Order Code RL33988
Genetic Nondiscrimination in Health Insurance:
A Side-by-Side Comparison of the Title I
Provisions in H.R. 493 and S. 358
May 2, 2007
C. Stephen Redhead
Specialist in Life Sciences
Domestic Social Policy Division

---

Genetic Nondiscrimination in Health Insurance:
A Side-by-Side Comparison of the Title I Provisions
in H.R. 493 and S. 358
Summary
On April 25, the House passed the Genetic Information Nondiscrimination Act
of 2007, H.R. 493, on a vote of 420-3. The Senate Health, Education, Labor, and
Pensions (HELP) Committee approved similar legislation (S. 358). S. 358 is
awaiting Senate floor action. The Genetic Information Nondiscrimination Act
would restrict health insurers’ (Title I) and employers’ (Title II) acquisition and use
of genetic information in several ways. These restrictions build upon those already
imposed in federal law.
This report provides a comparison of the Title I provisions in H.R. 493 and S.
358. Those provisions would extend the current Health Insurance Portability and
Accountability Act (HIPAA) protections against discrimination by group health plans
and issuers of health insurance in both the group and individual markets, and restrict
their collection, use and disclosure of genetic information. A separate CRS Report,
RL33987, Genetic Non-discrimination in Employment: A Comparison of Title II
Provisions in S. 358 and H.R. 493, 110th Congress, by Nancy Lee Jones, discusses
the Title II employment provisions.

---

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Overview of Title I Provisions in H.R. 493 and S. 358 . . . . . . . . . . . . . . . . . . . . . 1
List of Tables
Table 1. Genetic Nondiscrimination in Health Insurance:
H.R. 493 (Title I) vs. S. 358 (Title I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

---

Genetic Nondiscrimination in Health
Insurance: A Side-by-Side Comparison of
the Title I Provisions in H.R. 493 and S. 358
Introduction
On April 25, the House passed the Genetic Information Nondiscrimination Act
of 2007, H.R. 493, on a vote of 420-3. Earlier, the measure was reported by the
Education and Labor Committee (H.Rept. 110-28, Part I), the Ways and Means
Committee (H.Rept. 110-28, Part II), and the Energy and Commerce Committee
(H.Rept. 110-28, Parts III & IV). The Senate Health, Education, Labor, and Pensions
(HELP) Committee approved similar legislation (S. 358) on March 29, and filed its
report (S.Rept. 110-48) on April 10. S. 358 is awaiting Senate floor action. The
Genetic Information Nondiscrimination Act would restrict health insurers’ and
employers’ acquisition and use of genetic information in several ways. These
restrictions build upon those already imposed in federal law.
Overview of Title I Provisions in H.R. 493 and S. 358
Title 1 of H.R. 493 / S. 358 would extend the current Health Insurance
Portability and Accountability Act (HIPAA) protections against discrimination by
group health plans and issuers of health insurance in both the group and individual
markets, and restrict their acquisition, use and disclosure of genetic information. The
HIPAA nondiscrimination provisions appear in three separate statutes: (1) the
Employee Retirement Income Security Act (ERISA, Part 7), which regulates
employee benefit plans, including employer-sponsored group health plans; (2) the
Internal Revenue Code (IRC, Chapter 100), which also covers group health plans
(using a slightly broader definition than ERISA); and (3) the Public Health Service
Act (PHSA, Title XVII), which applies to insurance companies and managed care
organizations, and to non-federal government health plans. H.R. 493, but not S. 358,
would amend the HIPAA nondiscrimination provisions in all three statutes, as well
as amending comparable provisions in the Medicare statute (Social Security Act Title
XVIII) relating to supplementary health insurance benefits (Medigap).
Table 1, beginning on page 3, provides a side-by-side comparison of the two
bills, using the House-passed measure as the referent. The table only includes the
provisions in Title I (Genetic Nondiscrimination in Health Insurance). A separate
CRS Report, RL33987, Genetic Non-discrimination in Employment: A Comparison
of Title II Provisions in S. 358 and H.R. 493, 110th Congress, by Nancy Lee Jones,
discusses the Title II employment provisions.

