Federal · Senate Bill · 119th Congress, 1st Session
S2997
S. 2997 — Right to Override Act

Status ● Introduced Effective N/A Passage Likelihood L

WHAT THIS BILL REGULATES · 5 REQUIREMENT TYPES

How Is This Bill Enforced

Enforcement Authority
Title I is enforced by the Secretary of Health and Human Services acting through the Office for Civil Rights, via complaint-driven investigation and civil monetary penalties modeled on the HIPAA enforcement framework (42 U.S.C. § 1320d et seq.). Title II is enforced by the Secretary of Labor with investigative and subpoena authority modeled on the Fair Labor Standards Act. State attorneys general and state privacy regulators may also bring parens patriae civil actions. Title II also creates a private right of action for any individual adversely affected by a violation, in any federal court of competent jurisdiction. Predispute arbitration agreements and joint-action waivers are unenforceable for Title II claims.
Private Right of Action
private right of action for any individual adversely affected by a violation, in any federal court of competent jurisdiction.
Penalties
Title I: Civil monetary penalties imposed by HHS under the Social Security Act § 1128A framework. Title II administrative enforcement: up to $76,987 per violation, up to $769,870 per repeat violation (subject to annual CPI adjustment). Title II private right of action: actual damages including back pay, or up to treble damages; statutory damages of $5,000–$20,000 per violation of § 201 (adverse employment actions) and $10,000–$100,000 per violation of § 202 (whistleblower retaliation); injunctive and equitable relief; temporary relief including temporary reinstatement; reasonable attorney fees and litigation costs. All dollar amounts subject to annual CPI inflation adjustment.

What This Bill Requires

Verbatim statutory text on the left; plain-language analysis and a per-section checklist on the right. Numbered markers cross-link to the matching checklist row.

