘‘(I) 10 percent of the aggregate amount paid 
or incurred by the plan sponsor (or predecessor 
plan sponsor) during the preceding taxable year 
for group health plans; or 
‘‘(II) $500,000. 
‘‘(E) WAIVER BY SECRETARY.—In the case of a failure 
which is due to reasonable cause and not to willful neglect, 
the Secretary may waive part or all of the penalty imposed 
by subparagraph (A) to the extent that the payment of 
such penalty would be excessive relative to the failure 
involved. 
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122 STAT. 888 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(F) DEFINITIONS.—Terms used in this paragraph 
which are defined in section 733 shall have the meanings 
provided such terms in such section.’’. 
(f) REGULATIONS AND EFFECTIVE DATE.— 
(1) REGULATIONS.—The Secretary of Labor shall issue final 
regulations not later than 12 months after the date of enact-
ment of this Act to carry out the amendments made by this 
section. 
(2) EFFECTIVE DATE.—The amendments made by this sec-
tion shall apply with respect to group health plans for plan 
years beginning after the date that is 1 year after the date 
of enactment of this Act. 
SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT. 
(a) AMENDMENTS RELATING TO THE GROUP MARKET.— 
(1) NO
DISCRIMINATION
IN
GROUP
PREMIUMS
BASED
ON 
GENETIC INFORMATION.—Section 2702(b) of the Public Health 
Service Act (42 U.S.C. 300gg–1(b)) is amended— 
(A) in paragraph (2)(A), by inserting before the semi-
colon the following: ‘‘except as provided in paragraph (3)’’; 
and 
(B) by adding at the end the following: 
‘‘(3) NO GROUP-BASED DISCRIMINATION ON BASIS OF GENETIC 
INFORMATION.— 
‘‘(A) IN GENERAL.—For purposes of this section, a group 
health plan, and health insurance issuer offering group 
health insurance coverage in connection with a group 
health plan, may not adjust premium or contribution 
amounts for the group covered under such plan on the 
basis of genetic information. 
‘‘(B) RULE
OF
CONSTRUCTION.—Nothing in subpara-
graph (A) or in paragraphs (1) and (2) of subsection (d) 
shall be construed to limit the ability of a health insurance 
issuer offering health insurance coverage in connection with 
a group health plan to increase the premium for an 
employer based on the manifestation of a disease or dis-
order of an individual who is enrolled in the plan. In 
such case, the manifestation of a disease or disorder in 
one individual cannot also be used as genetic information 
about other group members and to further increase the 
premium for the employer.’’. 
(2) LIMITATIONS
ON
GENETIC
TESTING; PROHIBITION
ON 
COLLECTION
OF
GENETIC
INFORMATION; APPLICATION
TO
ALL 
PLANS.—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
REQUIRING
GENETIC 
TESTING.—A group health plan, and 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.—Paragraph (1) shall not be 
construed to limit the authority of a health care professional 
who is providing health care services to an individual to request 
that such individual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— 
Applicability. 
29 USC 1132 
note. 
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122 STAT. 889 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be 
construed to preclude a group health plan, or a health 
insurance issuer offering health insurance coverage in 
connection with a group health plan, from obtaining and 
using the results of a genetic test in making a determina-
tion regarding payment (as such term is defined for the 
purposes of applying the regulations promulgated by the 
Secretary under part C of title XI of the Social Security 
Act and section 264 of the Health Insurance Portability 
and Accountability Act of 1996, as may be revised from 
time to time) consistent with subsection (a). 
‘‘(B) LIMITATION.—For purposes of subparagraph (A), 
a group health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group 
health plan, may request only the minimum amount of 
information necessary to accomplish the intended purpose. 
‘‘(4) RESEARCH
EXCEPTION.—Notwithstanding paragraph 
(1), a group health plan, or a health insurance issuer offering 
health insurance coverage in connection with a group health 
plan, may request, but not require, that a participant or bene-
ficiary undergo a genetic test if each of the following conditions 
is met: 
‘‘(A) The request is made pursuant to research that 
complies with part 46 of title 45, Code of Federal Regula-
tions, or equivalent Federal regulations, and any applicable 
State or local law or regulations for the protection of human 
subjects in research. 
‘‘(B) The plan or issuer clearly indicates to each partici-
pant or beneficiary, or in the case of a minor child, to 
the legal guardian of such beneficiary, to whom the request 
is made that— 
‘‘(i) compliance with the request is voluntary; and 
‘‘(ii) non-compliance will have no effect on enroll-
ment status or premium or contribution amounts. 
‘‘(C) No genetic information collected or acquired under 
this paragraph shall be used for underwriting purposes. 
‘‘(D) The plan or issuer notifies the Secretary in writing 
that the plan or issuer is conducting activities pursuant 
to the exception provided for under this paragraph, 
including a description of the activities conducted. 
‘‘(E) The plan or issuer complies with such other condi-
tions as the Secretary may by regulation require for activi-
ties conducted under this paragraph. 
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— 
‘‘(1) IN GENERAL.—A group health plan, and a health insur-
ance issuer offering health insurance coverage in connection 
with a group health plan, shall not request, require, or purchase 
genetic information for underwriting purposes (as defined in 
section 2791). 
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION 
PRIOR TO ENROLLMENT.—A group health plan, and a health 
insurance issuer offering health insurance coverage in connec-
tion with a group health plan, shall not request, require, or 
purchase genetic information with respect to any individual 
prior to such individual’s enrollment under the plan or coverage 
in connection with such enrollment. 
Notification. 
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122 STAT. 890 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(3) INCIDENTAL COLLECTION.—If a group health plan, or 
a health insurance issuer offering health insurance coverage 
in connection with a group health plan, obtains genetic informa-
tion incidental to the requesting, requiring, or purchasing of 
other information concerning any individual, such request, 
requirement, or purchase shall not be considered a violation 
of paragraph (2) if such request, requirement, or purchase 
is not in violation of paragraph (1). 
‘‘(e) APPLICATION TO ALL PLANS.—The provisions of subsections 
(a)(1)(F), (b)(3), (c) , and (d) and subsection (b)(1) and section 2701 
with respect to genetic information, shall apply to group health 
plans and health insurance issuers without regard to section 
2721(a).’’. 
(3) APPLICATION TO GENETIC INFORMATION OF A FETUS OR 
EMBRYO.—Such section is further amended by adding at the 
end the following: 
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any ref-
erence in this part to genetic information concerning an individual 
or family member of an individual shall— 
‘‘(1) with respect to such an individual or family member 
of an individual who is a pregnant woman, include genetic 
information of any fetus carried by such pregnant woman; 
and 
‘‘(2) with respect to an individual or family member uti-
lizing an assisted reproductive technology, include genetic 
information of any embryo legally held by the individual or 
family member.’’. 
(4) 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 member’ means, 
with respect to any individual— 
‘‘(A) a dependent (as such term is used for purposes 
of section 2701(f)(2)) of such individual; and 
‘‘(B) any other individual who is a first-degree, second- 
degree, third-degree, or fourth-degree relative of such indi-
vidual or of an individual described in subparagraph (A). 
‘‘(16) GENETIC INFORMATION.— 
‘‘(A) IN
GENERAL.—The term ‘genetic information’ 
means, with respect to any individual, information about— 
‘‘(i) such individual’s genetic tests, 
‘‘(ii) the genetic tests of family members of such 
individual, and 
‘‘(iii) the manifestation of a disease or disorder 
in family members of such individual. 
‘‘(B) INCLUSION OF GENETIC SERVICES AND PARTICIPA-
TION
IN
GENETIC
RESEARCH.—Such term includes, with 
respect to any individual, any request for, or receipt of, 
genetic services, or participation in clinical research which 
includes genetic services, by such individual or any family 
member of such individual. 
‘‘(C) EXCLUSIONS.—The term ‘genetic information’ shall 
not include information about the sex or age of any indi-
vidual. 
‘‘(17) GENETIC TEST.— 
‘‘(A) IN GENERAL.—The term ‘genetic test’ means an 
analysis of human DNA, RNA, chromosomes, proteins, or 
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122 STAT. 891 
PUBLIC LAW 110–233—MAY 21, 2008 
metabolites, that detects genotypes, mutations, or chromo-
somal changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic test’ does not 
mean— 
‘‘(i) an analysis of proteins or metabolites that 
does not detect genotypes, mutations, or chromosomal 
changes; or 
‘‘(ii) an analysis of proteins or metabolites that 
is directly related to a manifested disease, disorder, 
or pathological condition that could reasonably be 
detected by a health care professional with appropriate 
training and expertise in the field of medicine involved. 
‘‘(18) GENETIC
SERVICES.—The term ‘genetic services’ 
means— 
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (including obtaining, inter-
preting, or assessing genetic information); or 
‘‘(C) genetic education. 
‘‘(19) UNDERWRITING PURPOSES.—The term ‘underwriting 
purposes’ means, with respect to any group health plan, or 
health insurance coverage offered in connection with a group 
health plan— 
‘‘(A) rules for, or determination of, eligibility (including 
enrollment and continued eligibility) for benefits under the 
plan or coverage; 
‘‘(B) the computation of premium or contribution 
amounts under the plan or coverage; 
‘‘(C) the application of any pre-existing condition exclu-
sion under the plan or coverage; and 
‘‘(D) other activities related to the creation, renewal, 
or replacement of a contract of health insurance or health 
benefits.’’. 
(5) REMEDIES AND ENFORCEMENT.—Section 2722(b) of the 
Public Health Service Act (42 U.S.C. 300gg–22(b)) is amended 
by adding at the end the following: 
‘‘(3) ENFORCEMENT
AUTHORITY
RELATING
TO
GENETIC 
DISCRIMINATION.— 
‘‘(A) GENERAL RULE.—In the cases described in para-
graph (1), notwithstanding the provisions of paragraph 
(2)(C), the succeeding subparagraphs of this paragraph 
shall apply with respect to an action under this subsection 
by the Secretary with respect to any failure of a health 
insurance issuer in connection with a group health plan, 
to meet the requirements of subsection (a)(1)(F), (b)(3), 
(c), or (d) of section 2702 or section 2701 or 2702(b)(1) 
with respect to genetic information in connection with the 
plan. 
‘‘(B) AMOUNT.— 
‘‘(i) IN
GENERAL.—The amount of the penalty 
imposed under this paragraph shall be $100 for each 
day in the noncompliance period with respect to each 
participant or beneficiary to whom such failure relates. 
‘‘(ii) NONCOMPLIANCE PERIOD.—For purposes of this 
paragraph, the term ‘noncompliance period’ means, 
with respect to any failure, the period— 
‘‘(I) beginning on the date such failure first 
occurs; and 
Penalties. 
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122 STAT. 892 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(II) ending on the date the failure is corrected. 
‘‘(C) MINIMUM
PENALTIES
WHERE
FAILURE
DISCOV-
ERED.—Notwithstanding clauses (i) and (ii) of subpara-
graph (D): 
‘‘(i) IN GENERAL.—In the case of 1 or more failures 
with respect to an individual— 
‘‘(I) which are not corrected before the date 
on which the plan receives a notice from the Sec-
retary of such violation; and 
‘‘(II) which occurred or continued during the 
period involved; 
the amount of penalty imposed by subparagraph (A) 
by reason of such failures with respect to such indi-
vidual shall not be less than $2,500. 
‘‘(ii) HIGHER MINIMUM PENALTY WHERE VIOLATIONS 
ARE MORE THAN DE MINIMIS.—To the extent violations 
for which any person is liable under this paragraph 
for any year are more than de minimis, clause (i) 
shall be applied by substituting ‘$15,000’ for ‘$2,500’ 
with respect to such person. 
