AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986.

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 Revenue 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 subparagraph (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 Collection of Genetic Information; Application to All Plans.—Section 9802 of such Code is amended by redesignating subsection (c) as subsection (f) and by inserting after subsection (b) the following 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 determination 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).122 STAT. 897“(B) Limitation.—For purposes of subparagraph (A), 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 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 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 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 enrollment 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 conducted 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 purposes (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 reference in this chapter 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 122 STAT. 898 information of any fetus carried by such pregnant woman; and“(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.”.(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 individual 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 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 individual.“(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 chromosomal 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, interpreting, 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—122 STAT. 899“(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 exclusion 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 section 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.