Statutory Text
Analysis & Obligations
Sec. 3
Definitions

(1)–(12) In this Act: (1) ADVERSE EMPLOYMENT ACTIONAdverse employment actionThe term "adverse employment action", with respect to a health care professional, includes— (A) the termination, suspension, or demotion of the health care professional from a job; (B) any disciplinary action or retaliatory investigation against the health care professional; (C) the imposition of a work schedule that is more burdensome to the health care professional; (D) the failure of the health care professional to receive, or any adverse adjustment in the ability of the health care professional to receive, a promotion; (E) the denial of the health care professional in receiving or being eligible to receive— (i) compensation, including the denial of an increase in compensation; or (ii) any other job-related benefit or opportunity, including for telework, training, or travel; (F) revocation of admitting privileges; (G) a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professional; (H) a change in the ability to practice at a location for which the health care professional would otherwise be able; (I) an adverse evaluation or performance review; (J) any other modification to the terms, conditions, or privileges of employment or work of the health care professional that, from the perspective of a reasonable person, puts the health care professional in a materially adverse position when compared to the position of the professional prior to the modification; and (K) any other action or inaction that results in the health care professional being in a materially adverse position when compared to the position of the professional prior to the action or inaction.Sec. 3(1).—The term ''adverse employment actionAdverse employment actionThe term "adverse employment action", with respect to a health care professional, includes— (A) the termination, suspension, or demotion of the health care professional from a job; (B) any disciplinary action or retaliatory investigation against the health care professional; (C) the imposition of a work schedule that is more burdensome to the health care professional; (D) the failure of the health care professional to receive, or any adverse adjustment in the ability of the health care professional to receive, a promotion; (E) the denial of the health care professional in receiving or being eligible to receive— (i) compensation, including the denial of an increase in compensation; or (ii) any other job-related benefit or opportunity, including for telework, training, or travel; (F) revocation of admitting privileges; (G) a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professional; (H) a change in the ability to practice at a location for which the health care professional would otherwise be able; (I) an adverse evaluation or performance review; (J) any other modification to the terms, conditions, or privileges of employment or work of the health care professional that, from the perspective of a reasonable person, puts the health care professional in a materially adverse position when compared to the position of the professional prior to the modification; and (K) any other action or inaction that results in the health care professional being in a materially adverse position when compared to the position of the professional prior to the action or inaction.Sec. 3(1)'', with respect to a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7), includes— (A) the termination, suspension, or demotion of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) from a job; (B) any disciplinary action or retaliatory investigation against the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7); (C) the imposition of a work schedule that is more burdensome to the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7); (D) the failure of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) to receive, or any adverse adjustment in the ability of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) to receive, a promotion; (E) the denial of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) in receiving or being eligible to receive— (i) compensation, including the denial of an increase in compensation; or (ii) any other job-related benefit or opportunity, including for telework, training, or travel; (F) revocation of admitting privileges; (G) a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7); (H) a change in the ability to practice at a location for which the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) would otherwise be able; (I) an adverse evaluation or performance review; (J) any other modification to the terms, conditions, or privileges of employment or work of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) that, from the perspective of a reasonable person, puts the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) in a materially adverse position when compared to the position of the professional prior to the modification; and (K) any other action or inaction that results in the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) being in a materially adverse position when compared to the position of the professional prior to the action or inaction. (2) ARTIFICIAL INTELLIGENCE CLINICAL DECISION SUPPORT SYSTEMArtificial intelligence clinical decision support systemThe term "artificial intelligence clinical decision support system" or "AI/CDSS" means technology that— (A) supports decision-making based on algorithms, or models, based in clinical practice guidelines or that derive relationships from training data, including such algorithms or models that are developed using unsupervised learning models; and (B) produces an output that results in a prediction, classification, recommendation, evaluation, or analysis.Sec. 3(2); AI/CDSS.—The term ''artificial intelligence clinical decision support systemArtificial intelligence clinical decision support systemThe term "artificial intelligence clinical decision support system" or "AI/CDSS" means technology that— (A) supports decision-making based on algorithms, or models, based in clinical practice guidelines or that derive relationships from training data, including such algorithms or models that are developed using unsupervised learning models; and (B) produces an output that results in a prediction, classification, recommendation, evaluation, or analysis.Sec. 3(2)'' or ''AI/CDSS'' means technology that— (A) supports decision-making based on algorithms, or models, based in clinical practice guidelines or that derive relationships from training data, including such algorithms or models that are developed using unsupervised learning models; and (B) produces an output that results in a prediction, classification, recommendation, evaluation, or analysis. (3) AI/CDSS OUTPUTAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3).—The term ''AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3)'' means any recommendation, decision, or other output of AI/CDSS. (4) COMMERCE; INDUSTRY OR ACTIVITY AFFECTING COMMERCE.—The terms ''commerce'' and ''industry or activity affecting commerce'' have the meanings given such terms in section 101 of the Family and Medical Leave Act of 1993 (29 U.S.C. 2611). (5) COVERED ENTITYCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5).—The term ''covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5)''— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7); and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health planHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9) or an administrator of a health planHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9). (6) ENGAGED IN THE PERFORMANCE OF WORK FOR REMUNERATIONEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6).—The term ''engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6)'', with respect to an individual performing work for a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5), includes the individual having admitting privileges for the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) without regard to whether such individual is employed by such entity. (7) HEALTH CARE PROFESSIONALHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7).—The term ''health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7)''— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care servicesHealth care servicesThe term "health care services" means any services that relate to— (A) the diagnosis, prevention, or treatment of any human disease or impairment; (B) the assessment or care of the health of human beings; or (C) making prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(8); or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, a health planHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9) to make prior authorization determinations or other determinations regarding coverage under a health planHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9). (8) HEALTH CARE SERVICESHealth care servicesThe term "health care services" means any services that relate to— (A) the diagnosis, prevention, or treatment of any human disease or impairment; (B) the assessment or care of the health of human beings; or (C) making prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(8).—The term ''health care servicesHealth care servicesThe term "health care services" means any services that relate to— (A) the diagnosis, prevention, or treatment of any human disease or impairment; (B) the assessment or care of the health of human beings; or (C) making prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(8)'' means any services that relate to— (A) the diagnosis, prevention, or treatment of any human disease or impairment; (B) the assessment or care of the health of human beings; or (C) making prior authorization determinations or other determinations regarding coverage under a health planHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9). (9) HEALTH PLANHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9).—The term ''health planHealth planThe term "health plan" has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).Sec. 3(9)'' has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj). (10) OVERRIDEOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10).—The term ''overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10)'', with respect to an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3), means making a decision contrary to such output. (11) OVERRIDE DATAOverride dataThe term "override data"— (A) means any data related to adherence to or deviation from AI/CDSS outputs; and (B) includes— (i) any such data that is metadata or audit data; or (ii) any such data related to a particular health care professional or group of health care professionals, or related to a particular AI/CDSS.Sec. 3(11).—The term ''override dataOverride dataThe term "override data"— (A) means any data related to adherence to or deviation from AI/CDSS outputs; and (B) includes— (i) any such data that is metadata or audit data; or (ii) any such data related to a particular health care professional or group of health care professionals, or related to a particular AI/CDSS.Sec. 3(11)''— (A) means any data related to adherence to or deviation from AI/CDSS outputsAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3); and (B) includes— (i) any such data that is metadata or audit data; or (ii) any such data related to a particular health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) or group of health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7), or related to a particular AI/CDSS. (12) STATE.—The term ''State'' has the meaning given the term in section 3000 of the Public Health Service Act.