‘‘(D) LIMITATIONS.— 
‘‘(i) PENALTY NOT TO APPLY WHERE FAILURE NOT 
DISCOVERED EXERCISING REASONABLE DILIGENCE.—No 
penalty shall be imposed by subparagraph (A) on any 
failure during any period for which it is established 
to the satisfaction of the Secretary that the person 
otherwise liable for such penalty did not know, and 
exercising reasonable diligence would not have known, 
that such failure existed. 
‘‘(ii) PENALTY
NOT
TO
APPLY
TO
FAILURES
COR-
RECTED WITHIN CERTAIN PERIODS.—No penalty shall 
be imposed by subparagraph (A) on any failure if— 
‘‘(I) such failure was due to reasonable cause 
and not to willful neglect; and 
‘‘(II) such failure is corrected during the 30- 
day period beginning on the first date the person 
otherwise liable for such penalty knew, or exer-
cising reasonable diligence would have known, that 
such failure existed. 
‘‘(iii) OVERALL
LIMITATION
FOR
UNINTENTIONAL 
FAILURES.—In the case of failures which are due to 
reasonable cause and not to willful neglect, the penalty 
imposed by subparagraph (A) for failures shall not 
exceed the amount equal to the lesser of— 
‘‘(I) 10 percent of the aggregate amount paid 
or incurred by the employer (or predecessor 
employer) during the preceding taxable year for 
group health plans; or 
‘‘(II) $500,000. 
‘‘(E) WAIVER BY SECRETARY.—In the case of a failure 
which is due to reasonable cause and not to willful neglect, 
the Secretary may waive part or all of the penalty imposed 
by subparagraph (A) to the extent that the payment of 
such penalty would be excessive relative to the failure 
involved.’’. 
(b) AMENDMENT RELATING TO THE INDIVIDUAL MARKET.— 
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122 STAT. 893 
PUBLIC LAW 110–233—MAY 21, 2008 
(1) IN GENERAL.—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) is amended— 
(A) by redesignating such subpart as subpart 2; and 
(B) by adding at the end the following: 
‘‘SEC. 2753. PROHIBITION OF HEALTH DISCRIMINATION ON THE BASIS 
OF GENETIC INFORMATION. 
‘‘(a) PROHIBITION ON GENETIC INFORMATION AS A CONDITION 
OF ELIGIBILITY.— 
‘‘(1) IN GENERAL.—A health insurance issuer offering health 
insurance coverage in the individual market may not establish 
rules for the eligibility (including continued eligibility) of any 
individual to enroll in individual health insurance coverage 
based on genetic information. 
‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) 
or in paragraphs (1) and (2) of subsection (e) shall be construed 
to preclude a health insurance issuer from establishing rules 
for eligibility for an individual to enroll in individual health 
insurance coverage based on the manifestation of a disease 
or disorder in that individual, or in a family member of such 
individual where such family member is covered under the 
policy that covers such individual. 
‘‘(b) PROHIBITION ON GENETIC INFORMATION IN SETTING PRE-
MIUM RATES.— 
‘‘(1) IN GENERAL.—A health insurance issuer offering health 
insurance coverage in the individual market shall not adjust 
premium or contribution amounts for an individual on the 
basis of genetic information concerning the individual or a 
family member of the individual. 
‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) 
or in paragraphs (1) and (2) of subsection (e) shall be construed 
to preclude a health insurance issuer from adjusting premium 
or contribution amounts for an individual on the basis of a 
manifestation of a disease or disorder in that individual, or 
in a family member of such individual where such family 
member is covered under the policy that covers such individual. 
In such case, the manifestation of a disease or disorder in 
one individual cannot also be used as genetic information about 
other individuals covered under the policy issued to such indi-
vidual and to further increase premiums or contribution 
amounts. 
‘‘(c) PROHIBITION
ON GENETIC INFORMATION
AS PREEXISTING 
CONDITION.— 
‘‘(1) IN GENERAL.—A health insurance issuer offering health 
insurance coverage in the individual market may not, on the 
basis of genetic information, impose any preexisting condition 
exclusion (as defined in section 2701(b)(1)(A)) with respect to 
such coverage. 
‘‘(2) RULE OF CONSTRUCTION.—Nothing in paragraph (1) 
or in paragraphs (1) and (2) of subsection (e) shall be construed 
to preclude a health insurance issuer from imposing any pre-
existing condition exclusion for an individual with respect to 
health insurance coverage on the basis of a manifestation of 
a disease or disorder in that individual. 
‘‘(d) GENETIC TESTING.— 
42 USC 
300gg–53. 
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122 STAT. 894 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(1) LIMITATION
ON
REQUESTING
OR
REQUIRING
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 genetic test. 
‘‘(2) RULE OF CONSTRUCTION.—Paragraph (1) shall not be 
construed to limit the authority of a health care professional 
who is providing health care services to an individual to request 
that such individual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— 
‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be 
construed to preclude a health insurance issuer offering 
health insurance coverage in the individual market from 
obtaining and using the results of a genetic test in making 
a determination regarding payment (as such term is defined 
for the purposes of applying the regulations promulgated 
by the Secretary under part C of title XI of the Social 
Security Act and section 264 of the Health Insurance Port-
ability and Accountability Act of 1996, as may be revised 
from time to time) consistent with subsection (a) and (c). 
‘‘(B) LIMITATION.—For purposes of subparagraph (A), 
a health insurance issuer offering health insurance cov-
erage in the individual market may request only the min-
imum amount of information necessary to accomplish the 
intended purpose. 
‘‘(4) RESEARCH
EXCEPTION.—Notwithstanding paragraph 
(1), a health insurance issuer offering health insurance coverage 
in the individual market may request, but not require, that 
an individual or a family member of such individual undergo 
a genetic test if each of the following conditions is met: 
‘‘(A) The request is made pursuant to research that 
complies with part 46 of title 45, Code of Federal Regula-
tions, or equivalent Federal regulations, and any applicable 
State or local law or regulations for the protection of human 
subjects in research. 
‘‘(B) The issuer clearly indicates to each individual, 
or in the case of a minor child, to the legal guardian 
of such child, to whom the request is made that— 
‘‘(i) compliance with the request is voluntary; and 
‘‘(ii) non-compliance will have no effect on enroll-
ment status or premium or contribution amounts. 
‘‘(C) No genetic information collected or acquired under 
this paragraph shall be used for underwriting purposes. 
‘‘(D) The issuer notifies the Secretary in writing that 
the issuer is conducting activities pursuant to the exception 
provided for under this paragraph, including a description 
of the activities conducted. 
‘‘(E) The issuer complies with such other conditions 
as the Secretary may by regulation require for activities 
conducted under this paragraph. 
‘‘(e) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— 
‘‘(1) IN GENERAL.—A health insurance issuer offering health 
insurance coverage in the individual market shall not request, 
require, or purchase genetic information for underwriting pur-
poses (as defined in section 2791). 
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION 
PRIOR
TO
ENROLLMENT.—A health insurance issuer offering 
Notification. 
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122 STAT. 895 
PUBLIC LAW 110–233—MAY 21, 2008 
health insurance coverage in the individual market shall not 
request, require, or purchase genetic information with respect 
to any individual prior to such individual’s enrollment under 
the plan in connection with such enrollment. 
‘‘(3) INCIDENTAL COLLECTION.—If a health insurance issuer 
offering health insurance coverage in the individual market 
obtains genetic information incidental to the requesting, 
requiring, or purchasing of other information concerning any 
individual, such request, requirement, or purchase shall not 
be considered a violation of paragraph (2) if such request, 
requirement, or purchase is not in violation of paragraph (1). 
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any ref-
erence in this part to genetic information concerning an individual 
or family member of an individual shall— 
‘‘(1) with respect to such an individual or family member 
of an individual who is a pregnant woman, include genetic 
information of any fetus carried by such pregnant woman; 
and 
‘‘(2) with respect to an individual or family member uti-
lizing an assisted reproductive technology, include genetic 
information of any embryo legally held by the individual or 
family member.’’. 
(2) REMEDIES AND ENFORCEMENT.—Section 2761(b) of the 
Public Health Service Act (42 U.S.C. 300gg–61(b)) is amended 
to read as follows: 
‘‘(b) SECRETARIAL ENFORCEMENT AUTHORITY.—The Secretary 
shall have the same authority in relation to enforcement of the 
provisions of this part with respect to issuers of health insurance 
coverage in the individual market in a State as the Secretary 
has under section 2722(b)(2), and section 2722(b)(3) with respect 
to violations of genetic nondiscrimination provisions, in relation 
to the enforcement of the provisions of part A with respect to 
issuers of health insurance coverage in the small group market 
in the State.’’. 
(c) ELIMINATION OF OPTION OF NON-FEDERAL GOVERNMENTAL 
PLANS
TO
BE
EXCEPTED
FROM
REQUIREMENTS
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 REQUIREMENTS CON-
CERNING GENETIC INFORMATION.—The election described in 
subparagraph (A) shall not be available with respect to 
the provisions of subsections (a)(1)(F), (b)(3), (c), and (d) 
of section 2702 and the provisions of sections 2701 and 
2702(b) to the extent that such provisions apply to genetic 
information.’’. 
(d) REGULATIONS AND EFFECTIVE DATE.— 
(1) REGULATIONS.—Not later than 12 months after the 
date of enactment of this Act, the Secretary of Health and 
Human Services shall issue final regulations to carry out the 
amendments made by this section. 
(2) EFFECTIVE DATE.—The amendments made by this sec-
tion shall apply— 
Applicability. 
42 USC 
300gg–1 note. 
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122 STAT. 896 
PUBLIC LAW 110–233—MAY 21, 2008 
(A) with respect to group health plans, and health 
insurance coverage offered in connection with group health 
plans, for plan years beginning after the date that is 1 
year after the date of enactment of this Act; and 
(B) with respect to health insurance coverage offered, 
sold, issued, renewed, in effect, or operated in the indi-
vidual market after the date that is 1 year after the date 
of enactment of this Act. 
SEC. 103. AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986. 
(a) NO DISCRIMINATION IN GROUP PREMIUMS BASED ON GENETIC 
INFORMATION.—Subsection (b) of section 9802 of the Internal Rev-
enue Code of 1986 is amended— 
(1) in paragraph (2)(A), by inserting before the semicolon 
the following: ‘‘except as provided in paragraph (3)’’; and 
(2) by adding at the end the following: 
‘‘(3) NO GROUP-BASED DISCRIMINATION ON BASIS OF GENETIC 
INFORMATION.— 
‘‘(A) IN GENERAL.—For purposes of this section, a group 
health plan may not adjust premium or contribution 
amounts for the group covered under such plan on the 
basis of genetic information. 
‘‘(B) RULE
OF
CONSTRUCTION.—Nothing in subpara-
graph (A) or in paragraphs (1) and (2) of subsection (d) 
shall be construed to limit the ability of a group health 
plan to increase the premium for an employer based on 
the manifestation of a disease or disorder of an individual 
who is enrolled in the plan. In such case, the manifestation 
of a disease or disorder in one individual cannot also be 
used as genetic information about other group members 
and to further increase the premium for the employer.’’. 
(b) LIMITATIONS ON GENETIC TESTING; PROHIBITION ON COLLEC-
TION OF GENETIC INFORMATION; APPLICATION TO ALL PLANS.—Sec-
tion 9802 of such Code is amended by redesignating subsection 
(c) as subsection (f) and by inserting after subsection (b) the fol-
lowing new subsections: 
‘‘(c) GENETIC TESTING.— 
‘‘(1) LIMITATION
ON
REQUESTING
OR
REQUIRING
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.—Paragraph (1) shall not be 
construed to limit the authority of a health care professional 
who is providing health care services to an individual to request 
that such individual undergo a genetic test. 