---

CRS-2
While the Title I provisions in the two bills are broadly similar there are a
number of significant differences, including the following.
! Whereas H.R. 493 would amend the four federal statutes (i.e.,
ERISA, IRC, PHSA, and Medigap), S. 358 would amend only three;
it does not include any provisions to amend IRC.
! H.R. 493, but not S. 358, includes a provision relating to the genetic
information of a fetus or embryo. It provides that references to
genetic information include genetic information on a fetus carried by
a pregnant woman and, with respect to an individual utilizing
assisted reproductive technology, includes genetic information of
any embryo legally held by the individual or family member.
! In H.R. 493, language that prohibits the collection of genetic
information by health plans and insurers for the purposes of
underwriting and related activities appears in each of the four
sections amending federal law. Comparable language in S. 358
appears only once in the privacy section (Sec. 104).
! Whereas both bills include provisions that would allow the relevant
Secretary (Labor, Treasury, HHS) to impose the same monetary
penalties for violations of the Title’s nondiscrimination provisions,
S. 358 includes additional remedies and enforcement provisions in
its amendments to ERISA.

---

CRS-3
Table 1. Genetic Nondiscrimination in Health Insurance: H.R. 493 (Title I) vs. S. 358 (Title I)
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Amendments to ERISA Part 7 (Group Market Requirements) — Section 101
No provision.
Clarifies that the ERISA provision prohibiting group health plans and insurance
issuers from denying an individual eligibility to enroll in a group based on that
individual’s genetic information includes information about a request for or
receipt of genetic services by that individual or a family member.
Prohibits group health plans and insurance issuers from adjusting a group’s
Prohibits group health plans and insurance issuers from adjusting a group’s
premium on the basis of genetic information.
premium based on an individual’s (or family member’s) genetic information,
including information about a request for or receipt of genetic services by that
individual or a family member.
Prohibits group health plans and insurance issuers from requesting or requiring
Prohibits group health plans and insurance issuers from requesting or requiring
that an individual or a family member of such individual undergo a genetic test.
that an individual or a family member of such individual undergo a genetic test.
Does not limit the authority of a health care professional who is providing health
Does not limit the authority of a health care professional who is providing health
care to an individual to request that the individual undergo a genetic test. Does
care to an individual to request that the individual (or a family member) undergo
not preclude a group health plan or insurance issuer from obtaining and using
a genetic test. Does not limit the authority of a health care professional employed
genetic test information for payment determinations (only the minimum amount
by or affiliated with a group health plan or insurance issuer, and who is providing
of information necessary to accomplish the intended purpose may be requested).
health care services to an individual as part of a wellness program, to notify such
Permits a group health plan or insurance issuer to request, but not require, that an
individual about the availability of a genetic test. Does not permit a health care
individual voluntarily undergo a genetic test as part of a research project.
professional to require that an individual undergo a genetic test.
Prohibits group health plans and insurance insurers from requesting, requiring, or
[Note: comparable language prohibiting the collection of genetic information is in
purchasing genetic information for the purposes of underwriting, eligibility
Section 104 (Privacy and Confidentiality) of S. 358; see below.]
determination (before or during the enrollment process), premium rating, or other
activities related to the creation, renewal, or replacement of a health insurance
plan or contract. Obtaining genetic information incidental to the acquisition of
other information would not be considered a violation.
Applies the above nondiscrimination provisions to all group health plans.
Applies the above nondiscrimination provisions to all group health plans.
Clarifies that any reference to genetic information about an individual or family
No provisions.
member who is pregnant shall include genetic information about the fetus.
Clarifies that any reference to genetic information about an individual or family
member using assisted reproductive technology shall include genetic information
about any fetus legally held by that individual or family member.

---

CRS-4
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Defines family member to include an individual’s dependent through marriage,
Defines family member to include an individual’s spouse and dependent children
birth, or adoption or placement for adoption, as well as any first-, second-, third-,
(including those born to or placed for adoption with the individual), as well as all
or fourth-degree relative of the individual or dependent.
others related by blood to the individual, the spouse, or the dependent or adopted
children.
Defines genetic information as information about an individual’s genetic tests, or
Defines genetic information as information about an individual’s genetic tests, or
those of family members, as well as information about family members’ manifest
those of family members, as well as information about the occurrence of a disease
diseases or disorders, to the extent that such information is taken into account as
or disorder in family members. Does not include age and sex of individual.
genetic information about other individuals. The term genetic information also
includes any request for, or receipt of, genetic services (defined below) by an
individual or family member. Does not include age and sex of individual.
Defines genetic test as an analysis of DNA, RNA, chromosomes, proteins, or
Same provisions.
metabolites that detects genotypes, mutations, or chromosomal changes. Genetic
test does not include an analysis of proteins or metabolites that is directly related
to a manifest disease, disorder or pathological condition.
Defines genetic services as a genetic test, genetic counseling, or genetic
Same provisions.
education.
Authorizes the Labor Secretary to impose monetary penalties, subject to certain
Same provisions.
conditions, for violation of the above nondiscrimination provisions. [Note: these
penalties are the same as the tax penalties in Section 4980D of the IRC.]
No provisions.
Provides for injunctive relief prior to the exhaustion of available administrative
remedies if the preponderance of evidence shows that the exhaustion of such
remedies would cause irreparable harm to the health of the participant or
beneficiary.
No provisions.
Provides for administrative penalties of $100 per day and the retroactive
reinstatement of coverage for violations of the above nondiscrimination
provisions.
Requires the Labor Secretary to issue final implementing regulations within one
Same provisions.
year. Amendments apply to plan years beginning after 18 months from
enactment.

