,,ii  #aai? ,,congress  #a/ ,session    
,s4 #biig  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #i1 #bjbe ,mr4 
,m>key 7= himself & ,mr4 ,blum5?al7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to protect ! indep5d5t      
judgm5t ( heal? c>e pr(essionals act+ 9 
! scope ( _! practice 9 ov]rid+         
,,ai_/,,cdss outputs1 & = o!r purposes4 
#a4  ,%ort title  ,?is ,act may be cit$ 
z ! ,"r to ,ov]ride ,act4  #b4  ,table (
 cont5ts  ,! table ( cont5ts = ?is ,act 
is z foll[s3  ,sec4 #a4 ,%ort title4    
,sec4 #b4 ,table ( cont5ts4 ,sec4 #c4   
,def9itions4 ,,title ,i--,policies = us+
 & ov]rid+ ,,ai_/,,cdss ,sec4 #aja4     
,policies ) respect to us+ & ov]rid+    
,,ai_/,,cdss4 ,sec4 #ajb4 ,en=cem5t4    
,sec4 #ajc4 ,regulations4 ,,title       
,,ii--,adv]se employm5t actions2        
:i/lebl[] protections ,sec4 #bja4       
,prohibition on adv]se employm5t        
actions4 ,sec4 #bjb4 ,:i/lebl[]         

protections4 ,sec4 #bjc4 ,en=cem5t4     
,sec4 #bjd4 ,regulations4 ,,title       
,,iii--,g5]al provisions ,sec4 #cja4    
,educational mat]ials = cov]$ entities &
 heal? c>e pr(essionals4 ,sec4 #cjb4    
,/ate en=cem5t4 ,sec4 #cjc4 ,rule (     
con/ruction4 ,sec4 #cjd4                
,non-preemption4  #c4  ,def9itions  ,9  
?is ,act3 7#a7 ,adv]se employm5t action 
,! t]m adv]se employm5t action1 )       
respect to a heal? c>e pr(essional1     
includes--  7,a7 ! t]m9ation1 susp5sion1
 or demotion ( ! heal? c>e pr(essional f
 a job2  7,b7 any discipl9>y action or  
retaliatory inve/igation aga9/ ! heal?  
c>e pr(essional2  7,c7 ! imposition ( a 
"w s*$ule t is m burd5some to ! heal?   
c>e pr(essional2  7,d7 ! failure ( !    
heal? c>e pr(essional to receive1 or any
 adv]se adju/m5t 9 ! ability ( ! heal?  
c>e pr(essional to receive1 a promotion2
  7,e7 ! d5ial ( ! heal? c>e pr(essional
 9 receiv+ or be+ eligible to receive-- 
7i7 comp5sation1 includ+ ! d5ial ( an   
increase 9 comp5sation2 or  7ii7 any o!r

 job-relat$ b5efit or opportunity1      
includ+ = telework1 tra9+1 or travel2   
7,f7 revocation ( admitt+ privileges2   
7,g7 a reassignm5t ( a duty or !        
assignm5t ( a duty inappropriate = !    
job1 skill set1 or exp]i5ce ( ! heal?   
c>e pr(essional2  7,h7 a *ange 9 !      
ability to practice at a location = :i* 
! heal? c>e pr(essional w\ld o!rwise be 
able2  7,i7 an adv]se evaluation or     
p]=mance review2  7,j7 any o!r          
modification to ! t]ms1 conditions1 or  
privileges ( employm5t or "w ( ! heal?  
c>e pr(essional t1 f ! p]spective ( a   
reasonable p]son1 puts ! heal? c>e      
pr(essional 9 a mat]ially adv]se        
position :5 comp>$ to ! position ( !    
pr(essional prior to ! modification2 &  
7,k7 any o!r action or inaction t       
results 9 ! heal? c>e pr(essional be+ 9 
a mat]ially adv]se position :5 comp>$ to
 ! position ( ! pr(essional prior to !  
action or inaction4  7#b7  ,artificial  
intellig5ce cl9ical decision support    
sy/em2 ,,ai_/,,cdss  ,! t]m artificial  