‘‘(3) RULE OF CONSTRUCTION REGARDING PAYMENT.— 
‘‘(A) IN GENERAL.—Nothing in paragraph (1) shall be 
construed to preclude a group health plan from obtaining 
and using the results of a genetic test in making a deter-
mination regarding payment (as such term is defined for 
the purposes of applying the regulations promulgated by 
the Secretary of Health and Human Services under part 
C of title XI of the Social Security Act and section 264 
of the Health Insurance Portability and Accountability Act 
of 1996, as may be revised from time to time) consistent 
with subsection (a). 
26 USC 9802. 
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122 STAT. 897 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(B) LIMITATION.—For purposes of subparagraph (A), 
a group health plan may request only the minimum amount 
of information necessary to accomplish the intended pur-
pose. 
‘‘(4) RESEARCH
EXCEPTION.—Notwithstanding paragraph 
(1), a group health plan may request, but not require, that 
a participant or beneficiary undergo a genetic test if each 
of the following conditions is met: 
‘‘(A) The request is made pursuant to research that 
complies with part 46 of title 45, Code of Federal Regula-
tions, or equivalent Federal regulations, and any applicable 
State or local law or regulations for the protection of human 
subjects in research. 
‘‘(B) The plan clearly indicates to each participant or 
beneficiary, or in the case of a minor child, to the legal 
guardian of such beneficiary, to whom the request is made 
that— 
‘‘(i) compliance with the request is voluntary; and 
‘‘(ii) non-compliance will have no effect on enroll-
ment status or premium or contribution amounts. 
‘‘(C) No genetic information collected or acquired under 
this paragraph shall be used for underwriting purposes. 
‘‘(D) The plan notifies the Secretary in writing that 
the plan is conducting activities pursuant to the exception 
provided for under this paragraph, including a description 
of the activities conducted. 
‘‘(E) The plan complies with such other conditions as 
the Secretary may by regulation require for activities con-
ducted under this paragraph. 
‘‘(d) PROHIBITION ON COLLECTION OF GENETIC INFORMATION.— 
‘‘(1) IN GENERAL.—A group health plan shall not request, 
require, or purchase genetic information for underwriting pur-
poses (as defined in section 9832). 
‘‘(2) PROHIBITION ON COLLECTION OF GENETIC INFORMATION 
PRIOR TO ENROLLMENT.—A group health plan shall not request, 
require, or purchase genetic information with respect to any 
individual prior to such individual’s enrollment under the plan 
or in connection with such enrollment. 
‘‘(3) INCIDENTAL
COLLECTION.—If a group health plan 
obtains genetic information incidental to the requesting, 
requiring, or purchasing of other information concerning any 
individual, such request, requirement, or purchase shall not 
be considered a violation of paragraph (2) if such request, 
requirement, or purchase is not in violation of paragraph (1). 
‘‘(e) APPLICATION TO ALL PLANS.—The provisions of subsections 
(a)(1)(F), (b)(3), (c), and (d) and subsection (b)(1) and section 9801 
with respect to genetic information, shall apply to group health 
plans without regard to section 9831(a)(2).’’. 
(c) APPLICATION
TO GENETIC INFORMATION
OF
A FETUS
OR 
EMBRYO.—Such section is further amended by adding at the end 
the following: 
‘‘(f) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any ref-
erence in this chapter to genetic information concerning an indi-
vidual or family member of an individual shall— 
‘‘(1) with respect to such an individual or family member 
of an individual who is a pregnant woman, include genetic 
Notification. 
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122 STAT. 898 
PUBLIC LAW 110–233—MAY 21, 2008 
information of any fetus carried by such pregnant woman; 
and 
‘‘(2) with respect to an individual or family member uti-
lizing an assisted reproductive technology, include genetic 
information of any embryo legally held by the individual or 
family member.’’. 
(d) DEFINITIONS.—Subsection (d) of section 9832 of such Code 
is amended by adding at the end the following: 
‘‘(6) FAMILY MEMBER.—The term ‘family member’ means, 
with respect to any individual— 
‘‘(A) a dependent (as such term is used for purposes 
of section 9801(f)(2)) of such individual, and 
‘‘(B) any other individual who is a first-degree, second- 
degree, third-degree, or fourth-degree relative of such indi-
vidual or of an individual described in subparagraph (A). 
‘‘(7) GENETIC INFORMATION.— 
‘‘(A) IN
GENERAL.—The term ‘genetic information’ 
means, with respect to any individual, information about— 
‘‘(i) such individual’s genetic tests, 
‘‘(ii) the genetic tests of family members of such 
individual, and 
‘‘(iii) the manifestation of a disease or disorder 
in family members of such individual. 
‘‘(B) INCLUSION OF GENETIC SERVICES AND PARTICIPA-
TION
IN
GENETIC
RESEARCH.—Such term includes, with 
respect to any individual, any request for, or receipt of, 
genetic services, or participation in clinical research which 
includes genetic services, by such individual or any family 
member of such individual. 
‘‘(C) EXCLUSIONS.—The term ‘genetic information’ shall 
not include information about the sex or age of any indi-
vidual. 
‘‘(8) GENETIC TEST.— 
‘‘(A) IN GENERAL.—The term ‘genetic test’ means an 
analysis of human DNA, RNA, chromosomes, proteins, or 
metabolites, that detects genotypes, mutations, or chromo-
somal changes. 
‘‘(B) EXCEPTIONS.—The term ‘genetic test’ does not 
mean— 
‘‘(i) an analysis of proteins or metabolites that 
does not detect genotypes, mutations, or chromosomal 
changes, or 
‘‘(ii) an analysis of proteins or metabolites that 
is directly related to a manifested disease, disorder, 
or pathological condition that could reasonably be 
detected by a health care professional with appropriate 
training and expertise in the field of medicine involved. 
‘‘(9) GENETIC
SERVICES.—The term ‘genetic services’ 
means— 
‘‘(A) a genetic test; 
‘‘(B) genetic counseling (including obtaining, inter-
preting, or assessing genetic information); or 
‘‘(C) genetic education. 
‘‘(10) UNDERWRITING PURPOSES.—The term ‘underwriting 
purposes’ means, with respect to any group health plan, or 
health insurance coverage offered in connection with a group 
health plan— 
26 USC 9832. 
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122 STAT. 899 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(A) rules for, or determination of, eligibility (including 
enrollment and continued eligibility) for benefits under the 
plan or coverage; 
‘‘(B) the computation of premium or contribution 
amounts under the plan or coverage; 
‘‘(C) the application of any pre-existing condition exclu-
sion under the plan or coverage; and 
‘‘(D) other activities related to the creation, renewal, 
or replacement of a contract of health insurance or health 
benefits.’’. 
(e) ENFORCEMENT.— 
(1) IN
GENERAL.—Subchapter C of chapter 100 of the 
Internal Revenue Code of 1986 (relating to general provisions) 
is amended by adding at the end the following new section: 
‘‘SEC. 9834. ENFORCEMENT. 
‘‘For the imposition of tax on any failure of a group health 
plan to meet the requirements of this chapter, see section 4980D.’’. 
(2) CONFORMING AMENDMENT.—The table of sections for 
subchapter C of chapter 100 of such Code is amended by 
adding at the end the following new item: 
‘‘Sec. 9834. Enforcement.’’. 
(f) REGULATIONS AND EFFECTIVE DATE.— 
(1) REGULATIONS.—The Secretary of the Treasury shall 
issue final regulations or other guidance not later than 12 
months after the date of the enactment of this Act to carry 
out the amendments made by this section. 
(2) EFFECTIVE DATE.—The amendments made by this sec-
tion shall apply with respect to group health plans for plan 
years beginning after the date that is 1 year after the date 
of the enactment of this Act. 
SEC. 104. AMENDMENTS TO TITLE XVIII OF THE SOCIAL SECURITY 
ACT RELATING TO MEDIGAP. 
(a) NONDISCRIMINATION.—Section 1882(s)(2) of the Social Secu-
rity Act (42 U.S.C. 1395ss(s)(2)) is amended by adding at the 
end the following: 
‘‘(E) An issuer of a medicare supplemental policy shall 
not deny or condition the issuance or effectiveness of the 
policy (including the imposition of any exclusion of benefits 
under the policy based on a pre-existing condition) and 
shall not discriminate in the pricing of the policy (including 
the adjustment of premium rates) of an individual on the 
basis of the genetic information with respect to such indi-
vidual. 
‘‘(F) RULE
OF
CONSTRUCTION.—Nothing in subpara-
graph (E) or in subparagraphs (A) or (B) of subsection 
(x)(2) shall be construed to limit the ability of an issuer 
of a medicare supplemental policy from, to the extent other-
wise permitted under this title— 
‘‘(i) denying or conditioning the issuance or 
effectiveness of the policy or increasing the premium 
for an employer based on the manifestation of a disease 
or disorder of an individual who is covered under the 
policy; or 
‘‘(ii) increasing the premium for any policy issued 
to an individual based on the manifestation of a disease 
Applicability. 
26 USC 9802 
note. 
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122 STAT. 900 
PUBLIC LAW 110–233—MAY 21, 2008 
or disorder of an individual who is covered under the 
policy (in such case, the manifestation of a disease 
or disorder in one individual cannot also be used as 
genetic information about other group members and 
to further increase the premium for the employer).’’. 
(b) LIMITATIONS ON GENETIC TESTING AND GENETIC INFORMA-
TION.— 
(1) IN GENERAL.—Section 1882 of the Social Security Act 
(42 U.S.C. 1395ss) is amended by adding at the end the fol-
lowing: 
‘‘(x) LIMITATIONS
ON GENETIC TESTING
AND INFORMATION.— 
‘‘(1) GENETIC TESTING.— 
‘‘(A) LIMITATION ON REQUESTING OR REQUIRING 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.—Subparagraph (A) shall 
not be construed to limit the authority of a health care 
professional who is providing health care services to an 
individual to request that such individual undergo a genetic 
test. 
‘‘(C) RULE OF CONSTRUCTION REGARDING PAYMENT.— 
‘‘(i) IN
GENERAL.—Nothing in subparagraph (A) 
shall be construed to preclude an issuer of a medicare 
supplemental policy from obtaining and using the 
results of a genetic test in making a determination 
regarding payment (as such term is defined for the 
purposes of applying the regulations promulgated by 
the Secretary under part C of title XI and section 
264 of the Health Insurance Portability and Account-
ability Act of 1996, as may be revised from time to 
time) consistent with subsection (s)(2)(E). 
‘‘(ii) LIMITATION.—For purposes of clause (i), an 
issuer of a medicare supplemental policy may request 
only the minimum amount of information necessary 
to accomplish the intended purpose. 
‘‘(D) RESEARCH EXCEPTION.—Notwithstanding subpara-
graph (A), an issuer of a medicare supplemental policy 
may request, but not require, that an individual or a family 
member of such individual undergo a genetic test if each 
of the following conditions is met: 
‘‘(i) The request is made pursuant to research that 
complies with part 46 of title 45, Code of Federal 
Regulations, or equivalent Federal regulations, and any 
applicable State or local law or regulations for the 
protection of human subjects in research. 
‘‘(ii) The issuer clearly indicates to each individual, 
or in the case of a minor child, to the legal guardian 
of such child, to whom the request is made that— 
‘‘(I) compliance with the request is voluntary; 
and 
‘‘(II) non-compliance will have no effect on 
enrollment status or premium or contribution 
amounts. 