Section 3 establishes the key defined terms used throughout the Act. Most significant are the broad definitions of covered entity (any employer of health care professionals engaged in commerce, including health care facilities, health plans, and health plan administrators), AI/CDSS (technology that supports clinical decision-making through algorithms or models and produces predictive, classificatory, or analytical outputs), and health care professional (any licensed, registered, or certified health care provider, including home health aides and health plan utilization review staff). The definition of adverse employment action is notably expansive, covering not only termination and demotion but also schedule changes, performance reviews, duty reassignment, and any modification that puts a professional in a materially adverse position.

Sec. 101
Policies with respect to using and overriding AI/CDSS
Deployer

(a)(1)(A)–(D) 1 IN GENERAL.—A covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) that uses AI/CDSS shall— (1) adopt and adhere to a policy with respect to such usage— (A) that ensures that AI/CDSS outputsAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3) are not substituted for the independent judgment of a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) while such health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) is acting in the scope of practice of such health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7); (B) that allows such a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) to overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3) in a timely manner if, at the time of the overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10), in the judgment of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) acting in the scope of practice of the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7), such an overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) is appropriate for the patient, or as necessary to comply with applicable law, including civil rights law; (C) that allows health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) and their representatives to provide feedback on AI/CDSS, including incorrect or biased outputs that require frequent overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10); and (D) that prohibits the sharing of override dataOverride dataThe term "override data"— (A) means any data related to adherence to or deviation from AI/CDSS outputs; and (B) includes— (i) any such data that is metadata or audit data; or (ii) any such data related to a particular health care professional or group of health care professionals, or related to a particular AI/CDSS.Sec. 3(11) on— (i) a specific health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7); or (ii) a group of health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) when the identity of those professionals can be reasonably inferred;

(a)(2) 2 inform health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5), and the representatives of such health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7), of the policy under paragraph (1), including the presence of AI/CDSS in the workplace and the ability of such health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) to overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3);

(a)(3) 3 provide training to such health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) on— (A) how to use AI/CDSS; (B) the circumstances where an AI/CDSS overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) is appropriate; (C) how to overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3); (D) AI/CDSS development processes and any data or other inputs involved in such processes; and (E) any potential limitations for AI/CDSS, including any potential areas of bias in the AI/CDSS;

(a)(4) 4 establish and maintain an AI/CDSS committee that shall— (A) convene upon the date that is later of— (i) the date of the adoption of AI/CDSS at the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5); or (ii) 120 days after the date of enactment of this Act; (B) be comprised of at least as many non-managers as managers; (C) include membership of any labor organization, or other authorized representative, of health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5); (D) provide consultation to the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) in developing policies and practices related to the use of AI/CDSS, including policy required under subparagraphs (A) through (D) of paragraph (1); and (E) meet at least quarterly to— (i) review implementation of policies adopted by the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) with respect to AI/CDSS; and (ii) report to the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) on findings and suggestions for improvements;

(a)(5) 5 review— (A) all findings and suggestions from the AI/CDSS committee provided under paragraph (4)(E)(ii); and (B) any other feedback from health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) on the AI/CDSS technology and the policies of the entity with respect to such technology, including by reviewing any such feedback on patterns of issues with the AI/CDSS, such as incorrect or biased outputs that require frequent overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10).

(b) DATA SHARING EXCEPTION.—The prohibition under subsection (a)(1)(D) shall not apply— (1) in a case in which a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) is informing a patient or an authorized representative of a patient about a decision rendered in the administration of the care of such patient; or (2) in a case of a civil, criminal, or administrative action involving medical malpractice, negligence, or violation of any law.

(c) OVERSIGHT MECHANISM.—Nothing in this Act shall prohibit a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) from reviewing the performance outcomes of AI/CDSS.

Section 101 is the operational core of Title I. It requires every covered entity that uses AI/CDSS to adopt and adhere to a comprehensive policy ensuring that AI/CDSS outputs are not substituted for the independent judgment of health care professionals acting within their scope of practice. The policy must guarantee a timely override right, establish a feedback channel for clinicians to report incorrect or biased outputs, and prohibit sharing override data on individual or identifiable groups of professionals — with narrow exceptions for patient-care communications and legal proceedings.

Beyond the policy itself, covered entities must affirmatively inform health care professionals about the policy, provide training on AI/CDSS use, limitations, and override procedures, and establish a standing AI/CDSS committee with at least equal non-manager representation that meets quarterly to review implementation and report findings. The covered entity must review all committee findings and clinician feedback, including patterns of incorrect or biased outputs.

