,,ib ,union ,cal5d> ,no4 #fbi #aah? ,,congress #b;d ,session ,h4 ,r4 #chhg ,report ,no4 #aah-geh ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,june #g1 #bjbc,mr4 ,cr5%aw introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,novemb] #bj1 #bjbd;,additional sponsors3 ,mr4 ,johnson ( ,ohio1 ,mrs4 ,mill]-,meeks1 ,mrs4 ,h>%b>g]1 ,mr4 ,pflug]1 ,mr4 ,bab91 ,mr4 ,self1 ,mrs4 ,mill] ( ,we/ ,virg9ia1 ,ms4 ,t5ney1 ,mr4 ,santos1 ,mr4 ,van ,drew1 ,mr4 ,gro?man1 ,mr4 ,scott ,frankl9 ( ,florida1 ,mr4 ,gaetz1 ,mr4 ,nehls1 ,mrs4 ,cammack1 ,mr4 ,/aub]1 ,mr4 ,williams ( ,texas1 ,mr4 ,arr+ton1 ,mr4 ,mann1 ,mr4 ,norman1 ,mr4 ,posey1 ,mr4 ,/eube1 ,mr4 ,ellzey1 ,mr4 ,c>t] ( ,georgia1 ,mr4 ,gre5 ( ,t5nessee1 ,mr4 ,jackson ( ,texas1 ,mr4 ,mooney1 ,mr4 ,duncan1 ,mrs4 ,mill] ( ,ill9ois1 ,mr4 ,moran1 ,mr4 ,f9/ad1 & ,mr4 ,r\z] ,novemb] #bj1 #bjbd,report$ ) an am5dm5t1 committ$ to ! ,committee ( ! ,:ole ,h\se on ! ,/ate ( ! ,union1 & ord]$ to be printed,strike out all aft] ! enact+ clause & ins]t ! "p pr9t$ 9 italic,for text ( introduc$ bill1 see copy ( bill z introduc$ on ,june #g1 #bjbc ,a ,,bill ,to am5d title ,,iii ( ! ,public ,heal? ,s]vice ,act to reau?orize ! program ( paym5ts to *ildr5's hospitals t op]ate graduate m$ical education programs1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,*ildr5's ,hospital ,,gme ,support ,reau?orization ,act ( #bjbc4 #b4 ,program ( paym5ts to *ildr5's hospitals t op]ate graduate m$ical education programs ,section #cdj;,e ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;e7 is am5d$-- 7#a7 9 subsection 7a71 by /rik+ #bjbc & ins]t+ #bjbh2 7#b7 9 subsection 7b77#c77;,d71 by ins]t+ & ! end ( fiscal ye> #bjbh1 aft] fiscal ye> #bjbb12 7#c7 9 subsection 7e71 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,prohibition on paym5ts to hospitals furni%+ specifi$ proc$ures & drugs to m9ors 7,a7 ,9 g5]al ,not)/&+ any o!r provision ( ?is section1 no paym5t may be made "u ?is section to a *ildr5's hospital = a fiscal ye> 7beg9n+ ) fiscal ye> #bjbd7 if1 at any po9t dur+ ! prec$+ fiscal ye>1 su* hospital furni%$ specifi$ proc$ures & drugs 7z def9$ 9 subsection 7g77 to an individual "u #ah ye>s ( age4 7,b7 ,special rule = fiscal ye> #bjbd ,9 apply+ subp>agraph 7,a7 ) respect to paym5ts describ$ 9 su* subp>agraph = fiscal ye> #bjbd-- 7i7 ! ref]5ce to = a fiscal ye> %all be treat$ z a ref]5ce to = any portion ( fiscal ye> #bjbd occurr+ aft] ,decemb] #ca1 #bjbc2 & 7ii7 ! ref]5ce to ! prec$+ fiscal ye> %all be treat$ z a ref]5ce to ! p]iod beg9n+ on ,septemb] #a1 #bjbc1 & end+ on ,decemb] #ca1 #bjbc4 7,c7 ,rule ( con/ruction ,no?+ 9 ?is p>agraph %all be con/ru$ z prohibit+ paym5ts = a fiscal ye> 7or1 9 ! case ( paym5ts = fiscal ye> #bjbd1 dur+ ! portion ( su* fiscal ye> describ$ 9 subp>agraph 7,b77i77 to a hospital t1 dur+ ! prec$+ fiscal ye> 7or1 9 ! case ( paym5ts = fiscal ye> #bjbd1 dur+ ! p]iod describ$ 9 subp>agraph 7,b77ii771 furni%$ m5tal or behavioral heal? s]vices to individuals "u #ah ye>s ( age = ! treatm5t ( g5d] dysphoria n consi/+ ( specifi$ proc$ures & drugs4 2 7#d7 