---

CRS-5
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Amendments to the Public Health Service Act Title XVII (Group Market Requirements) — Section 102(a)
No provision.
Clarifies that the PHS Act provision prohibiting group health plans and insurance
issuers from denying an individual eligibility to enroll in a group based on that
individual’s genetic information includes information about a request for or
receipt of genetic services by that individual or a family member.
Prohibits group health plans and insurance issuers from adjusting a group’s
Prohibits group health plans and insurance issuers from adjusting a group’s
premium on the basis of genetic information.
premium based on an individual’s (or family member’s) genetic information,
including information about a request for or receipt of genetic services by that
individual or a family member.
Prohibits group health plans and insurance issuers from requesting or requiring
Prohibits group health plans and insurance issuers from requesting or requiring
that an individual or a family member of such individual undergo a genetic test.
that an individual or a family member of such individual undergo a genetic test.
Does not limit the authority of a health care professional who is providing health
Does not limit the authority of a health care professional who is providing health
care to an individual to request that the individual undergo a genetic test. Does
care to an individual to request that the individual (or a family member) undergo
not preclude a group health plan or insurance issuer from obtaining and using
a genetic test. Does not limit the authority of a health care professional employed
genetic test information for payment determinations (only the minimum amount
by or affiliated with a group health plan or insurance issuer, and who is providing
of information necessary to accomplish the intended purpose may be requested).
health care services to an individual as part of a wellness program, to notify such
Permits a group health plan or insurance issuer to request, but not require, that an
individual about the availability of a genetic test. Does not permit a health care
individual voluntarily undergo a genetic test as part of a research project.
professional to require that an individual undergo a genetic test.
Prohibits group health plans and insurance issuers from requesting, requiring, or
[Note: comparable language prohibiting the collection of genetic information is in
purchasing genetic information for the purposes of underwriting, eligibility
Section 104 (Privacy and Confidentiality) of S. 358; see below.]
determination (before or during the enrollment process), premium rating, or other
activities related to the creation, renewal, or replacement of a health insurance
plan or contract. Obtaining genetic information incidental to the acquisition of
other information would not be considered a violation.
Applies the above nondiscrimination provisions to all group health plans.
Applies the above nondiscrimination provisions to all group health plans.
Clarifies that any reference to genetic information about an individual or family
No provisions.
member who is pregnant shall include genetic information about the fetus.
Clarifies that any reference to genetic information about an individual or family
member using assisted reproductive technology shall include genetic information
about any fetus legally held by that individual or family member.
Defines family member to include an individual’s dependent through marriage,
Defines family member to include an individual’s spouse and dependent children
birth, or adoption or placement for adoption, as well as any first-, second-, third-,
(including those born to or placed for adoption with the individual), as well as all
or fourth-degree relative of the individual or dependent.
others related by blood to the individual, the spouse, or the dependent or adopted
children.