Compliance actions 5 items
1
Covered entities must adopt and adhere to a policy that (1) ensures AI/CDSS outputsAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3) are not substituted for the independent judgment of health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) acting within their scope of practice, (2) allows professionals to overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) AI/CDSS outputsAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3) in a timely manner when clinically appropriate or required by law, (3) provides a feedback channel for professionals to report incorrect or biased outputs, and (4) prohibits sharing override dataOverride dataThe term "override data"— (A) means any data related to adherence to or deviation from AI/CDSS outputs; and (B) includes— (i) any such data that is metadata or audit data; or (ii) any such data related to a particular health care professional or group of health care professionals, or related to a particular AI/CDSS.Sec. 3(11) identifying individual professionals or identifiable groups, except for patient-care communications or legal proceedings.
H-01.6
2
Covered entities must inform health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) and their representatives of the AI/CDSS usage policy, including the presence of AI/CDSS in the workplace and the professional's ability to overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3).
HC-01.6
3
Covered entities must provide training to health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) on how to use AI/CDSS, circumstances where overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) is appropriate, how to overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) outputs, AI/CDSS development processes and data inputs, and potential limitations and biases of the AI/CDSS.
G-01
4
Covered entities must establish and maintain an AI/CDSS committee with at least equal non-manager representation and labor organization membership that convenes within 120 days of enactment or AI/CDSS adoption, provides consultation on AI/CDSS policies, and meets at least quarterly to review policy implementation and report findings and improvement suggestions to the entity.
G-01.6
5
Covered entities must review all findings and suggestions from the AI/CDSS committee and all other feedback from health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) on AI/CDSS technology and policies, including patterns of incorrect or biased outputs requiring frequent overrideOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10).
G-01.2
Sec. 102
Enforcement (Title I)

(a)–(c) IN GENERAL.—Except as provided in subsection (c), the Secretary of Health and Human Services, acting through the Office for Civil Rights (referred to in this title as the ''Secretary''), shall receive, investigate, and attempt to resolve, including through imposing civil monetary penalties, complaints of violations of this title in the same manner as the Secretary receives, investigates, and attempts to resolve, including through imposing civil monetary penalties, complaints of violations of part C of title XI of the Social Security Act (42 U.S.C. 1320d et seq.). (b) CIVIL MONETARY PENALTIES.—The provisions of section 1128A of the Social Security Act (42 U.S.C. 1320a–7a) (other than subsections (a) and (b) and the second sentence of subsection (f)) shall apply to the imposition of a civil monetary penalty under this section in the same manner as such provisions apply to the imposition of a penalty under such section 1128A. (c) EXCEPTION.—No complaint of a violation of this title shall be referred to the Attorney General for investigation as a criminal violation.

Section 102 establishes the enforcement mechanism for Title I (AI/CDSS usage policies). The Secretary of Health and Human Services, acting through the Office for Civil Rights, receives, investigates, and resolves complaints using the same procedures as HIPAA administrative simplification enforcement (42 U.S.C. § 1320d et seq.). Civil monetary penalties may be imposed under the Social Security Act § 1128A framework. Notably, no complaint under Title I may be referred to the Attorney General for criminal investigation, distinguishing this from HIPAA's criminal enforcement track.

Sec. 103
Regulations (Title I)

(a)–(b) IN GENERAL.—The Secretary may prescribe such regulations as may be necessary to carry out this title. (b) CONSULTATION.—In prescribing any regulations authorized under this section, the Secretary— (1) shall consult with the Secretary of Labor; and (2) may consult with— (A) other Federal agencies that have expertise in artificial intelligence or health care; and (B) other Federal agencies that have jurisdiction over labor and employment issues, including the Equal Employment Opportunity Commission, the Department of Justice, and the National Labor Relations Board.

Section 103 authorizes the Secretary of HHS to prescribe regulations to carry out Title I, with mandatory consultation of the Secretary of Labor and optional consultation with other federal agencies having expertise in AI, health care, or labor and employment issues, including the EEOC, DOJ, and NLRB.

Sec. 201
Prohibition on adverse employment actions
Deployer

6 No covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) shall take an adverse employment actionAdverse employment actionThe term "adverse employment action", with respect to a health care professional, includes— (A) the termination, suspension, or demotion of the health care professional from a job; (B) any disciplinary action or retaliatory investigation against the health care professional; (C) the imposition of a work schedule that is more burdensome to the health care professional; (D) the failure of the health care professional to receive, or any adverse adjustment in the ability of the health care professional to receive, a promotion; (E) the denial of the health care professional in receiving or being eligible to receive— (i) compensation, including the denial of an increase in compensation; or (ii) any other job-related benefit or opportunity, including for telework, training, or travel; (F) revocation of admitting privileges; (G) a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professional; (H) a change in the ability to practice at a location for which the health care professional would otherwise be able; (I) an adverse evaluation or performance review; (J) any other modification to the terms, conditions, or privileges of employment or work of the health care professional that, from the perspective of a reasonable person, puts the health care professional in a materially adverse position when compared to the position of the professional prior to the modification; and (K) any other action or inaction that results in the health care professional being in a materially adverse position when compared to the position of the professional prior to the action or inaction.Sec. 3(1) against a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) because the health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) overridesOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3) in a manner consistent with the requirements under section 101.