intellig5ce cl9ical decision support    
sy/em or ,,ai_/,,cdss means te*nology   
t--  7,a7 supports decision-mak+ bas$ on
 algori?ms1 or models1 bas$ 9 cl9ical   
practice guidel9es or t d]ive           
relation%ips f tra9+ data1 includ+ su*  
algori?ms or models t are develop$ us+  
unsup]vis$ le>n+ models2 &  7,b7        
produces an output t results 9 a        
pr$iction1 classification1              
recomm5dation1 evaluation1 or analysis4 
7#c7  ,,ai_/,,cdss output  ,! t]m       
,,ai_/,,cdss output means any           
recomm5dation1 decision1 or o!r output (
 ,,ai_/,,cdss4  7#d7  ,comm]ce2 indu/ry 
or activity affect+ comm]ce  ,! t]ms    
comm]ce & indu/ry or activity affect+   
comm]ce h ! mean+s giv5 su* t]ms 9      
section #aja ( ! ,family & ,m$ical      
,leave ,act ( #aiic 7#bi ,u4,s4,c4      
#bfaa74  7#e7  ,cov]$ entity  ,! t]m    
cov]$ entity-- 7,a7 means any individual
 or entity t--  7i7 employs1 or o!rwise 
engages 9 ! p]=mance ( "w = remun]ation1
 a heal? c>e pr(essional2 &  7ii7 is    

engag$ 9 comm]ce 7includ+ gov]nm5t71 or 
an indu/ry or activity affect+ comm]ce  
7includ+ gov]nm5t72 &  7,b7 includes su*
 an individual or entity t is-- 7i7 a   
heal? c>e facility 9 any sett+1 su* z a 
nurse's (fice 9 a s*ool sett+2 or  7ii7 
a heal? plan or an adm9i/rator ( a heal?
 plan4  7#f7 ,engag$ 9 ! p]=mance ( "w =
 remun]ation ,! t]m engag$ 9 ! p]=mance 
( "w = remun]ation1 ) respect to an     
individual p]=m+ "w = a cov]$ entity1   
includes ! individual hav+ admitt+      
privileges = ! cov]$ entity )\t reg>d to
 :e!r su* individual is employ$ by su*  
entity4  7#g7  ,heal? c>e pr(essional   
,! t]m heal? c>e pr(essional-- 7,a7     
means an individual--  7i7 lic5s$1      
regi/]$1 or c]tifi$ "u ,f$]al or ,/ate  
laws or regulations to provide heal? c>e
 s]vices2 or  7ii7 requir$ to be s      
lic5s$1 regi/]$1 or c]tifi$ b t is      
exempt$ by o!r /atute or regulation2 &  
7,b7 includes-- 7i7 an individual       
describ$ 9 subp>agraph 7,a7 )\t reg>d to
 :e!r ! individual works at a heal? c>e 

facility1 includ+ a home heal? aide or a
 home c>e provid]2 &  7ii7 an individual
 :o is employ$ by1 or o!rwise engag$ 9 !
 p]=mance ( "w = remun]ation =1 a heal? 
plan to make prior au?orization         
det]m9ations or o!r det]m9ations reg>d+ 
cov]age "u a heal? plan4  7#h7  ,heal?  
c>e s]vices  ,! t]m heal? c>e s]vices   
means any s]vices t relate to--  7,a7 ! 
diagnosis1 prev5tion1 or treatm5t ( any 
human disease or impairm5t2  7,b7 !     
assessm5t or c>e ( ! heal? ( human be+s2
 or  7,c7 mak+ prior au?orization       
det]m9ations or o!r det]m9ations reg>d+ 
cov]age "u a heal? plan4  7#i7  ,heal?  
plan  ,! t]m heal? plan has ! mean+ giv5
 ! t]m 9 section #cjjj ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;jj74  7#aj7  ,ov]ride  ,! t]m      
ov]ride1 ) respect to an ,,ai_/,,cdss   
output1 means mak+ a decision contr>y to
 su* output4  7#aa7  ,ov]ride data  ,!  
t]m ov]ride data-- 7,a7 means any data  
relat$ to adh]5ce to or deviation f     
,,ai_/,,cdss outputs2 &  7,b7 includes--