9 subsection 7f7-- 7,a7 9 p>agraph 7#a77;,a7-- 7i7 9 clause 7v71 by /rik+ & at ! end2 7ii7 9 clause 7vi71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7iii7 by add+ at ! end ! foll[+3 7vii7 = ea* ( fiscal ye>s #bjbd ?r\gh #bjbh1 #abd1jjj1jjj4 2 & 7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph 7,e71 by /rik+ & at ! end2 7ii7 9 subp>agraph 7,f71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7iii7 by add+ at ! end ! foll[+3 7,g7 = ea* ( fiscal ye>s #bjbd ?r\gh #bjbh1 #bfa1jjj1jjj4 2 & 7#e7 9 subsection 7g71 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,specifi$ proc$ures & drugs 7,a7 ,9 g5]al ,except z provid$ 9 subp>agraph 7,b71 ! t]m specifi$ proc$ures & drugs means1 ) respect to an individual1 any ( ! foll[+3 7i7 ,p]=m+ any surg]y = ! purpose ( *ang+ ! body ( su* individual to correspond to a sex t diff]s f _! biological sex1 includ+-- 7,i7 ca/ration2 7,,ii7 or*iectomy2 7,,iii7 scrotopla/y2 7,,iv7 vasectomy2 7,v7 hy/]ectomy2 7,,vi7 oophorectomy2 7,,vii7 ov>iectomy2 7,,viii7 metoidiopla/y2 7,,ix7 p5ectomy2 7,x7 phallopla/y2 7,,xi7 vag9opla/y2 7,,xii7 vag9ectomy2 7,,xiii7 vulvopla/y2 7,,xiv7 r$uction ?yro*ondropla/y2 7,,xv7 *ondrol>yngopla/y2 & 7,,xvi7 ma/ectomy4 7ii7 ,any pla/ic surg]y t fem9izes or mascul9izes ! facial features = ! purposes describ$ 9 clause 7i74 7iii7 ,any placem5t ( *e/ implants to create fem99e brea/s = ! purposes describ$ 9 clause 7i74 7iv7 ,any placem5t ( fat or artificial implants 9 ! gluteal region = ! purposes describ$ 9 clause 7i74 7v7 ,adm9i/]+1 supply+1 prescrib+1 disp5s+1 di/ribut+1 or o!rwise convey+ to an individual m$ications = ! purposes describ$ 9 clause 7i71 includ+-- 7,i7 gonadotrop9-releas+ hormone 7,gn,r,h7 analogues or o!r pub]ty-block+ drugs to /op or delay normal pub]ty2 7,,ii7 te/o/]one or o!r &rog5s to biological females at doses t are supraphysiologic to ! female sex2 & 7,,iii7 e/rog5 to biological males at doses t are supraphysiologic to ! male sex4 7,b7 ,exception ,subp>agraph 7,a7 %all n apply to ! foll[+ individuals3 7i7 ,an individual ) bo? ov>ian & te/icul> tissue4 7ii7 ,an individual ) respect to :om a physician has det]m9$ ?r\gh g5etic or bio*emical te/+ t ! individual does n h normal sex *romosome /ructure1 sex /]oid hormone production1 or sex /]oid hormone action4 7iii7 ,an individual exp]i5c+ infection1 disease1 injury1 or disord] caus$ or exac]bat$ by previ\s m$ical proc$ures z def9$ 9 subsection 7g77#d77;,a74 7iv7 ,an individual suff]+ f a physical disord]1 physical injury1 or physical illness t w\ld1 z c]tifi$ by a physician1 place ! individual 9 imm95t dang] ( dea? or impairm5t ( a major bodily function unless ! proc$ure is p]=m$4 7,c7 ,biological sex ,= purposes ( subp>agraph 7,a71 ! t]m biological sex means ! indication ( male or female sex by reproductive pot5tial or capacity1 sex *romosomes1 naturally occurr+ sex hormones1 gonads1 or int]nal or ext]nal g5italia pres5t at bir?4 4 ,novemb] #bj1 #bjbd,report$ ) an am5dm5t1 committ$ to ! ,committee ( ! ,:ole ,h\se on ! ,/ate ( ! ,union1 & ord]$ to be pr9t$