Section 201 prohibits covered entities from taking an adverse employment action against a health care professional because the professional overrides an AI/CDSS output in a manner consistent with the requirements of Section 101. This creates a categorical prohibition — a covered entity may not retaliate against a clinician for exercising the override right that Section 101 requires the entity to provide.

Compliance actions 1 item
6
Covered entities must not take any adverse employment actionAdverse employment actionThe term "adverse employment action", with respect to a health care professional, includes— (A) the termination, suspension, or demotion of the health care professional from a job; (B) any disciplinary action or retaliatory investigation against the health care professional; (C) the imposition of a work schedule that is more burdensome to the health care professional; (D) the failure of the health care professional to receive, or any adverse adjustment in the ability of the health care professional to receive, a promotion; (E) the denial of the health care professional in receiving or being eligible to receive— (i) compensation, including the denial of an increase in compensation; or (ii) any other job-related benefit or opportunity, including for telework, training, or travel; (F) revocation of admitting privileges; (G) a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professional; (H) a change in the ability to practice at a location for which the health care professional would otherwise be able; (I) an adverse evaluation or performance review; (J) any other modification to the terms, conditions, or privileges of employment or work of the health care professional that, from the perspective of a reasonable person, puts the health care professional in a materially adverse position when compared to the position of the professional prior to the modification; and (K) any other action or inaction that results in the health care professional being in a materially adverse position when compared to the position of the professional prior to the action or inaction.Sec. 3(1) against a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) because the professional overridesOverrideThe term "override", with respect to an AI/CDSS output, means making a decision contrary to such output.Sec. 3(10) an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3) consistent with Section 101 requirements.
G-03.3
Sec. 202
Whistleblower protections
Deployer

7 No covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) shall discriminate or retaliate (including through intimidation, threats, coercion, or harassment) against any individual employed by, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) for, the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5)— (1) because the individual exercises, or attempts to exercise, any right provided under this Act; or (2) because the individual (or another individual or representative acting at the request of the individual) has— (A) filed a written or oral complaint to the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) or a Federal, State, local, or Tribal government entity of a possible violation of this Act; (B) sought assistance or intervention with respect to an AI/CDSS-related concern from the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5), a Federal, State, local, or Tribal government, or any individual or entity representing workers; (C) instituted, caused to be instituted, or otherwise participated in any inquiry or proceeding under or related to this Act; (D) given, or is about to give, any information in connection with any inquiry or proceeding relating to any right provided under this Act; (E) testified, or is about to testify, in any inquiry or proceeding relating to any right provided under this Act; or (F) discussed a possible violation of this Act with a co-worker.

Section 202 prohibits covered entities from discriminating or retaliating — including through intimidation, threats, coercion, or harassment — against any individual employed by or performing work for the entity for exercising rights under the Act, filing complaints, seeking assistance, participating in proceedings, providing information or testimony, or discussing possible violations with co-workers. The protection extends beyond health care professionals to any individual employed by or performing work for the covered entity.

Compliance actions 1 item
7
Covered entities must not discriminate or retaliate against any individual for exercising rights under the Act, filing complaints about possible violations, seeking assistance on AI/CDSS-related concerns, participating in proceedings, providing testimony or information, or discussing possible violations with co-workers.
G-03.3
Sec. 203
Enforcement (Title II)
Deployer