 7i7 any su* data t is metadata or audit
 data2 or  7ii7 any su* data relat$ to a
 p>ticul> heal? c>e pr(essional or gr\p 
( heal? c>e pr(essionals1 or relat$ to a
 p>ticul> ,,ai_/,,cdss4  7#ab7  ,/ate   
,! t]m ,/ate has ! mean+ giv5 ! t]m 9   
section #cjjj ( ! ,public ,heal? ,s]vice
 ,act4  ,i  ,policies = us+ & ov]rid+   
,,ai_/,,cdss  #aja4  ,policies ) respect
 to us+ & ov]rid+ ,,ai_/,,cdss  7a7  ,9 
g5]al  ,a cov]$ entity t uses           
,,ai_/,,cdss %all-- 7#a7 adopt & adh]e  
to a policy ) respect to su* usage--    
7,a7 t ensures t ,,ai_/,,cdss outputs   
are n sub/itut$ = ! indep5d5t judgm5t ( 
a heal? c>e pr(essional employ$ by1 or  
o!rwise engag$ 9 ! p]=mance ( "w =      
remun]ation =1 ! cov]$ entity :ile su*  
heal? c>e pr(essional is act+ 9 ! scope 
( practice ( su* heal? c>e pr(essional2 
7,b7 t all[s su* a heal? c>e pr(essional
 to ov]ride an ,,ai_/,,cdss output 9 a  
timely mann] if1 at ! "t ( ! ov]ride1 9 
! judgm5t ( ! heal? c>e pr(essional act+
 9 ! scope ( practice ( ! heal? c>e     

pr(essional1 su* an ov]ride is          
appropriate = ! pati5t1 or z necess>y to
 comply ) applicable law1 includ+ civil 
rights law2  7,c7 t all[s heal? c>e     
pr(essionals & _! repres5tatives to     
provide fe$back on ,,ai_/,,cdss1 includ+
 incorrect or bias$ outputs t require   
frequ5t ov]ride2 &  7,d7 t prohibits !  
%>+ ( ov]ride data on-- 7i7 a specific  
heal? c>e pr(essional2 or  7ii7 a gr\p (
 heal? c>e pr(essionals :5 ! id5tity (  
^? pr(essionals c be reasonably inf]r$2 
7#b7 in=m heal? c>e pr(essionals employ$
 by1 or o!rwise engag$ 9 ! p]=mance ( "w
 = remun]ation =1 ! cov]$ entity1 & !   
repres5tatives ( su* heal? c>e          
pr(essionals1 ( ! policy "u p>agraph    
7#a71 includ+ ! pres5ce ( ,,ai_/,,cdss 9
 ! workplace & ! ability ( su* heal? c>e
 pr(essionals to ov]ride an ,,ai_/,,cdss
 output2  7#c7 provide tra9+ to su*     
heal? c>e pr(essionals on-- 7,a7 h[ to  
use ,,ai_/,,cdss2  7,b7 ! circum/ances  
:]e an ,,ai_/,,cdss ov]ride is          
appropriate2  7,c7 h[ to ov]ride an     