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122 STAT. 901 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(iii) No genetic information collected or acquired 
under this subparagraph shall be used for under-
writing, determination of eligibility to enroll or main-
tain enrollment status, premium rating, or the cre-
ation, renewal, or replacement of a plan, contract, or 
coverage for health insurance or health benefits. 
‘‘(iv) The issuer notifies the Secretary in writing 
that the issuer is conducting activities pursuant to 
the exception provided for under this subparagraph, 
including a description of the activities conducted. 
‘‘(v) The issuer complies with such other conditions 
as the Secretary may by regulation require for activi-
ties conducted under this subparagraph. 
‘‘(2) PROHIBITION
ON
COLLECTION
OF
GENETIC
INFORMA-
TION.— 
‘‘(A) IN
GENERAL.—An issuer of a medicare supple-
mental policy shall not request, require, or purchase genetic 
information for underwriting purposes (as defined in para-
graph (3)). 
‘‘(B) PROHIBITION ON COLLECTION OF GENETIC INFORMA-
TION
PRIOR
TO
ENROLLMENT.—An issuer of a medicare 
supplemental policy shall not request, require, or purchase 
genetic information with respect to any individual prior 
to such individual’s enrollment under the policy in connec-
tion with such enrollment. 
‘‘(C) INCIDENTAL COLLECTION.—If an issuer of a medi-
care supplemental policy obtains genetic information inci-
dental to the requesting, requiring, or purchasing of other 
information concerning any individual, such request, 
requirement, or purchase shall not be considered a violation 
of subparagraph (B) if such request, requirement, or pur-
chase is not in violation of subparagraph (A). 
‘‘(3) DEFINITIONS.—In this subsection: 
‘‘(A) FAMILY
MEMBER.—The term ‘family member’ 
means with respect to an individual, any other individual 
who is a first-degree, second-degree, third-degree, or fourth- 
degree relative of such individual. 
‘‘(B) GENETIC INFORMATION.— 
‘‘(i) IN GENERAL.—The term ‘genetic information’ 
means, with respect to any individual, information 
about— 
‘‘(I) such individual’s genetic tests, 
‘‘(II) the genetic tests of family members of 
such individual, and 
‘‘(III) subject to clause (iv), the manifestation 
of a disease or disorder in family members of such 
individual. 
‘‘(ii) INCLUSION OF GENETIC SERVICES AND PARTICI-
PATION
IN
GENETIC
RESEARCH.—Such term includes, 
with respect to any individual, any request for, or 
receipt of, genetic services, or participation in clinical 
research which includes genetic services, by such indi-
vidual or any family member of such individual. 
‘‘(iii) EXCLUSIONS.—The term ‘genetic information’ 
shall not include information about the sex or age 
of any individual. 
‘‘(C) GENETIC TEST.— 
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122 STAT. 902 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(i) IN GENERAL.—The term ‘genetic test’ means 
an analysis of human DNA, RNA, chromosomes, pro-
teins, 
or 
metabolites, 
that 
detects 
genotypes, 
mutations, or chromosomal changes. 
‘‘(ii) EXCEPTIONS.—The term ‘genetic test’ does not 
mean— 
‘‘(I) an analysis of proteins or metabolites that 
does not detect genotypes, mutations, or chromo-
somal changes; or 
‘‘(II) an analysis of proteins or metabolites that 
is directly related to a manifested disease, dis-
order, or pathological condition that could reason-
ably be detected by a health care professional with 
appropriate training and expertise in the field of 
medicine involved. 
‘‘(D) GENETIC SERVICES.—The term ‘genetic services’ 
means— 
‘‘(i) a genetic test; 
‘‘(ii) genetic counseling (including obtaining, inter-
preting, or assessing genetic information); or 
‘‘(iii) genetic education. 
‘‘(E) UNDERWRITING
PURPOSES.—The term ‘under-
writing purposes’ means, with respect to a medicare supple-
mental policy— 
‘‘(i) rules for, or determination of, eligibility 
(including enrollment and continued eligibility) for 
benefits under the policy; 
‘‘(ii) the computation of premium or contribution 
amounts under the policy; 
‘‘(iii) the application of any pre-existing condition 
exclusion under the policy; and 
‘‘(iv) other activities related to the creation, 
renewal, or replacement of a contract of health insur-
ance or health benefits. 
‘‘(F) ISSUER OF A MEDICARE SUPPLEMENTAL POLICY.— 
The term ‘issuer of a medicare supplemental policy’ 
includes a third-party administrator or other person acting 
for or on behalf of such issuer.’’. 
(2) APPLICATION TO GENETIC INFORMATION OF A FETUS OR 
EMBRYO.—Section 1882(x) of such Act, as added by paragraph 
(1), is further amended by adding at the end the following: 
‘‘(4) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any 
reference in this section to genetic information concerning an 
individual or family member of an individual shall— 
‘‘(A) with respect to such an individual or family 
member of an individual who is a pregnant woman, include 
genetic information of any fetus carried by such pregnant 
woman; and 
‘‘(B) with respect to an individual or family member 
utilizing an assisted reproductive technology, include 
genetic information of any embryo legally held by the indi-
vidual or family member.’’. 
(3) CONFORMING
AMENDMENT.—Section 1882(o) of the 
Social Security Act (42 U.S.C. 1395ss(o)) is amended by adding 
at the end the following: 
‘‘(4) The issuer of the medicare supplemental policy com-
plies with subsection (s)(2)(E) and subsection (x).’’. 
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122 STAT. 903 
PUBLIC LAW 110–233—MAY 21, 2008 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall apply with respect to an issuer of a medicare supplemental 
policy for policy years beginning on or after the date that is 1 
year after the date of enactment of this Act. 
(d) TRANSITION PROVISIONS.— 
(1) IN GENERAL.—If the Secretary of Health and Human 
Services identifies a State as requiring a change to its statutes 
or regulations to conform its regulatory program to the changes 
made by this section, the State regulatory program shall not 
be considered to be out of compliance with the requirements 
of section 1882 of the Social Security Act due solely to failure 
to make such change until the date specified in paragraph 
(4). 
(2) NAIC STANDARDS.—If, not later than October 31, 2008, 
the National Association of Insurance Commissioners (in this 
subsection referred to as the ‘‘NAIC’’) modifies its NAIC Model 
Regulation relating to section 1882 of the Social Security Act 
(referred to in such section as the 1991 NAIC Model Regulation, 
as subsequently modified) to conform to the amendments made 
by this section, such revised regulation incorporating the modi-
fications shall be considered to be the applicable NAIC model 
regulation (including the revised NAIC model regulation and 
the 1991 NAIC Model Regulation) for the purposes of such 
section. 
(3) SECRETARY STANDARDS.—If the NAIC does not make 
the modifications described in paragraph (2) within the period 
specified in such paragraph, the Secretary of Health and 
Human Services shall, not later than July 1, 2009, make the 
modifications described in such paragraph and such revised 
regulation incorporating the modifications shall be considered 
to be the appropriate regulation for the purposes of such section. 
(4) DATE SPECIFIED.— 
(A) IN GENERAL.—Subject to subparagraph (B), the date 
specified in this paragraph for a State is the earlier of— 
(i) the date the State changes its statutes or regu-
lations to conform its regulatory program to the 
changes made by this section, or 
(ii) July 1, 2009. 
(B) ADDITIONAL LEGISLATIVE ACTION REQUIRED.—In the 
case of a State which the Secretary identifies as— 
(i) requiring State legislation (other than legisla-
tion appropriating funds) to conform its regulatory pro-
gram to the changes made in this section, but 
(ii) having a legislature which is not scheduled 
to meet in 2009 in a legislative session in which such 
legislation may be considered, the date specified in 
this paragraph is the first day of the first calendar 
quarter beginning after the close of the first legislative 
session of the State legislature that begins on or after 
July 1, 2009. For purposes of the previous sentence, 
in the case of a State that has a 2-year legislative 
session, each year of such session shall be deemed 
to be a separate regular session of the State legislature. 
SEC. 105. PRIVACY AND CONFIDENTIALITY. 
(a) IN GENERAL.—Part C of title XI of the Social Security 
Act is amended by adding at the end the following new section: 
Deadline. 
Deadline. 
42 USC 
1395ss note. 
Applicability. 
42 USC 
1395ss note. 
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122 STAT. 904 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘APPLICATION OF HIPAA REGULATIONS TO GENETIC INFORMATION 
‘‘SEC. 1180. (a) IN GENERAL.—The Secretary shall revise the 
HIPAA privacy regulation (as defined in subsection (b)) so it is 
consistent with the following: 
‘‘(1) Genetic information shall be treated as health informa-
tion described in section 1171(4)(B). 
‘‘(2) The use or disclosure by a covered entity that is a 
group health plan, health insurance issuer that issues health 
insurance coverage, or issuer of a medicare supplemental policy 
of protected health information that is genetic information 
about an individual for underwriting purposes under the group 
health plan, health insurance coverage, or medicare supple-
mental policy shall not be a permitted use or disclosure. 
‘‘(b) DEFINITIONS.—For purposes of this section: 
‘‘(1) 
GENETIC
INFORMATION; 
GENETIC
TEST; 
FAMILY 
MEMBER.—The terms ‘genetic information’, ‘genetic test’, and 
‘family member’ have the meanings given such terms in section 
2791 of the Public Health Service Act (42 U.S.C. 300gg–91), 
as amended by the Genetic Information Nondiscrimination Act 
of 2007. 
‘‘(2) GROUP HEALTH PLAN; HEALTH INSURANCE COVERAGE; 
MEDICARE
SUPPLEMENTAL
POLICY.—The terms ‘group health 
plan’ and ‘health insurance coverage’ have the meanings given 
such terms under section 2791 of the Public Health Service 
Act (42 U.S.C. 300gg–91), and the term ‘medicare supplemental 
policy’ has the meaning given such term in section 1882(g). 
‘‘(3) HIPAA PRIVACY REGULATION.—The term ‘HIPAA pri-
vacy regulation’ means the regulations promulgated by the 
Secretary under this part and section 264 of the Health Insur-
ance Portability and Accountability Act of 1996 (42 U.S.C. 
1320d–2 note). 
‘‘(4) UNDERWRITING
PURPOSES.—The term ‘underwriting 
purposes’ means, with respect to a group health plan, health 
insurance coverage, or a medicare supplemental policy— 
‘‘(A) rules for, or determination of, eligibility (including 
enrollment and continued eligibility) for, or determination 
of, benefits under the plan, coverage, or policy; 
‘‘(B) the computation of premium or contribution 
amounts under the plan, coverage, or policy; 
‘‘(C) the application of any pre-existing condition exclu-
sion under the plan, coverage, or policy; and 
‘‘(D) other activities related to the creation, renewal, 
or replacement of a contract of health insurance or health 
benefits. 
‘‘(c) PROCEDURE.—The revisions under subsection (a) shall be 
made by notice in the Federal Register published not later than 
60 days after the date of the enactment of this section and shall 
be effective upon publication, without opportunity for any prior 
public comment, but may be revised, consistent with this section, 
after opportunity for public comment. 
‘‘(d) ENFORCEMENT.—In addition to any other sanctions or rem-
edies that may be available under law, a covered entity that is 
a group health plan, health insurance issuer, or issuer of a medicare 
supplemental policy and that violates the HIPAA privacy regulation 
(as revised under subsection (a) or otherwise) with respect to the 
use or disclosure of genetic information shall be subject to the 
Notice. 