(a)(1)–(6) 8 ENFORCEMENT BY DEPARTMENT OF LABOR.— (1) INVESTIGATION.— (A) IN GENERAL.—To ensure compliance with this title, the Secretary of Labor (referred to in this title as the ''Secretary'')— (i) shall have— (I) the investigative authority provided under section 11(a) of the Fair Labor Standards Act of 1938 (29 U.S.C. 211(a)); and (II) the subpoena authority provided under section 9 of such Act (29 U.S.C. 209); and (ii) may require, by general or special orders, a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) to file with the Secretary, in such form as the Secretary may prescribe, annual or special reports or answers in writing to specific questions (including information and records) as the Secretary may require as to the organization, business, conduct, practices, management, and relation to other corporations, partnerships, and individuals, of the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5). (B) REPORTS AND ANSWERS.—A covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) shall file any reports and answers (including information and records) required under subparagraph (A)(ii) in such manner, including under oath or otherwise, and within such reasonable time period as the Secretary may require. (C) JOINT INVESTIGATIONS.—The Secretary may conduct investigations and make requests for information, as authorized under this Act, on a joint basis with another Federal agency, a State attorney general, or a State agency. (D) OBLIGATION TO KEEP, PRESERVE, AND MAKE AVAILABLE RECORDS.—A covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) shall make, keep, preserve, and make available to the Secretary records pertaining to compliance with this title in accordance with section 11(c) of the Fair Labor Standards Act of 1938 (29 U.S.C. 211(c)) and in accordance with any regulation or order issued by the Secretary. (2) ENFORCEMENT.—The Secretary shall receive, investigate, and attempt to resolve complaints of violations of this title in the same manner that the Secretary receives, investigates, and attempts to resolve complaints of violations of sections 6 and 7 of the Fair Labor Standards Act of 1938 (29 U.S.C. 206 and 207). (3) CIVIL MONETARY PENALTIES.—Subject to subsection (c), the Secretary may impose a civil monetary penalty on any person that violates this title— (A) in an amount of not more than $76,987 per violation; or (B) for repeat violations, in an amount of not more than $769,870 per violation. (4) ADMINISTRATIVE COMPLAINTS.—An individual adversely affected by an alleged violation of this title may— (A) file a complaint of a violation of this title with the Secretary; and (B) designate a representative of a labor organization, regardless of the relationship between the individual and the labor organization, to— (i) file the complaint on behalf of the individual; or (ii) represent the individual for purposes of engagement with the Secretary regarding such complaint, including being present at worker interviews and participating in workplace inspections, conferences, and settlement negotiations. (5) LITIGATION.—The Solicitor of Labor may appear for and represent the Secretary on any litigation brought under this subsection. If the Secretary determines that a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) has violated this title, the Secretary may file a civil action in any appropriate United States district court to obtain injunctive relief to enforce this title. (6) BURDENS OF PROOF.—All complaints under this subsection shall be governed by the legal burdens of proof set forth in section 42121(b) of title 49, United States Code.

(b)(1)–(4) PRIVATE RIGHT OF ACTION.— (1) IN GENERAL.—Notwithstanding any action by the Secretary under subsection (a), any individual adversely affected by an alleged violation of this title (or a representative on behalf of such individual) may commence a civil action against any covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) that violates this title in any Federal court of competent jurisdiction. (2) RELIEF.— (A) IN GENERAL.—In a civil action brought under paragraph (1) in which the individual described in such paragraph prevails, the court may award the individual— (i) damages of— (I) an amount equal to the sum of any actual damages including back pay sustained by the individual; or (II) not more than treble damages; (ii) statutory damages described in subparagraph (B); (iii) injunctive relief; (iv) equitable relief; (v) reasonable attorney fees and litigation costs; and (vi) while the action is pending, temporary relief, including temporary reinstatement. (B) STATUTORY DAMAGES.— (i) IN GENERAL.—The court may, in accordance with clause (ii), award statutory damages under subparagraph (A)(ii) against a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) in the following amounts: (I) For each violation of section 201 (regarding adverse employment actionsAdverse employment actionThe term "adverse employment action", with respect to a health care professional, includes— (A) the termination, suspension, or demotion of the health care professional from a job; (B) any disciplinary action or retaliatory investigation against the health care professional; (C) the imposition of a work schedule that is more burdensome to the health care professional; (D) the failure of the health care professional to receive, or any adverse adjustment in the ability of the health care professional to receive, a promotion; (E) the denial of the health care professional in receiving or being eligible to receive— (i) compensation, including the denial of an increase in compensation; or (ii) any other job-related benefit or opportunity, including for telework, training, or travel; (F) revocation of admitting privileges; (G) a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professional; (H) a change in the ability to practice at a location for which the health care professional would otherwise be able; (I) an adverse evaluation or performance review; (J) any other modification to the terms, conditions, or privileges of employment or work of the health care professional that, from the perspective of a reasonable person, puts the health care professional in a materially adverse position when compared to the position of the professional prior to the modification; and (K) any other action or inaction that results in the health care professional being in a materially adverse position when compared to the position of the professional prior to the action or inaction.Sec. 3(1)), the court may award damages of an amount (subject to subsection (c)) of not less than $5,000 and not more than $20,000. (II) For each violation of section 202 (regarding whistleblower protections), the court may award damages of an amount (subject to subsection (c)) of not less than $10,000 and not more than $100,000. (ii) CONSIDERATIONS FOR STATUTORY DAMAGES.—In determining the amount of statutory damages assessed under this subparagraph against a covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5), the court shall consider any relevant circumstances presented by the parties to the action, including— (I) the nature and seriousness of the violation; (II) the number of violations; (III) the persistence of the misconduct; (IV) the length of time over which the misconduct occurred; (V) the willfulness of the misconduct; and (VI) the assets, liabilities, and net worth of the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5). (3) REMEDIES FOR STATE WORKERS.— (A) WAIVER OF SOVEREIGN IMMUNITY.—A State's receipt or use of Federal financial assistance for any program or activity of a State shall constitute a waiver of sovereign immunity, under the 11th Amendment to the Constitution of the United States or otherwise, to a suit under this subsection for the relief described in paragraph (2) authorized under this subsection brought by an individual employed under, or otherwise engaged in the performance of work for remunerationEngaged in the performance of work for remunerationThe term "engaged in the performance of work for remuneration", with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.Sec. 3(6) under, that program or activity. (B) OFFICIAL CAPACITY.—An official of a State may be sued in the official capacity of the official by any individual who has complied with the procedures under this paragraph, for injunctive relief that is authorized under this subsection. In such a suit the court may award to the prevailing party those costs authorized by section 722 of the Revised Statutes (42 U.S.C. 1988). (C) APPLICABILITY.—With respect to a particular program or activity, subparagraph (A) applies to conduct that occurs— (i) after the date of enactment of this Act; and (ii) on or after the day on which a State first receives or uses Federal financial assistance for that program or activity. (4) DEFINITION OF PROGRAM OR ACTIVITY.—In this subsection, the term ''program or activity'' has the meaning given the term in section 606 of the Civil Rights Act of 1964 (42 U.S.C. 2000d–4a).