---

CRS-6
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Defines genetic information as information about an individual’s genetic tests, or
Defines genetic information as information about an individual’s genetic tests, or
those of family members, as well as information about family members’ manifest
those of family members, as well as information about the occurrence of a disease
diseases or disorders, to the extent that such information is taken into account as
or disorder in family members. Does not include age and sex of individual.
genetic information about other individuals. The term genetic information also
includes any request for, or receipt of, genetic services (defined below) by an
individual or family member. Does not include age and sex of individual.
Defines genetic test as an analysis of DNA, RNA, chromosomes, proteins, or
Same provisions.
metabolites that detects genotypes, mutations, or chromosomal changes. Genetic
test does not include an analysis of proteins or metabolites that is directly related
to a manifest disease, disorder or pathological condition.
Defines genetic services as a genetic test, genetic counseling, or genetic
Same provisions.
education.
Authorizes the HHS Secretary to impose monetary penalties, subject to certain
Same provisions.
conditions, for violation of the above nondiscrimination provisions. Note: these
penalties are the same as the tax penalties in Section 4980D of the IRC.
Requires the HHS Secretary to issue final implementing regulations within one
Same provisions.
year. Amendments apply to plan years beginning after 18 months from
enactment.
Amendments to the Public Health Service Act Title XVII (Individual Market Requirements) — Section 102(b)
Prohibits insurance issuers from denying eligibility, adjusting premiums, or
Prohibits insurance issuers from denying eligibility or adjusting premiums based
imposing any preexisting condition exclusion on the basis of genetic information.
on an individual’s (or family member’s) genetic information, including
information about a request for or receipt of genetic services by that individual or
a family member.
Prohibits insurance issuers from requesting or requiring that an individual or a
Prohibits insurance issuers from requesting or requiring that an individual or a
family member of such individual undergo a genetic test. Does not limit the
family member of such individual undergo a genetic test. Does not limit the
authority of a health care professional who is providing health care to an
authority of a health care professional who is providing health care to an
individual to request that the individual undergo a genetic test. Does not preclude
individual to request that the individual (or a family member) undergo a genetic
a group health plan or insurance issuer from obtaining and using genetic test
test. Does not limit the authority of a health care professional employed by or
information for payment determinations (only the minimum amount of
affiliated with a health plan or insurance issuer, and who is providing health care
information necessary to accomplish the intended purpose may be requested).
services to an individual as part of a wellness program, to notify such individual
Permits a group health plan or insurance issuer to request, but not require, that an
about the availability of a genetic test. Does not permit a health care professional
individual voluntarily undergo a genetic test as part of a research project.
to require that an individual undergo a genetic test.

---

CRS-7
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Prohibits insurance issuers from requesting, requiring, or purchasing genetic
[Note: comparable language prohibiting the collection of genetic information is in
information for the purposes of underwriting, eligibility determination (before or
Section 104 (Privacy and Confidentiality) of S. 358; see below.]
during the enrollment process), premium rating, or other activities related to the
creation, renewal, or replacement of a health insurance plan or contract.
Obtaining genetic information incidental to the acquisition of other information
would not be considered a violation.
Clarifies that any reference to genetic information about an individual or family
No provisions.
member who is pregnant shall include genetic information about the fetus.
Clarifies that any reference to genetic information about an individual or family
member using assisted reproductive technology shall include genetic information
about any fetus legally held by that individual or family member.
For violations of the above nondiscrimination provisions, grants the HHS
Same provisions.
Secretary the same enforcement authority with respect to insurance issuers in the
individual market as the Secretary has for violations by insurance issuers in the
small group market.
Eliminates the option of non-federal government plans to be excepted from the
Same provision.
above genetic nondiscrimination provisions.
Requires the HHS Secretary to issue final implementing regulations within one
Same provisions.
year. Amendments apply to insurance coverage offered, sold, issued, renewed, or
in effect beginning 18 months after enactment.
Amendments to the Internal Revenue Code Chapter 100 (Group Health Plan Requirements) — Section 103
Prohibits group health plans from adjusting a group’s premium on the basis of
No provision.
genetic information.
Prohibits group health plans from requesting or requiring that an individual or a
No provisions.
family member of such individual undergo a genetic test. Does not limit the
authority of a health care professional who is providing health care to an
individual to request that the individual undergo a genetic test. Does not preclude
a group health plan from obtaining and using genetic test information for
payment determinations (only the minimum amount of information necessary to
accomplish the intended purpose may be requested). Permits a group health plan
to request, but not require, that an individual voluntarily undergo a genetic test as
part of a research project.