,,ai_/,,cdss output2  7,d7 ,,ai_/,,cdss 
developm5t processes & any data or o!r  
inputs involv$ 9 su* processes2 &  7,e7 
any pot5tial limitations = ,,ai_/,,cdss1
 includ+ any pot5tial areas ( bias 9 !  
,,ai_/,,cdss2  7#d7 e/abli% & ma9ta9 an 
,,ai_/,,cdss committee t %all-- 7,a7    
conv5e ^u ! date t is lat] (--  7i7 !   
date ( ! adoption ( ,,ai_/,,cdss at !   
cov]$ entity2 or  7ii7 #abj days aft] ! 
date ( enactm5t ( ?is ,act2  7,b7 be    
compris$ ( at lea/ z _m non-manag]s z   
manag]s2  7,c7 include memb]%ip ( any   
labor organization1 or o!r au?oriz$     
repres5tative1 ( heal? c>e pr(essionals 
employ$ by1 or o!rwise engag$ 9 !       
p]=mance ( "w = remun]ation =1 ! cov]$  
entity2  7,d7 provide consultation to ! 
cov]$ entity 9 develop+ policies &      
practices relat$ to ! use (             
,,ai_/,,cdss1 includ+ policy requir$ "u 
subp>agraphs 7,a7 ?r\gh 7,d7 ( p>agraph 
7#a72 &  7,e7 meet at lea/ qu>t]ly to-- 
7i7 review implem5tation ( policies     
adopt$ by ! cov]$ entity ) respect to   

,,ai_/,,cdss2 &  7ii7 report to ! cov]$ 
entity on f9d+s & sugge/ions =          
improvem5ts2 &  7#e7 review-- 7,a7 all  
f9d+s & sugge/ions f ! ,,ai_/,,cdss     
committee provid$ "u p>agraph           
7#d77;,e77ii72 &  7,b7 any o!r fe$back f
 heal? c>e pr(essionals employ$ by1 or  
o!rwise engag$ 9 ! p]=mance ( "w =      
remun]ation =1 ! cov]$ entity on !      
,,ai_/,,cdss te*nology & ! policies ( ! 
entity ) respect to su* te*nology1      
includ+ by review+ any su* fe$back on   
patt]ns ( issues ) ! ,,ai_/,,cdss1 su* z
 incorrect or bias$ outputs t require   
frequ5t ov]ride4  7b7  ,data %>+        
exception  ,! prohibition "u subsection 
7a77#a77;,d7 %all n apply-- 7#a7 9 a    
case 9 :i* a cov]$ entity is in=m+ a    
pati5t or an au?oriz$ repres5tative ( a 
pati5t ab\t a decision r5d]$ 9 !        
adm9i/ration ( ! c>e ( su* pati5t2 or   
7#b7 9 a case ( a civil1 crim9al1 or    
adm9i/rative action involv+ m$ical      
malpractice1 neglig5ce1 or violation (  
any law4  7c7  ,ov]sight me*anism  ,no?+

 9 ?is ,act %all prohibit a cov]$ entity
 f review+ ! p]=mance outcomes (        
,,ai_/,,cdss4  #ajb4  ,en=cem5t  7a7  ,9
 g5]al  ,except z provid$ 9 subsection  
7c71 ! ,secret>y ( ,heal? & ,human      
,s]vices1 act+ ?r\gh ! ,(fice = ,civil  
,rights 7ref]r$ to 9 ?is title z !      
,secret>y71 %all receive1 inve/igate1 & 
attempt to resolve1 includ+ ?r\gh impos+
 civil monet>y p5alties1 compla9ts (    
violations ( ?is title 9 ! same mann] z 
! ,secret>y receives1 inve/igates1 &    
attempts to resolve1 includ+ ?r\gh      
impos+ civil monet>y p5alties1 compla9ts
 ( violations ( "p ,c ( title ,,xi ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;d et seq474  7b7  ,civil monet>y  
p5alties  ,! provisions ( section       
#aabh;,a ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acbj;a-#g;a7 7o!r ?an       
subsections 7a7 & 7b7 & ! second s5t5ce 
( subsection 7f77 %all apply to !       
imposition ( a civil monet>y p5alty "u  
?is section 9 ! same mann] z su*        
provisions apply to ! imposition ( a    