(c) INFLATION ADJUSTMENT.— (1) IN GENERAL.—Subject to paragraphs (2) and (3), the Secretary, not later than September 1 of each calendar year, shall adjust the dollar amounts referred to in subsections (a)(3) and (b)(2)(B)(i) by the percent increase, if any, in the consumer price index for all urban consumers (United States city average), or a successor index, as determined by the Bureau of Labor Statistics, or a successor agency, for the most recent 12-month period for which data is available. (2) ROUNDING.—Any adjustment under paragraph (1) that is not a multiple of $10 shall be rounded to the nearest multiple of $10. (3) PUBLICATION.—The Secretary shall publish the adjusted amounts under paragraph (1) in the Federal Register, and on the official website of the Department of Labor, not later than October 1, of the applicable calendar year for the increase under such paragraph. (4) EFFECTIVE DATE.—Each adjustment under paragraph (1) shall take effect on January 1 of the first calendar year beginning after the date of the increase under such paragraph.

(d) ARBITRATION AND CLASS ACTION.—Notwithstanding any other provision of law, no predispute arbitration agreement or predispute joint-action waiver shall be valid or enforceable with respect to any alleged violation of this title.

Section 203 establishes a dual enforcement mechanism for Title II (adverse employment actions and whistleblower protections). The Secretary of Labor has investigative authority modeled on the Fair Labor Standards Act, including subpoena power, and may impose civil monetary penalties up to $76,987 per violation (up to $769,870 for repeat violations), subject to annual CPI adjustment. Separately, any adversely affected individual has a private right of action in federal court, with remedies including actual damages or treble damages, statutory damages ($5,000–$20,000 per § 201 violation, $10,000–$100,000 per § 202 violation), injunctive and equitable relief, temporary reinstatement, and attorney fees. Predispute arbitration agreements and class-action waivers are unenforceable. Sovereign immunity is waived for state-employer violations where the state receives federal financial assistance.

Compliance actions 1 item
8
Covered entities must make, keep, preserve, and make available to the Secretary of Labor records pertaining to compliance with Title II, and must file annual or special reports as the Secretary may require.
R-02.2
Sec. 204
Regulations (Title II)

(a)–(b) IN GENERAL.—The Secretary may prescribe such regulations as may be necessary to carry out this title. (b) CONSULTATION.—In prescribing any regulations authorized under this section, the Secretary— (1) shall consult with the Secretary of Health and Human Services; and (2) may consult with— (A) other Federal agencies that have expertise in artificial intelligence or health care; and (B) other Federal agencies that have jurisdiction over labor and employment issues, including the Equal Employment Opportunity Commission, the Department of Justice, and the National Labor Relations Board.

Section 204 authorizes the Secretary of Labor to prescribe regulations to carry out Title II, with mandatory consultation of the Secretary of Health and Human Services and optional consultation with other federal agencies having AI, health care, or employment expertise.

Sec. 301
Educational materials for covered entities and health care professionals
Government

9 Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services, in consultation with the Secretary of Labor, shall develop and disseminate education materials for— (1) covered entities with respect to the compliance of such entities with the requirements under this Act; and (2) health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) to inform such professionals of their rights and protections under this Act.