---

CRS-8
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Prohibits group health plans from requesting, requiring, or purchasing genetic
No provisions.
information for the purposes of underwriting, eligibility determination (before or
during the enrollment process), premium rating, or other activities related to the
creation, renewal, or replacement of a health insurance plan or contract.
Obtaining genetic information incidental to the acquisition of other information
would not be considered a violation.
Applies the above nondiscrimination provisions to all group health plans.
No provision.
Clarifies that any reference to genetic information about an individual or family
No provisions.
member who is pregnant shall include genetic information about the fetus.
Clarifies that any reference to genetic information about an individual or family
member using assisted reproductive technology shall include genetic information
about any fetus legally held by that individual or family member.
Defines family member to include an individual’s dependent through marriage,
No provisions.
birth, or adoption or placement for adoption, as well as any first-, second-, third-,
or fourth-degree relative of the individual or dependent.
Defines genetic information as information about an individual’s genetic tests, or
No provisions.
those of family members, as well as information about family members’ manifest
diseases or disorders, to the extent that such information is taken into account as
genetic information about other individuals. The term genetic information also
includes any request for, or receipt of, genetic services (defined below) by an
individual or family member. Does not include age and sex of individual.
Defines genetic test as an analysis of DNA, RNA, chromosomes, proteins, or
No provisions.
metabolites that detects genotypes, mutations, or chromosomal changes. Genetic
test does not include an analysis of proteins or metabolites that is directly related
to a manifest disease, disorder or pathological condition.
Defines genetic services as a genetic test, genetic counseling, or genetic
No provisions.
education.
Clarifies that group health plans that fail to meet the requirements set out in
No provisions.
Chapter 100 of the IRC, which include the above nondiscrimination provisions,
will be subject to the tax penalties in Section 4980D of the IRC.
Requires the Treasury Secretary to issue final implementing regulations within
No provisions.
one year. Amendments apply to plan years beginning at least 18 months after
enactment.

---

CRS-9
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Amendments to Social Security Act Title XVIII (Medicare) Relating to Medigap — Section 104 (H.R. 493), Section 103 (S. 358)
Prohibits an issuer of a Medigap policy from: (1) denying or conditioning the
Prohibits an issuer of a Medigap policy from: (1) denying or conditioning the
issuance or effectiveness of a policy; or (2) discriminating in the pricing of a
issuance or effectiveness of a policy, or (2) discriminating in the pricing of a
policy, on the basis of genetic information.
policy, based on an individual’s (or family member’s) genetic information,
including information about a request for or receipt of genetic services by that
individual or a family member.
Prohibits an issuer of a Medigap policy from requesting or requiring that an
Prohibits an issuer of a Medigap policy from requesting or requiring that an
individual or a family member of such individual undergo a genetic test. Does
individual or a family member undergo a genetic test. Does not limit the
not limit the authority of a health care professional who is providing health care
authority of a health care professional who is providing health care to an
to an individual to request that the individual undergo a genetic test. Does not
individual to request that the individual (or a family member) undergo a genetic
preclude an issuer of a Medigap policy from obtaining and using genetic test
test. Does not limit the authority of a health care professional employed by or
information for payment determinations (only the minimum amount of
affiliated with a health plan or insurance issuer, and who is providing health care
information necessary to accomplish the intended purpose may be requested).
services to an individual as part of a wellness program, to notify such individual
Permits an issuer of a Medigap policy to request, but not require, that an
about the availability of a genetic test. Does not permit a health care professional
individual voluntarily undergo a genetic test as part of a research project.
to require that an individual undergo a genetic test.
Prohibits an issuer of a Medigap policy from requesting, requiring, or purchasing
[Note: comparable language prohibiting the collection of genetic information is in
genetic information for the purposes of underwriting, eligibility determination
Section 104 (Privacy and Confidentiality) of S. 358; see below.]
(before or during the enrollment process), premium rating, or other activities
related to the creation, renewal, or replacement of a health insurance plan or
contract. Obtaining genetic information incidental to the acquisition of other
information would not be considered a violation.
Defines family member to include any first-, second-, third-, or fourth-degree
Defines family member to include an individual’s spouse and dependent children
relative of the individual.
(including those born to or placed for adoption with the individual), as well as all
others related by blood to the individual, the spouse, or the dependent or adopted
children.
Defines genetic information as information about an individual’s genetic tests, or
Defines genetic information as information about an individual’s genetic tests, or
those of family members, as well as information about family members’ manifest
those of family members, as well as information about the occurrence of a disease
diseases or disorders. The term genetic information also includes any request for,
or disorder in family members. Does not include age and sex of individual.
or receipt of, genetic services (defined below) by an individual or family member.
Does not include age and sex of individual.
Defines genetic test as an analysis of DNA, RNA, chromosomes, proteins, or
Same provisions.
metabolites that detects genotypes, mutations, or chromosomal changes. Genetic
test does not include an analysis of proteins or metabolites that is directly related
to a manifest disease, disorder or pathological condition.