p5alty "u su* section #aabh;,a4  7c7    
,exception  ,no compla9t ( a violation (
 ?is title %all be ref]r$ to ! ,attorney
 ,g5]al = inve/igation z a crim9al      
violation4  #ajc4  ,regulations  7a7  ,9
 g5]al  ,! ,secret>y may prescribe su*  
regulations z may be necess>y to c>ry   
out ?is title4  7b7  ,consultation  ,9  
prescrib+ any regulations au?oriz$ "u   
?is section1 ! ,secret>y--  7#a7 %all   
consult ) ! ,secret>y ( ,labor2 &  7#b7 
may consult )-- 7,a7 o!r ,f$]al ag5cies 
t h exp]tise 9 artificial intellig5ce or
 heal? c>e2 &  7,b7 o!r ,f$]al ag5cies t
 h jurisdiction ov] labor & employm5t   
issues1 includ+ ! ,equal ,employm5t     
,opportunity ,commission1 ! ,dep>tm5t ( 
,ju/ice1 & ! ,national ,labor ,relations
 ,bo>d4  ,,ii  ,adv]se employm5t        
actions2 :i/lebl[] protections  #bja4   
,prohibition on adv]se employm5t actions
  ,no cov]$ entity %all take an adv]se  
employm5t action aga9/ a heal? c>e      
pr(essional employ$ by1 or o!rwise      
engag$ 9 ! p]=mance ( "w = remun]ation  

=1 ! cov]$ entity because ! heal? c>e   
pr(essional ov]rides an ,,ai_/,,cdss    
output 9 a mann] consi/5t ) !           
requirem5ts "u section #aja4  #bjb4     
,:i/lebl[] protections  ,no cov]$ entity
 %all discrim9ate or retaliate 7includ+ 
?r\gh intimidation1 ?reats1 co]cion1 or 
h>assm5t7 aga9/ any individual employ$  
by1 or o!rwise engag$ 9 ! p]=mance ( "w 
= remun]ation =1 ! cov]$ entity--  7#a7 
because ! individual ex]cises1 or       
attempts to ex]cise1 any "r provid$ "u  
?is ,act2 or  7#b7 because ! individual 
7or ano!r individual or repres5tative   
act+ at ! reque/ ( ! individual7 has--  
7,a7 fil$ a writt5 or oral compla9t to !
 cov]$ entity or a ,f$]al1 ,/ate1 local1
 or ,tribal gov]nm5t entity ( a possible
 violation ( ?is ,act2  7,b7 s\ght      
assi/ance or int]v5tion ) respect to an 
,,ai_/,,cdss-relat$ conc]n f ! cov]$    
entity1 a ,f$]al1 ,/ate1 local1 or      
,tribal gov]nm5t1 or any individual or  
entity repres5t+ work]s2  7,c7 in/itut$1
 caus$ to be in/itut$1 or o!rwise       

p>ticipat$ 9 any inquiry or proce$+ "u  
or relat$ to ?is ,act2  7,d7 giv51 or is
 ab\t to give1 any in=mation 9          
connection ) any inquiry or proce$+     
relat+ to any "r provid$ "u ?is ,act2   
7,e7 te/ifi$1 or is ab\t to te/ify1 9   
any inquiry or proce$+ relat+ to any "r 
provid$ "u ?is ,act2 or  7,f7 discuss$ a
 possible violation ( ?is ,act ) a      
co-work]4  #bjc4 ,en=cem5t  7a7         
,en=cem5t by ,dep>tm5t ( ,labor  7#a7   
,inve/igation  7,a7 ,9 g5]al ,to ensure 
compliance ) ?is title1 ! ,secret>y (   
,labor 7ref]r$ to 9 ?is title z !       
,secret>y7--  7i7 %all h-- 7,i7 !       
inve/igative au?ority provid$ "u section
 #aa7;a7 ( ! ,fair ,labor ,/&>ds ,act ( 
#aich 7#bi ,u4,s4,c4 #baa7;a772 &       
7,,ii7 ! subpo5a au?ority provid$ "u    
section #i ( su* ,act 7#bi ,u4,s4,c4    
#bji72 &  7ii7 may require1 by g5]al or 
special ord]s1 a cov]$ entity to file ) 
! ,secret>y1 9 su* =m z ! ,secret>y may 
prescribe1 annual or special reports or 
answ]s 9 writ+ to specific que/ions     