Federal Register, 
publication. 
Deadline. 
Effective date. 
42 USC 1320d–9. 
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122 STAT. 905 
PUBLIC LAW 110–233—MAY 21, 2008 
penalties described in sections 1176 and 1177 in the same manner 
and to the same extent that such penalties apply to violations 
of this part.’’. 
(b) REGULATIONS; EFFECTIVE DATE.— 
(1) REGULATIONS.—Not later than 12 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall issue final regulations to carry out 
the revision required by section 1180(a) of the Social Security 
Act, as added by subsection (a). The Secretary has the sole 
authority to promulgate such regulations, but shall promulgate 
such regulations in consultation with the Secretaries of Labor 
and the Treasury. 
(2) EFFECTIVE DATE.—The amendment made by subsection 
(a) shall take effect on the date that is 1 year after the date 
of the enactment of this Act. 
SEC. 106. ASSURING COORDINATION. 
Except as provided in section 105(b)(1), the Secretary of Health 
and Human Services, the Secretary of Labor, and the Secretary 
of the Treasury shall ensure, through the execution of an inter-
agency memorandum of understanding among such Secretaries, 
that— 
(1) regulations, rulings, and interpretations issued by such 
Secretaries relating to the same matter over which two or 
more such Secretaries have responsibility under this title (and 
the amendments made by this title) 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. 
TITLE II—PROHIBITING EMPLOYMENT 
DISCRIMINATION ON THE BASIS OF 
GENETIC INFORMATION 
SEC. 201. DEFINITIONS. 
In this title: 
(1) COMMISSION.—The term ‘‘Commission’’ means the Equal 
Employment Opportunity Commission as created by section 
705 of the Civil Rights Act of 1964 (42 U.S.C. 2000e–4). 
(2) EMPLOYEE; EMPLOYER; EMPLOYMENT
AGENCY; LABOR 
ORGANIZATION; MEMBER.— 
(A) IN GENERAL.—The term ‘‘employee’’ means— 
(i) an employee (including an applicant), as defined 
in section 701(f) of the Civil Rights Act of 1964 (42 
U.S.C. 2000e(f)); 
(ii) a State employee (including an applicant) 
described in section 304(a) of the Government 
Employee Rights Act of 1991 (42 U.S.C. 2000e–16c(a)); 
(iii) a covered employee (including an applicant), 
as defined in section 101 of the Congressional Account-
ability Act of 1995 (2 U.S.C. 1301); 
42 USC 2000ff. 
Memorandum. 
42 USC 
300gg–1 note. 
Deadline. 
42 USC 
1320d–9 note. 
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122 STAT. 906 
PUBLIC LAW 110–233—MAY 21, 2008 
(iv) a covered employee (including an applicant), 
as defined in section 411(c) of title 3, United States 
Code; or 
(v) an employee or applicant to which section 
717(a) of the Civil Rights Act of 1964 (42 U.S.C. 2000e– 
16(a)) applies. 
(B) EMPLOYER.—The term ‘‘employer’’ means— 
(i) an employer (as defined in section 701(b) of 
the Civil Rights Act of 1964 (42 U.S.C. 2000e(b))); 
(ii) an entity employing a State employee described 
in section 304(a) of the Government Employee Rights 
Act of 1991; 
(iii) an employing office, as defined in section 101 
of the Congressional Accountability Act of 1995; 
(iv) an employing office, as defined in section 411(c) 
of title 3, United States Code; or 
(v) an entity to which section 717(a) of the Civil 
Rights Act of 1964 applies. 
(C) EMPLOYMENT AGENCY; LABOR ORGANIZATION.—The 
terms ‘‘employment agency’’ and ‘‘labor organization’’ have 
the meanings given the terms in section 701 of the Civil 
Rights Act of 1964 (42 U.S.C. 2000e). 
(D) MEMBER.—The term ‘‘member’’, with respect to 
a labor organization, includes an applicant for membership 
in a labor organization. 
(3) FAMILY MEMBER.—The term ‘‘family member’’ means, 
with respect to an individual— 
(A) a dependent (as such term is used for purposes 
of section 701(f)(2) of the Employee Retirement Income 
Security Act of 1974) of such individual, and 
(B) any other individual who is a first-degree, second- 
degree, third-degree, or fourth-degree relative of such indi-
vidual or of an individual described in subparagraph (A). 
(4) GENETIC INFORMATION.— 
(A) IN
GENERAL.—The term ‘‘genetic information’’ 
means, with respect to any individual, information about— 
(i) such individual’s genetic tests, 
(ii) the genetic tests of family members of such 
individual, and 
(iii) the manifestation of a disease or disorder in 
family members of such individual. 
(B) INCLUSION OF GENETIC SERVICES AND PARTICIPATION 
IN GENETIC RESEARCH.—Such term includes, with respect 
to any individual, any request for, or receipt of, genetic 
services, or participation in clinical research which includes 
genetic services, by such individual or any family member 
of such individual. 
(C) EXCLUSIONS.—The term ‘‘genetic information’’ shall 
not include information about the sex or age of any indi-
vidual. 
(5) GENETIC MONITORING.—The term ‘‘genetic monitoring’’ 
means the periodic examination of employees to evaluate 
acquired modifications to their genetic material, such as 
chromosomal damage or evidence of increased occurrence of 
mutations, that may have developed in the course of employ-
ment due to exposure to toxic substances in the workplace, 
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122 STAT. 907 
PUBLIC LAW 110–233—MAY 21, 2008 
in order to identify, evaluate, and respond to the effects of 
or control adverse environmental exposures in the workplace. 
(6) GENETIC
SERVICES.—The term ‘‘genetic services’’ 
means— 
(A) a genetic test; 
(B) genetic counseling (including obtaining, inter-
preting, or assessing genetic information); or 
(C) genetic education. 
(7) GENETIC TEST.— 
(A) IN GENERAL.—The term ‘‘genetic test’’ means an 
analysis of human DNA, RNA, chromosomes, proteins, or 
metabolites, that detects genotypes, mutations, or chromo-
somal changes. 
(B) EXCEPTIONS.—The term ‘‘genetic test’’ does not 
mean an analysis of proteins or metabolites that does not 
detect genotypes, mutations, or chromosomal changes. 
SEC. 202. EMPLOYER PRACTICES. 
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—It shall 
be an unlawful employment practice for an employer— 
(1) to fail or refuse to hire, or to discharge, any employee, 
or otherwise to discriminate against any employee with respect 
to the compensation, terms, conditions, or privileges of employ-
ment of the employee, because of genetic information with 
respect to the employee; or 
(2) to limit, segregate, or classify the employees of the 
employer in any way that would deprive or tend to deprive 
any employee of employment opportunities or otherwise 
adversely affect the status of the employee as an employee, 
because of genetic information with respect to the employee. 
(b) ACQUISITION
OF GENETIC INFORMATION.—It shall be an 
unlawful employment practice for an employer to request, require, 
or purchase genetic information with respect to an employee or 
a family member of the employee except— 
(1) where an employer inadvertently requests or requires 
family medical history of the employee or family member of 
the employee; 
(2) where— 
(A) health or genetic services are offered by the 
employer, including such services offered as part of a 
wellness program; 
(B) the employee provides prior, knowing, voluntary, 
and written authorization; 
(C) only the employee (or family member if the family 
member is receiving genetic services) and the licensed 
health care professional or board certified genetic counselor 
involved in providing such services receive individually 
identifiable information concerning the results of such serv-
ices; and 
(D) any individually identifiable genetic information 
provided under subparagraph (C) in connection with the 
services provided under subparagraph (A) is only available 
for purposes of such services and shall not be disclosed 
to the employer except in aggregate terms that do not 
disclose the identity of specific employees; 
(3) where an employer requests or requires family medical 
history from the employee to comply with the certification 
42 USC 2000ff–1. 
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122 STAT. 908 
PUBLIC LAW 110–233—MAY 21, 2008 
provisions of section 103 of the Family and Medical Leave 
Act of 1993 (29 U.S.C. 2613) or such requirements under State 
family and medical leave laws; 
(4) where an employer purchases documents that are 
commercially and publicly available (including newspapers, 
magazines, periodicals, and books, but not including medical 
databases or court records) that include family medical history; 
(5) where the information involved is to be used for genetic 
monitoring of the biological effects of toxic substances in the 
workplace, but only if— 
(A) the employer provides written notice of the genetic 
monitoring to the employee; 
(B)(i) the employee provides prior, knowing, voluntary, 
and written authorization; or 
(ii) the genetic monitoring is required by Federal or 
State law; 
(C) the employee is informed of individual monitoring 
results; 
(D) the monitoring is in compliance with— 
(i) any Federal genetic monitoring regulations, 
including any such regulations that may be promul-
gated by the Secretary of Labor pursuant to the 
Occupational Safety and Health Act of 1970 (29 U.S.C. 
651 et seq.), the Federal Mine Safety and Health Act 
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy 
Act of 1954 (42 U.S.C. 2011 et seq.); or 
(ii) State genetic monitoring regulations, in the 
case of a State that is implementing genetic monitoring 
regulations under the authority of the Occupational 
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); 
and 
(E) the employer, excluding any licensed health care 
professional or board certified genetic counselor that is 
involved in the genetic monitoring program, receives the 
results of the monitoring only in aggregate terms that 
do not disclose the identity of specific employees; or 
(6) where the employer conducts DNA analysis for law 
enforcement purposes as a forensic laboratory or for purposes 
of human remains identification, and requests or requires 
genetic information of such employer’s employees, but only 
to the extent that such genetic information is used for analysis 
of DNA identification markers for quality control to detect 
sample contamination. 
(c) PRESERVATION OF PROTECTIONS.—In the case of information 
to which any of paragraphs (1) through (6) of subsection (b) applies, 
such information may not be used in violation of paragraph (1) 
or (2) of subsection (a) or treated or disclosed in a manner that 
violates section 206. 
SEC. 203. EMPLOYMENT AGENCY PRACTICES. 
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—It shall 
be an unlawful employment practice for an employment agency— 
(1) to fail or refuse to refer for employment, or otherwise 
to discriminate against, any individual because of genetic 
information with respect to the individual; 
(2) to limit, segregate, or classify individuals or fail or 
refuse to refer for employment any individual in any way 
42 USC 2000ff–2. 
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122 STAT. 909 
PUBLIC LAW 110–233—MAY 21, 2008 
that would deprive or tend to deprive any individual of employ-
ment opportunities, or otherwise adversely affect the status 
of the individual as an employee, because of genetic information 
with respect to the individual; or 
(3) to cause or attempt to cause an employer to discriminate 
against an individual in violation of this title. 