Section 301 directs the Secretary of HHS, in consultation with the Secretary of Labor, to develop and disseminate educational materials within one year of enactment — one set for covered entities on compliance requirements, and one for health care professionals on their rights and protections. This is a government obligation, not a covered-entity compliance duty.

Compliance actions 1 item
9
The Secretary of HHS must develop and disseminate educational materials for covered entities on compliance and for health care professionalsHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) on their rights within one year of enactment.
Sec. 302
State enforcement

(a)–(e) IN GENERAL.—In any case in which a State attorney general or a State privacy regulator has reason to believe that an interest of the residents of a State has been or is adversely affected by any covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5) that violates any provision of this Act, the State attorney general or State privacy regulator, as parens patriae, may bring a civil action on behalf of the residents of the State in an appropriate State court or an appropriate district court of the United States to— (1) enjoin further violation of such provision by the covered entityCovered entityThe term "covered entity"— (A) means any individual or entity that— (i) employs, or otherwise engages in the performance of work for remuneration, a health care professional; and (ii) is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and (B) includes such an individual or entity that is— (i) a health care facility in any setting, such as a nurse's office in a school setting; or (ii) a health plan or an administrator of a health plan.Sec. 3(5); (2) compel compliance with such provision; (3) obtain damages, civil penalties, restitution, or other compensation on behalf of the residents of the State; or (4) obtain reasonable attorney's fees and other litigation costs reasonably incurred. (b) RIGHTS OF AGENCY.—Before initiating a civil action under subsection (a), the State attorney general or State privacy regulator, as the case may be, shall notify the Secretary in writing of such civil action. Upon receiving such notice, the Secretary may— (1) intervene in such action; and (2) upon intervening— (A) be heard on all matters arising in such civil action; and (B) file petitions for appeal of a decision in such action. (c) PREEMPTIVE ACTION BY AGENCY.—In any case in which a civil action is instituted by or on behalf of the Secretary for a violation of this Act, a State attorney general or State privacy regulator may not, during the pendency of such action, institute a civil action against any defendant named in the complaint in the action instituted by or on behalf of the Secretary for a violation that is alleged in such complaint. In a case brought by the Secretary that affects the interests of a State, the State attorney general or State privacy regulator may intervene as of right pursuant to the Federal Rules of Civil Procedure. (d) PRESERVATION OF STATE POWERS.—Except as provided in subsection (c), no provision of this Act shall be construed as altering, limiting, or affecting the authority of a State attorney general or State privacy regulator to— (1) bring an action or other regulatory proceeding arising solely under the laws in effect in that State; or (2) exercise the powers conferred on the State attorney general or State privacy regulator by the laws of the State, including the ability to conduct investigations, administer oaths or affirmations, or compel the attendance of witnesses or the production of documentary or other evidence. (e) DEFINITION OF SECRETARY.—In this section, the term ''Secretary'' means— (1) with respect to a violation of title I, the Secretary of Health and Human Services; and (2) with respect to a violation of title II, the Secretary of Labor.

Section 302 authorizes state attorneys general and state privacy regulators to bring parens patriae civil actions on behalf of state residents to enjoin violations, compel compliance, obtain damages, civil penalties, restitution, and attorney fees. The applicable Secretary (HHS for Title I, Labor for Title II) must be notified before suit and may intervene. When the Secretary has already brought suit, state enforcement is stayed during pendency, though the state may intervene as of right. The section preserves existing state enforcement powers.

Sec. 303
Rule of construction

Nothing in this Act shall protect a health care professionalHealth care professionalThe term "health care professional"— (A) means an individual— (i) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or (ii) required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and (B) includes— (i) an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and (ii) an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(7) from a medical malpractice or negligence claim for health care servicesHealth care servicesThe term "health care services" means any services that relate to— (A) the diagnosis, prevention, or treatment of any human disease or impairment; (B) the assessment or care of the health of human beings; or (C) making prior authorization determinations or other determinations regarding coverage under a health plan.Sec. 3(8) provided through overriding an AI/CDSS outputAI/CDSS outputThe term "AI/CDSS output" means any recommendation, decision, or other output of AI/CDSS.Sec. 3(3).

Section 303 provides that nothing in the Act protects a health care professional from medical malpractice or negligence claims arising from health care services provided through overriding an AI/CDSS output. The override right does not create a safe harbor against tort liability.

Sec. 304
Non-preemption

Nothing in this Act shall preempt a State law or collective bargaining agreement.

Section 304 expressly provides that nothing in the Act preempts any state law or collective bargaining agreement, establishing the Act as a federal floor rather than a ceiling.

Passage Likelihood

Low
Status Introduced
Chamber No passage
Committee No action
Majority party (No data)
Bipartisan No
Prior session None

Legislative History

2025-10-09 Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Entry Last Reviewed

2026-05-20
AI generated