7includ+ in=mation & records7 z !       
,secret>y may require z to !            
organization1 bus9ess1 conduct1         
practices1 managem5t1 & relation to o!r 
corporations1 p>tn]%ips1 & individuals1 
( ! cov]$ entity4  7,b7  ,reports &     
answ]s  ,a cov]$ entity %all file any   
reports & answ]s 7includ+ in=mation &   
records7 requir$ "u subp>agraph 7,a77ii7
 9 su* mann]1 includ+ "u oa? or o!rwise1
 & )9 su* reasonable "t p]iod z !       
,secret>y may require4  7,c7  ,jo9t     
inve/igations  ,! ,secret>y may conduct 
inve/igations & make reque/s =          
in=mation1 z au?oriz$ "u ?is ,act1 on a 
jo9t basis ) ano!r ,f$]al ag5cy1 a ,/ate
 attorney g5]al1 or a ,/ate ag5cy4  7,d7
  ,obligation to keep1 pres]ve1 & make  
available records  ,a cov]$ entity %all 
make1 keep1 pres]ve1 & make available to
 ! ,secret>y records p]ta9+ to          
compliance ) ?is title 9 accordance )   
section #aa7;c7 ( ! ,fair ,labor ,/&>ds 
,act ( #aich 7#bi ,u4,s4,c4 #baa7;c77 & 
9 accordance ) any regulation or ord]   

issu$ by ! ,secret>y4  7#b7  ,en=cem5t  
,! ,secret>y %all receive1 inve/igate1 &
 attempt to resolve compla9ts (         
violations ( ?is title 9 ! same mann] t 
! ,secret>y receives1 inve/igates1 &    
attempts to resolve compla9ts (         
violations ( sections #f & #g ( ! ,fair 
,labor ,/&>ds ,act ( #aich 7#bi         
,u4,s4,c4 #bjf & #bjg74  7#c7  ,civil   
monet>y p5alties  ,subject to subsection
 7c71 ! ,secret>y may impose a civil    
monet>y p5alty on any p]son t violates  
?is title--  7,a7 9 an am\nt ( n m ?an  
#gf1ihg p] violation2 or  7,b7 = repeat 
violations1 9 an am\nt ( n m ?an        
#gfi1hgj p] violation4  7#d7            
,adm9i/rative compla9ts  ,an individual 
adv]sely affect$ by an alleg$ violation 
( ?is title may--  7,a7 file a compla9t 
( a violation ( ?is title ) ! ,secret>y2
 &  7,b7 designate a repres5tative ( a  
labor organization1 reg>dless ( !       
relation%ip betwe5 ! individual & !     
labor organization1 to--  7i7 file !    
compla9t on behalf ( ! individual2 or   

7ii7 repres5t ! individual = purposes ( 
engagem5t ) ! ,secret>y reg>d+ su*      
compla9t1 includ+ be+ pres5t at work]   
int]views & p>ticipat+ 9 workplace      
inspections1 conf]5ces1 & settlem5t     
negotiations4  7#e7  ,litigation  ,!    
,solicitor ( ,labor may appe> = &       
repres5t ! ,secret>y on any litigation  
br\ght "u ?is subsection4 ,if !         
,secret>y det]m9es t a cov]$ entity has 
violat$ ?is title1 ! ,secret>y may file 
a civil action 9 any appropriate ,unit$ 
,/ates di/rict c\rt to obta9 injunctive 
relief to en=ce ?is title4  7#f7        
,burd5s ( pro(  ,all compla9ts "u ?is   
subsection %all be gov]n$ by ! legal    
burd5s ( pro( set =? 9 section          
#dbaba7;b7 ( title #di1 ,unit$ ,/ates   
,code4  7b7  ,private "r ( action  7#a7 
,9 g5]al  ,not)/&+ any action by !      
,secret>y "u subsection 7a71 any        
individual adv]sely affect$ by an alleg$
 violation ( ?is title 7or a            
repres5tative on behalf ( su*           
individual7 may comm5ce a civil action  