(b) ACQUISITION
OF GENETIC INFORMATION.—It shall be an 
unlawful employment practice for an employment agency to request, 
require, or purchase genetic information with respect to an indi-
vidual or a family member of the individual except— 
(1) where an employment agency inadvertently requests 
or requires family medical history of the individual or family 
member of the individual; 
(2) where— 
(A) health or genetic services are offered by the employ-
ment agency, including such services offered as part of 
a wellness program; 
(B) the individual provides prior, knowing, voluntary, 
and written authorization; 
(C) only the individual (or family member if the family 
member is receiving genetic services) and the licensed 
health care professional or board certified genetic counselor 
involved in providing such services receive individually 
identifiable information concerning the results of such serv-
ices; and 
(D) any individually identifiable genetic information 
provided under subparagraph (C) in connection with the 
services provided under subparagraph (A) is only available 
for purposes of such services and shall not be disclosed 
to the employment agency except in aggregate terms that 
do not disclose the identity of specific individuals; 
(3) where an employment agency requests or requires 
family medical history from the individual to comply with the 
certification provisions of section 103 of the Family and Medical 
Leave Act of 1993 (29 U.S.C. 2613) or such requirements under 
State family and medical leave laws; 
(4) where an employment agency purchases documents that 
are commercially and publicly available (including newspapers, 
magazines, periodicals, and books, but not including medical 
databases or court records) that include family medical history; 
or 
(5) where the information involved is to be used for genetic 
monitoring of the biological effects of toxic substances in the 
workplace, but only if— 
(A) the employment agency provides written notice 
of the genetic monitoring to the individual; 
(B)(i) the individual provides prior, knowing, voluntary, 
and written authorization; or 
(ii) the genetic monitoring is required by Federal or 
State law; 
(C) the individual is informed of individual monitoring 
results; 
(D) the monitoring is in compliance with— 
(i) any Federal genetic monitoring regulations, 
including any such regulations that may be promul-
gated by the Secretary of Labor pursuant to the 
Occupational Safety and Health Act of 1970 (29 U.S.C. 
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122 STAT. 910 
PUBLIC LAW 110–233—MAY 21, 2008 
651 et seq.), the Federal Mine Safety and Health Act 
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy 
Act of 1954 (42 U.S.C. 2011 et seq.); or 
(ii) State genetic monitoring regulations, in the 
case of a State that is implementing genetic monitoring 
regulations under the authority of the Occupational 
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); 
and 
(E) the employment agency, excluding any licensed 
health care professional or board certified genetic counselor 
that is involved in the genetic monitoring program, receives 
the results of the monitoring only in aggregate terms that 
do not disclose the identity of specific individuals. 
(c) PRESERVATION OF PROTECTIONS.—In the case of information 
to which any of paragraphs (1) through (5) of subsection (b) applies, 
such information may not be used in violation of paragraph (1), 
(2), or (3) of subsection (a) or treated or disclosed in a manner 
that violates section 206. 
SEC. 204. LABOR ORGANIZATION PRACTICES. 
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—It shall 
be an unlawful employment practice for a labor organization— 
(1) to exclude or to expel from the membership of the 
organization, or otherwise to discriminate against, any member 
because of genetic information with respect to the member; 
(2) to limit, segregate, or classify the members of the 
organization, or fail or refuse to refer for employment any 
member, in any way that would deprive or tend to deprive 
any member of employment opportunities, or otherwise 
adversely affect the status of the member as an employee, 
because of genetic information with respect to the member; 
or 
(3) to cause or attempt to cause an employer to discriminate 
against a member in violation of this title. 
(b) ACQUISITION
OF GENETIC INFORMATION.—It shall be an 
unlawful employment practice for a labor organization to request, 
require, or purchase genetic information with respect to a member 
or a family member of the member except— 
(1) where a labor organization inadvertently requests or 
requires family medical history of the member or family 
member of the member; 
(2) where— 
(A) health or genetic services are offered by the labor 
organization, including such services offered as part of 
a wellness program; 
(B) the member provides prior, knowing, voluntary, 
and written authorization; 
(C) only the member (or family member if the family 
member is receiving genetic services) and the licensed 
health care professional or board certified genetic counselor 
involved in providing such services receive individually 
identifiable information concerning the results of such serv-
ices; and 
(D) any individually identifiable genetic information 
provided under subparagraph (C) in connection with the 
services provided under subparagraph (A) is only available 
for purposes of such services and shall not be disclosed 
42 USC 2000ff–3. 
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122 STAT. 911 
PUBLIC LAW 110–233—MAY 21, 2008 
to the labor organization except in aggregate terms that 
do not disclose the identity of specific members; 
(3) where a labor organization requests or requires family 
medical history from the members to comply with the certifi-
cation provisions of section 103 of the Family and Medical 
Leave Act of 1993 (29 U.S.C. 2613) or such requirements under 
State family and medical leave laws; 
(4) where a labor organization purchases documents that 
are commercially and publicly available (including newspapers, 
magazines, periodicals, and books, but not including medical 
databases or court records) that include family medical history; 
or 
(5) where the information involved is to be used for genetic 
monitoring of the biological effects of toxic substances in the 
workplace, but only if— 
(A) the labor organization provides written notice of 
the genetic monitoring to the member; 
(B)(i) the member provides prior, knowing, voluntary, 
and written authorization; or 
(ii) the genetic monitoring is required by Federal or 
State law; 
(C) the member is informed of individual monitoring 
results; 
(D) the monitoring is in compliance with— 
(i) any Federal genetic monitoring regulations, 
including any such regulations that may be promul-
gated by the Secretary of Labor pursuant to the 
Occupational Safety and Health Act of 1970 (29 U.S.C. 
651 et seq.), the Federal Mine Safety and Health Act 
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy 
Act of 1954 (42 U.S.C. 2011 et seq.); or 
(ii) State genetic monitoring regulations, in the 
case of a State that is implementing genetic monitoring 
regulations under the authority of the Occupational 
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); 
and 
(E) the labor organization, excluding any licensed 
health care professional or board certified genetic counselor 
that is involved in the genetic monitoring program, receives 
the results of the monitoring only in aggregate terms that 
do not disclose the identity of specific members. 
(c) PRESERVATION OF PROTECTIONS.—In the case of information 
to which any of paragraphs (1) through (5) of subsection (b) applies, 
such information may not be used in violation of paragraph (1), 
(2), or (3) of subsection (a) or treated or disclosed in a manner 
that violates section 206. 
SEC. 205. TRAINING PROGRAMS. 
(a) DISCRIMINATION BASED ON GENETIC INFORMATION.—It shall 
be an unlawful employment practice for any employer, labor 
organization, or joint labor-management committee controlling 
apprenticeship or other training or retraining, including on-the- 
job training programs— 
(1) to discriminate against any individual because of genetic 
information with respect to the individual in admission to, 
or employment in, any program established to provide 
apprenticeship or other training or retraining; 
42 USC 2000ff–4. 
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122 STAT. 912 
PUBLIC LAW 110–233—MAY 21, 2008 
(2) to limit, segregate, or classify the applicants for or 
participants in such apprenticeship or other training or 
retraining, or fail or refuse to refer for employment any indi-
vidual, in any way that would deprive or tend to deprive 
any individual of employment opportunities, or otherwise 
adversely affect the status of the individual as an employee, 
because of genetic information with respect to the individual; 
or 
(3) to cause or attempt to cause an employer to discriminate 
against an applicant for or a participant in such apprenticeship 
or other training or retraining in violation of this title. 
(b) ACQUISITION
OF GENETIC INFORMATION.—It shall be an 
unlawful employment practice for an employer, labor organization, 
or joint labor-management committee described in subsection (a) 
to request, require, or purchase genetic information with respect 
to an individual or a family member of the individual except— 
(1) where the employer, labor organization, or joint labor- 
management committee inadvertently requests or requires 
family medical history of the individual or family member of 
the individual; 
(2) where— 
(A) health or genetic services are offered by the 
employer, labor organization, or joint labor-management 
committee, including such services offered as part of a 
wellness program; 
(B) the individual provides prior, knowing, voluntary, 
and written authorization; 
(C) only the individual (or family member if the family 
member is receiving genetic services) and the licensed 
health care professional or board certified genetic counselor 
involved in providing such services receive individually 
identifiable information concerning the results of such serv-
ices; and 
(D) any individually identifiable genetic information 
provided under subparagraph (C) in connection with the 
services provided under subparagraph (A) is only available 
for purposes of such services and shall not be disclosed 
to the employer, labor organization, or joint labor-manage-
ment committee except in aggregate terms that do not 
disclose the identity of specific individuals; 
(3) where the employer, labor organization, or joint labor- 
management committee requests or requires family medical 
history from the individual to comply with the certification 
provisions of section 103 of the Family and Medical Leave 
Act of 1993 (29 U.S.C. 2613) or such requirements under State 
family and medical leave laws; 
(4) where the employer, labor organization, or joint labor- 
management committee purchases documents that are commer-
cially and publicly available (including newspapers, magazines, 
periodicals, and books, but not including medical databases 
or court records) that include family medical history; 
(5) where the information involved is to be used for genetic 
monitoring of the biological effects of toxic substances in the 
workplace, but only if— 
(A) the employer, labor organization, or joint labor- 
management committee provides written notice of the 
genetic monitoring to the individual; 
Notification. 
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122 STAT. 913 
PUBLIC LAW 110–233—MAY 21, 2008 
(B)(i) the individual provides prior, knowing, voluntary, 
and written authorization; or 
(ii) the genetic monitoring is required by Federal or 
State law; 
(C) the individual is informed of individual monitoring 
results; 
(D) the monitoring is in compliance with— 
(i) any Federal genetic monitoring regulations, 
including any such regulations that may be promul-
gated by the Secretary of Labor pursuant to the 
Occupational Safety and Health Act of 1970 (29 U.S.C. 
651 et seq.), the Federal Mine Safety and Health Act 
of 1977 (30 U.S.C. 801 et seq.), or the Atomic Energy 
Act of 1954 (42 U.S.C. 2011 et seq.); or 
(ii) State genetic monitoring regulations, in the 
case of a State that is implementing genetic monitoring 
regulations under the authority of the Occupational 
Safety and Health Act of 1970 (29 U.S.C. 651 et seq.); 
and 
(E) the employer, labor organization, or joint labor- 
management committee, excluding any licensed health care 
professional or board certified genetic counselor that is 
involved in the genetic monitoring program, receives the 
results of the monitoring only in aggregate terms that 
do not disclose the identity of specific individuals; or 
(6) where the employer conducts DNA analysis for law 
enforcement purposes as a forensic laboratory or for purposes 
of human remains identification, and requests or requires 
genetic information of such employer’s apprentices or trainees, 
but only to the extent that such genetic information is used 
for analysis of DNA identification markers for quality control 
to detect sample contamination. 
(c) PRESERVATION OF PROTECTIONS.—In the case of information 
to which any of paragraphs (1) through (6) of subsection (b) applies, 
such information may not be used in violation of paragraph (1), 
(2), or (3) of subsection (a) or treated or disclosed in a manner 
that violates section 206. 
SEC. 206. CONFIDENTIALITY OF GENETIC INFORMATION. 
(a) TREATMENT
OF INFORMATION
AS PART
OF CONFIDENTIAL 
MEDICAL RECORD.—If an employer, employment agency, labor 
organization, or joint labor-management committee possesses 
genetic information about an employee or member, such information 
shall be maintained on separate forms and in separate medical 
files and be treated as a confidential medical record of the employee 
or member. An employer, employment agency, labor organization, 
or joint labor-management committee shall be considered to be 
in compliance with the maintenance of information requirements 
of this subsection with respect to genetic information subject to 
this subsection that is maintained with and treated as a confidential 
medical record under section 102(d)(3)(B) of the Americans With 
Disabilities Act (42 U.S.C. 12112(d)(3)(B)). 