---

CRS-10
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
Defines genetic services as a genetic test, genetic counseling, or genetic
Same provisions.
education.
Defines issuer of a Medigap policy to include a third-party administrator or other
Same provisions.
person acting for or on behalf of such issuer.
Clarifies that any reference to genetic information about an individual or family
No provisions.
member who is pregnant shall include genetic information about the fetus.
Clarifies that any reference to genetic information about an individual or family
member using assisted reproductive technology shall include genetic information
about any fetus legally held by that individual or family member.
Applies to Medigap policies beginning at least 18 months after enactment.
Applies to Medigap policies beginning at least 18 months after enactment.
A state identified by the HHS Secretary as requiring a change in its statutes or
Same provisions.
regulations to conform its regulatory program to the requirements of this section
would have until October 1, 2008, to make such a change before being considered
out of compliance. States requiring a statutory change that do not meet in
legislative session in 2008 would be given additional time to come into
compliance. The bill would give the National Association of Insurance
Commissioners (NAIC) until June 30, 2008, to modify its model regulation to
conform to the requirements of this section. If NAIC failed to meet that deadline,
the HHS Secretary would have until October 1, 2008, to make the modifications.
Privacy and Confidentiality — Section 105 (H.R. 493), Section 104 (S. 358)
Amends HIPAA to require the HHS Secretary, by rulemaking, to revise the
Applies the HIPAA privacy rule protections to the use and disclosure of genetic
HIPAA privacy rule as follows: (1) genetic information (as defined in the bill)
information (as defined in this act). Prohibits a group health plan, health
would be treated as health information under the privacy rule; and (2) the use and
insurance issuer, or issuer of a Medigap policy from using or disclosing genetic
disclosure of genetic information by a group health plan, health insurance issuer,
information (including information about a request for or receipt of genetic
or issuer of a Medigap policy for underwriting and other activities related to the
services by an individual or family member) for underwriting, premium rating, or
creation, renewal, or replacement of a contract of health insurance or health
other activities related to the creation, renewal, or replacement of a contract of
benefits would be prohibited. Requires the HHS Secretary to publish the
health insurance or health benefits.
revisions as a notice in the Federal Register, not later than 60 days after
enactment. The revisions would take effect upon publication without any prior
public comment, but may be further modified, after opportunity for public
comment.

---

CRS-11
H.R. 493 (as passed by the House, April 25, 2007)
S. 358 (as reported by the HELP Committee, March 29, 2007)
[Note: similar language prohibiting the collection of genetic information appears
Prohibits a group health plan, health insurance issuer, or issuer of a Medigap
in each of Sections 101 — 104; see above.]
policy from requesting, requiring, or purchasing genetic information (including
information about a request for or receipt of genetic services by an individual or
family member) for underwriting, eligibility determination (before or during the
enrollment process), premium rating, or other activities related to the creation,
renewal, or replacement of a contract for health insurance or health benefits.
Obtaining genetic information incidental to the acquisition of other information
would not be considered a violation.
No comparable provisions.
The above privacy and confidentiality provisions would not apply to plans,
insurers, and Medigap issuers that are not HIPAA covered entities, nor would
they apply to genetic information that is not considered individually identifiable
under the HIPAA privacy rule.
Provides that any group health plan, health insurance issuer, or issuer of a
Provides that any group health plan, health insurance issuer, or issuer of a
Medigap policy who violates the privacy rule with respect to the use or disclosure
Medigap policy who violates the above privacy and confidentiality provisions
of genetic information would be subject to the civil and criminal penalties set out
would be subject to the civil and criminal penalties set out in the Administrative
in the Administrative Simplification provisions of HIPAA.
Simplification provisions of HIPAA.
No comparable provisions.
The above privacy and confidentiality provisions would not preempt more
stringent state requirements.
Requires the HHS Secretary, within one year, to issue final regulations to
Requires the HHS Secretary to coordinate implementation of the above privacy
implement the above revisions to the privacy rule, in consultation with the
and confidentiality provisions with the administration of the HIPAA privacy rule.
Secretaries of Labor and the Treasury. Provides that the above amendments to
the privacy rule will take effect 18 months after enactment.
Interagency Coordination — Section 106 (H.R. 493), Sections 105 & 106 (S. 358)
Requires the Secretaries of HHS, Labor, and the Treasury, through an interagency
Same provision.
memorandum of understanding, to coordinate implementation and enforcement of
Title I of this act.
No comparable provisions. [Note: effective date provisions appear in each
Requires the Secretaries of HHS, Labor, and the Treasury to issue final
section of Title I.]
regulations within one year of enactment. Unless otherwise noted, the
amendments made by this Title shall take effect 18 months after enactment.

---