(b) LIMITATION
ON DISCLOSURE.—An employer, employment 
agency, labor organization, or joint labor-management committee 
shall not disclose genetic information concerning an employee or 
member except— 
42 USC 2000ff–5. 
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122 STAT. 914 
PUBLIC LAW 110–233—MAY 21, 2008 
(1) to the employee or member of a labor organization 
(or family member if the family member is receiving the genetic 
services) at the written request of the employee or member 
of such organization; 
(2) to an occupational or other health researcher if the 
research is conducted in compliance with the regulations and 
protections provided for under part 46 of title 45, Code of 
Federal Regulations; 
(3) in response to an order of a court, except that— 
(A) the employer, employment agency, labor organiza-
tion, or joint labor-management committee may disclose 
only the genetic information expressly authorized by such 
order; and 
(B) if the court order was secured without the knowl-
edge of the employee or member to whom the information 
refers, the employer, employment agency, labor organiza-
tion, or joint labor-management committee shall inform 
the employee or member of the court order and any genetic 
information that was disclosed pursuant to such order; 
(4) to government officials who are investigating compliance 
with this title if the information is relevant to the investigation; 
(5) to the extent that such disclosure is made in connection 
with the employee’s compliance with the certification provisions 
of section 103 of the Family and Medical Leave Act of 1993 
(29 U.S.C. 2613) or such requirements under State family and 
medical leave laws; or 
(6) to a Federal, State, or local public health agency only 
with regard to information that is described in section 
201(4)(A)(iii) and that concerns a contagious disease that pre-
sents an imminent hazard of death or life-threatening illness, 
and that the employee whose family member or family members 
is or are the subject of a disclosure under this paragraph 
is notified of such disclosure. 
(c) RELATIONSHIP TO HIPAA REGULATIONS.—With respect to 
the regulations promulgated by the Secretary of Health and Human 
Services under part C of title XI of the Social Security Act (42 
U.S.C. 1320d et seq.) and section 264 of the Health Insurance 
Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 note), 
this title does not prohibit a covered entity under such regulations 
from any use or disclosure of health information that is authorized 
for the covered entity under such regulations. The previous sentence 
does not affect the authority of such Secretary to modify such 
regulations. 
SEC. 207. REMEDIES AND ENFORCEMENT. 
(a) EMPLOYEES COVERED BY TITLE VII OF THE CIVIL RIGHTS 
ACT OF 1964.— 
(1) IN GENERAL.—The powers, procedures, and remedies 
provided in sections 705, 706, 707, 709, 710, and 711 of the 
Civil Rights Act of 1964 (42 U.S.C. 2000e–4 et seq.) to the 
Commission, the Attorney General, or any person, alleging 
a violation of title VII of that Act (42 U.S.C. 2000e et seq.) 
shall be the powers, procedures, and remedies this title provides 
to the Commission, the Attorney General, or any person, respec-
tively, alleging an unlawful employment practice in violation 
of this title against an employee described in section 
201(2)(A)(i), except as provided in paragraphs (2) and (3). 
42 USC 2000ff–6. 
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122 STAT. 915 
PUBLIC LAW 110–233—MAY 21, 2008 
(2) COSTS AND FEES.—The powers, remedies, and proce-
dures provided in subsections (b) and (c) of section 722 of 
the Revised Statutes of the United States (42 U.S.C. 1988), 
shall be powers, remedies, and procedures this title provides 
to the Commission, the Attorney General, or any person, 
alleging such a practice. 
(3) DAMAGES.—The powers, remedies, and procedures pro-
vided in section 1977A of the Revised Statutes of the United 
States (42 U.S.C. 1981a), including the limitations contained 
in subsection (b)(3) of such section 1977A, shall be powers, 
remedies, and procedures this title provides to the Commission, 
the Attorney General, or any person, alleging such a practice 
(not an employment practice specifically excluded from coverage 
under section 1977A(a)(1) of the Revised Statutes of the United 
States). 
(b) EMPLOYEES COVERED BY GOVERNMENT EMPLOYEE RIGHTS 
ACT OF 1991.— 
(1) IN GENERAL.—The powers, remedies, and procedures 
provided in sections 302 and 304 of the Government Employee 
Rights Act of 1991 (42 U.S.C. 2000e–16b, 2000e–16c) to the 
Commission, or any person, alleging a violation of section 
302(a)(1) of that Act (42 U.S.C. 2000e–16b(a)(1)) shall be the 
powers, remedies, and procedures this title provides to the 
Commission, or any person, respectively, alleging an unlawful 
employment practice in violation of this title against an 
employee described in section 201(2)(A)(ii), except as provided 
in paragraphs (2) and (3). 
(2) COSTS AND FEES.—The powers, remedies, and proce-
dures provided in subsections (b) and (c) of section 722 of 
the Revised Statutes of the United States (42 U.S.C. 1988), 
shall be powers, remedies, and procedures this title provides 
to the Commission, or any person, alleging such a practice. 
(3) DAMAGES.—The powers, remedies, and procedures pro-
vided in section 1977A of the Revised Statutes of the United 
States (42 U.S.C. 1981a), including the limitations contained 
in subsection (b)(3) of such section 1977A, shall be powers, 
remedies, and procedures this title provides to the Commission, 
or any person, alleging such a practice (not an employment 
practice specifically excluded from coverage under section 
1977A(a)(1) of the Revised Statutes of the United States). 
(c) EMPLOYEES COVERED BY CONGRESSIONAL ACCOUNTABILITY 
ACT OF 1995.— 
(1) IN GENERAL.—The powers, remedies, and procedures 
provided in the Congressional Accountability Act of 1995 (2 
U.S.C. 1301 et seq.) to the Board (as defined in section 101 
of that Act (2 U.S.C. 1301)), or any person, alleging a violation 
of section 201(a)(1) of that Act (42 U.S.C. 1311(a)(1)) shall 
be the powers, remedies, and procedures this title provides 
to that Board, or any person, alleging an unlawful employment 
practice in violation of this title against an employee described 
in section 201(2)(A)(iii), except as provided in paragraphs (2) 
and (3). 
(2) COSTS AND FEES.—The powers, remedies, and proce-
dures provided in subsections (b) and (c) of section 722 of 
the Revised Statutes of the United States (42 U.S.C. 1988), 
shall be powers, remedies, and procedures this title provides 
to that Board, or any person, alleging such a practice. 
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122 STAT. 916 
PUBLIC LAW 110–233—MAY 21, 2008 
(3) DAMAGES.—The powers, remedies, and procedures pro-
vided in section 1977A of the Revised Statutes of the United 
States (42 U.S.C. 1981a), including the limitations contained 
in subsection (b)(3) of such section 1977A, shall be powers, 
remedies, and procedures this title provides to that Board, 
or any person, alleging such a practice (not an employment 
practice specifically excluded from coverage under section 
1977A(a)(1) of the Revised Statutes of the United States). 
(4) OTHER APPLICABLE PROVISIONS.—With respect to a claim 
alleging a practice described in paragraph (1), title III of the 
Congressional Accountability Act of 1995 (2 U.S.C. 1381 et 
seq.) shall apply in the same manner as such title applies 
with respect to a claim alleging a violation of section 201(a)(1) 
of such Act (2 U.S.C. 1311(a)(1)). 
(d) EMPLOYEES COVERED BY CHAPTER 5 OF TITLE 3, UNITED 
STATES CODE.— 
(1) IN GENERAL.—The powers, remedies, and procedures 
provided in chapter 5 of title 3, United States Code, to the 
President, the Commission, the Merit Systems Protection 
Board, or any person, alleging a violation of section 411(a)(1) 
of that title, shall be the powers, remedies, and procedures 
this title provides to the President, the Commission, such 
Board, or any person, respectively, alleging an unlawful employ-
ment practice in violation of this title against an employee 
described in section 201(2)(A)(iv), except as provided in para-
graphs (2) and (3). 
(2) COSTS AND FEES.—The powers, remedies, and proce-
dures provided in subsections (b) and (c) of section 722 of 
the Revised Statutes of the United States (42 U.S.C. 1988), 
shall be powers, remedies, and procedures this title provides 
to the President, the Commission, such Board, or any person, 
alleging such a practice. 
(3) DAMAGES.—The powers, remedies, and procedures pro-
vided in section 1977A of the Revised Statutes of the United 
States (42 U.S.C. 1981a), including the limitations contained 
in subsection (b)(3) of such section 1977A, shall be powers, 
remedies, and procedures this title provides to the President, 
the Commission, such Board, or any person, alleging such a 
practice (not an employment practice specifically excluded from 
coverage under section 1977A(a)(1) of the Revised Statutes 
of the United States). 
(e) EMPLOYEES COVERED BY SECTION 717 OF THE CIVIL RIGHTS 
ACT OF 1964.— 
(1) IN GENERAL.—The powers, remedies, and procedures 
provided in section 717 of the Civil Rights Act of 1964 (42 
U.S.C. 2000e–16) to the Commission, the Attorney General, 
the Librarian of Congress, or any person, alleging a violation 
of that section shall be the powers, remedies, and procedures 
this title provides to the Commission, the Attorney General, 
the Librarian of Congress, or any person, respectively, alleging 
an unlawful employment practice in violation of this title 
against an employee or applicant described in section 
201(2)(A)(v), except as provided in paragraphs (2) and (3). 
(2) COSTS AND FEES.—The powers, remedies, and proce-
dures provided in subsections (b) and (c) of section 722 of 
the Revised Statutes of the United States (42 U.S.C. 1988), 
shall be powers, remedies, and procedures this title provides 
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122 STAT. 917 
PUBLIC LAW 110–233—MAY 21, 2008 
to the Commission, the Attorney General, the Librarian of 
Congress, or any person, alleging such a practice. 
(3) DAMAGES.—The powers, remedies, and procedures pro-
vided in section 1977A of the Revised Statutes of the United 
States (42 U.S.C. 1981a), including the limitations contained 
in subsection (b)(3) of such section 1977A, shall be powers, 
remedies, and procedures this title provides to the Commission, 
the Attorney General, the Librarian of Congress, or any person, 
alleging such a practice (not an employment practice specifically 
excluded from coverage under section 1977A(a)(1) of the Revised 
Statutes of the United States). 
(f) PROHIBITION
AGAINST
RETALIATION.—No person shall 
discriminate against any individual because such individual has 
opposed any act or practice made unlawful by this title or because 
such individual made a charge, testified, assisted, or participated 
in any manner in an investigation, proceeding, or hearing under 
this title. The remedies and procedures otherwise provided for under 
this section shall be available to aggrieved individuals with respect 
to violations of this subsection. 
(g) DEFINITION.—In this section, the term ‘‘Commission’’ means 
the Equal Employment Opportunity Commission. 
SEC. 208. DISPARATE IMPACT. 
(a) GENERAL RULE.—Notwithstanding any other provision of 
this Act, ‘‘disparate impact’’, as that term is used in section 703(k) 
of the Civil Rights Act of 1964 (42 U.S.C. 2000e–2(k)), on the 
basis of genetic information does not establish a cause of action 
under this Act. 
(b) COMMISSION.—On the date that is 6 years after the date 
of enactment of this Act, there shall be established a commission, 
to be known as the Genetic Nondiscrimination Study Commission 
(referred to in this section as the ‘‘Commission’’) to review the 
developing science of genetics and to make recommendations to 
Congress regarding whether to provide a disparate impact cause 
of action under this Act. 
(c) MEMBERSHIP.— 
(1) IN GENERAL.—The Commission shall be composed of 
8 members, of which— 
(A) 1 member shall be appointed by the Majority 
Leader of the Senate; 
(B) 1 member shall be appointed by the Minority 
Leader of the Senate; 
(C) 1 member shall be appointed by the Chairman 
of the Committee on Health, Education, Labor, and Pen-
sions of the Senate; 
(D) 1 member shall be appointed by the ranking 
minority member of the Committee on Health, Education, 
Labor, and Pensions of the Senate; 
(E) 1 member shall be appointed by the Speaker of 
the House of Representatives; 
(F) 1 member shall be appointed by the Minority 
Leader of the House of Representatives; 
(G) 1 member shall be appointed by the Chairman 
of the Committee on Education and Labor of the House 
of Representatives; and 
Effective date. 
Establishment. 
42 USC 2000ff–7. 
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122 STAT. 918 
PUBLIC LAW 110–233—MAY 21, 2008 
(H) 1 member shall be appointed by the ranking 
minority member of the Committee on Education and Labor 
of the House of Representatives. 
(2) COMPENSATION AND EXPENSES.—The members of the 
Commission shall not receive compensation for the performance 
of services for the Commission, but shall be allowed travel 
expenses, including per diem in lieu of subsistence, at rates 
authorized for employees of agencies under subchapter I of 
chapter 57 of title 5, United States Code, while away from 
their homes or regular places of business in the performance 
of services for the Commission. 
(d) ADMINISTRATIVE PROVISIONS.— 
(1) LOCATION.—The Commission shall be located in a 
facility maintained by the Equal Employment Opportunity 
Commission. 
(2) DETAIL
OF
GOVERNMENT
EMPLOYEES.—Any Federal 
Government employee may be detailed to the Commission with-
out reimbursement, and such detail shall be without interrup-
tion or loss of civil service status or privilege. 
(3) INFORMATION FROM FEDERAL AGENCIES.—The Commis-
sion may secure directly from any Federal department or agency 
such information as the Commission considers necessary to 
carry out the provisions of this section. Upon request of the 
Commission, the head of such department or agency shall fur-
nish such information to the Commission. 
(4) HEARINGS.—The Commission may hold such hearings, 
sit and act at such times and places, take such testimony, 
and receive such evidence as the Commission considers advis-
able to carry out the objectives of this section, except that, 
to the extent possible, the Commission shall use existing data 
and research. 
(5) POSTAL SERVICES.—The Commission may use the United 
States mails in the same manner and under the same conditions 
as other departments and agencies of the Federal Government. 
(e) REPORT.—Not later than 1 year after all of the members 
are appointed to the Commission under subsection (c)(1), the 
Commission shall submit to Congress a report that summarizes 
the findings of the Commission and makes such recommendations 
for legislation as are consistent with this Act. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to the Equal Employment Opportunity Commis-
sion such sums as may be necessary to carry out this section. 
SEC. 209. CONSTRUCTION. 
(a) IN GENERAL.—Nothing in this title shall be construed to— 
(1) limit the rights or protections of an individual under 
any other Federal or State statute that provides equal or 
greater protection to an individual than the rights or protections 
provided for under this title, including the protections of an 
individual under the Americans with Disabilities Act of 1990 
(42 U.S.C. 12101 et seq.) (including coverage afforded to individ-
uals under section 102 of such Act (42 U.S.C. 12112)), or 
under the Rehabilitation Act of 1973 (29 U.S.C. 701 et seq.); 
(2)(A) limit the rights or protections of an individual to 
bring an action under this title against an employer, employ-
ment agency, labor organization, or joint labor-management 
committee for a violation of this title; or 
42 USC 2000ff–8. 
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122 STAT. 919 
PUBLIC LAW 110–233—MAY 21, 2008 
(B) provide for enforcement of, or penalties for violation 
of, any requirement or prohibition applicable to any employer, 
employment agency, labor organization, or joint labor-manage-
ment committee subject to enforcement for a violation under— 
(i) the amendments made by title I of this Act; 
(ii)(I) subsection (a) of section 701 of the Employee 
Retirement Income Security Act of 1974 as such section 
applies with respect to genetic information pursuant to 
subsection (b)(1)(B) of such section; 
(II) section 702(a)(1)(F) of such Act; or 
(III) section 702(b)(1) of such Act as such section 
applies with respect to genetic information as a health 
status-related factor; 
(iii)(I) subsection (a) of section 2701 of the Public 
Health Service Act as such section applies with respect 
to genetic information pursuant to subsection (b)(1)(B) of 
such section; 
(II) section 2702(a)(1)(F) of such Act; or 
(III) section 2702(b)(1) of such Act as such section 
applies with respect to genetic information as a health 
status-related factor; or 
(iv)(I) subsection (a) of section 9801 of the Internal 
Revenue Code of 1986 as such section applies with respect 
to genetic information pursuant to subsection (b)(1)(B) of 
such section; 
(II) section 9802(a)(1)(F) of such Act; or 
(III) section 9802(b)(1) of such Act as such section 
applies with respect to genetic information as a health 
status-related factor; 
(3) apply to the Armed Forces Repository of Specimen 
Samples for the Identification of Remains; 
(4) limit or expand the protections, rights, or obligations 
of employees or employers under applicable workers’ compensa-
tion laws; 
(5) limit the authority of a Federal department or agency 
to conduct or sponsor occupational or other health research 
that is conducted in compliance with the regulations contained 
in part 46 of title 45, Code of Federal Regulations (or any 
corresponding or similar regulation or rule); 
(6) limit the statutory or regulatory authority of the 
Occupational Safety and Health Administration or the Mine 
Safety and Health Administration to promulgate or enforce 
workplace safety and health laws and regulations; or 
(7) require any specific benefit for an employee or member 
or a family member of an employee or member under any 
group health plan or health insurance issuer offering group 
health insurance coverage in connection with a group health 
plan. 
(b) GENETIC INFORMATION OF A FETUS OR EMBRYO.—Any ref-
erence in this title to genetic information concerning an individual 
or family member of an individual shall— 
(1) with respect to such an individual or family member 
of an individual who is a pregnant woman, include genetic 
information of any fetus carried by such pregnant woman; 
and 
Applicability. 
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122 STAT. 920 
PUBLIC LAW 110–233—MAY 21, 2008 
(2) with respect to an individual or family member utilizing 
an assisted reproductive technology, include genetic information 
of any embryo legally held by the individual or family member. 
(c) RELATION TO AUTHORITIES UNDER TITLE I.—With respect 
to a group health plan, or a health insurance issuer offering group 
health insurance coverage in connection with a group health plan, 
this title does not prohibit any activity of such plan or issuer 
that is authorized for the plan or issuer under any provision of 
law referred to in clauses (i) through (iv) of subsection (a)(2)(B). 
SEC. 210. MEDICAL INFORMATION THAT IS NOT GENETIC INFORMA-
TION. 
An employer, employment agency, labor organization, or joint 
labor-management committee shall not be considered to be in viola-
tion of this title based on the use, acquisition, or disclosure of 
medical information that is not genetic information about a mani-
fested disease, disorder, or pathological condition of an employee 
or member, including a manifested disease, disorder, or pathological 
condition that has or may have a genetic basis. 
SEC. 211. REGULATIONS. 
Not later than 1 year after the date of enactment of this 
title, the Commission shall issue final regulations to carry out 
this title. 
SEC. 212. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to be appropriated such sums as may 
be necessary to carry out this title (except for section 208). 
SEC. 213. EFFECTIVE DATE. 
This title takes effect on the date that is 18 months after 
the date of enactment of this Act. 
TITLE III—MISCELLANEOUS 
PROVISIONS 
SEC. 301. SEVERABILITY. 
If any provision of this Act, an amendment made by this 
Act, or the application of such provision or amendment to any 
person or circumstance is held to be unconstitutional, the remainder 
of this Act, the amendments made by this Act, and the application 
of such provisions to any person or circumstance shall not be 
affected thereby. 
SEC. 302. CHILD LABOR PROTECTIONS. 
(a) IN GENERAL.—Section 16(e) of the Fair Labor Standards 
Act of 1938 (29 U.S.C. 216(e)) is amended to read as follows: 
‘‘(e)(1)(A) Any person who violates the provisions of sections 
12 or 13(c), relating to child labor, or any regulation issued pursuant 
to such sections, shall be subject to a civil penalty not to exceed— 
‘‘(i) $11,000 for each employee who was the subject 
of such a violation; or 
‘‘(ii) $50,000 with regard to each such violation 
that causes the death or serious injury of any employee 
under the age of 18 years, which penalty may be dou-
bled where the violation is a repeated or willful viola-
tion. 
Penalties. 
42 USC 2000ff 
note. 
42 USC 2000ff 
note. 
42 USC 
2000ff–11. 
Deadline. 
42 USC 
2000ff–10. 
42 USC 2000ff–9. 
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122 STAT. 921 
PUBLIC LAW 110–233—MAY 21, 2008 
‘‘(B) For purposes of subparagraph (A), the term ‘serious injury’ 
means— 
‘‘(i) permanent loss or substantial impairment of one of 
the senses (sight, hearing, taste, smell, tactile sensation); 
‘‘(ii) permanent loss or substantial impairment of the func-
tion of a bodily member, organ, or mental faculty, including 
the loss of all or part of an arm, leg, foot, hand or other 
body part; or 
‘‘(iii) permanent paralysis or substantial impairment that 
causes loss of movement or mobility of an arm, leg, foot, hand 
or other body part. 
‘‘(2) Any person who repeatedly or willfully violates section 
6 or 7, relating to wages, shall be subject to a civil penalty not 
to exceed $1,100 for each such violation. 
‘‘(3) In determining the amount of any penalty under this 
subsection, the appropriateness of such penalty to the size of the 
business of the person charged and the gravity of the violation 
shall be considered. The amount of any penalty under this sub-
section, when finally determined, may be— 
‘‘(A) deducted from any sums owing by the United States 
to the person charged; 
‘‘(B) recovered in a civil action brought by the Secretary 
in any court of competent jurisdiction, in which litigation the 
Secretary shall be represented by the Solicitor of Labor; or 
‘‘(C) ordered by the court, in an action brought for a viola-
tion of section 15(a)(4) or a repeated or willful violation of 
section 15(a)(2), to be paid to the Secretary. 
‘‘(4) Any administrative determination by the Secretary of the 
amount of any penalty under this subsection shall be final, unless 
within 15 days after receipt of notice thereof by certified mail 
the person charged with the violation takes exception to the deter-
mination that the violations for which the penalty is imposed 
occurred, in which event final determination of the penalty shall 
be made in an administrative proceeding after opportunity for 
hearing in accordance with section 554 of title 5, United States 
Code, and regulations to be promulgated by the Secretary. 
‘‘(5) Except for civil penalties collected for violations of section 
12, sums collected as penalties pursuant to this section shall be 
applied toward reimbursement of the costs of determining the viola-
tions and assessing and collecting such penalties, in accordance 
with the provision of section 2 of the Act entitled ‘An Act to 
authorize the Department of Labor to make special statistical 
studies upon payment of the cost thereof and for other purposes’ 
(29 U.S.C. 9a). Civil penalties collected for violations of section 
12 shall be deposited in the general fund of the Treasury.’’. 
Deadline. 
Notification. 
Regulations. 
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122 STAT. 922 
PUBLIC LAW 110–233—MAY 21, 2008 
LEGISLATIVE HISTORY—H.R. 493 (S. 358): 
HOUSE REPORTS: No. 110–28, Pt. 1 (Comm. on Education and Labor), Pt. 2 
(Comm. on Ways and Means), and Pts. 3 and 4 (Comm. on En-
ergy and Commerce). 
SENATE REPORTS: No. 110–48 accompanying S. 358 (Comm. on Health, Edu-
cation, Labor, and Pensions). 
CONGRESSIONAL RECORD: 
Vol. 153 (2007): Apr. 25, considered and passed House. 
Vol. 154 (2008): Apr. 24, considered and passed Senate, amended. 
May 1, House concurred in Senate amendment. 
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 44 (2008): 
May 21, Presidential remarks. 
(b) EFFECTIVE DATE.—The amendments made by this section 
shall take effect on the date of the enactment of this Act. 
Approved May 21, 2008. 
29 USC 216 note. 
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