aga9/ any cov]$ entity t violates ?is   
title 9 any ,f$]al c\rt ( compet5t      
jurisdiction4  7#b7  ,relief  7,a7  ,9  
g5]al  ,9 a civil action br\ght "u      
p>agraph 7#a7 9 :i* ! individual        
describ$ 9 su* p>agraph prevails1 ! c\rt
 may aw>d ! individual--  7i7 damages   
(-- 7,i7 an am\nt equal to ! sum ( any  
actual damages includ+ back pay su/a9$  
by ! individual2 or  7,,ii7 n m ?an     
treble damages2  7ii7 /atutory damages  
describ$ 9 subp>agraph 7,b72  7iii7     
injunctive relief2  7iv7 equitable      
relief2  7v7 reasonable attorney fees & 
litigation co/s2 &  7vi7 :ile ! action  
is p5d+1 tempor>y relief1 includ+       
tempor>y re9/atem5t4  7,b7  ,/atutory   
damages  7i7  ,9 g5]al  ,! c\rt may1 9  
accordance ) clause 7ii71 aw>d /atutory 
damages "u subp>agraph 7,a77ii7 aga9/ a 
cov]$ entity 9 ! foll[+ am\nts3  7,i7 ,=
 ea* violation ( section #bja 7reg>d+   
adv]se employm5t actions71 ! c\rt may   
aw>d damages ( an am\nt 7subject to     
subsection 7c77 ( n less ?an #e1jjj & n 

m ?an #bj1jjj4  7,,ii7 ,= ea* violation 
( section #bjb 7reg>d+ :i/lebl[]        
protections71 ! c\rt may aw>d damages ( 
an am\nt 7subject to subsection 7c77 ( n
 less ?an #aj1jjj & n m ?an #ajj1jjj4   
7ii7  ,consid]ations = /atutory damages 
,9 det]m9+ ! am\nt ( /atutory damages   
assess$ "u ?is subp>agraph aga9/ a cov]$
 entity1 ! c\rt %all consid] any        
relevant circum/ances pres5t$ by !      
p>ties to ! action1 includ+--  7,i7 !   
nature & s]i\sness ( ! violation2       
7,,ii7 ! numb] ( violations2  7,,iii7 ! 
p]si/5ce ( ! misconduct2  7,,iv7 ! l5g? 
( "t ov] :i* ! misconduct occurr$2  7,v7
 ! willfulness ( ! misconduct2 &  7,,vi7
 ! assets1 liabilities1 & net wor? ( !  
cov]$ entity4  7#c7  ,rem$ies = ,/ate   
work]s  7,a7  ,waiv] ( sov]eign immunity
  ,a ,/ate's receipt or use ( ,f$]al    
f9ancial assi/ance = any program or     
activity ( a ,/ate %all con/itute a     
waiv] ( sov]eign immunity1 "u ! #aa?    
,am5dm5t to ! ,con/itution ( ! ,unit$   
,/ates or o!rwise1 to a suit "u ?is     

subsection = ! relief describ$ 9        
p>agraph 7#b7 au?oriz$ "u ?is subsection
 br\ght by an individual employ$ "u1 or 
o!rwise engag$ 9 ! p]=mance ( "w =      
remun]ation "u1 t program or activity4  
7,b7  ,(ficial capacity  ,an (ficial ( a
 ,/ate may be su$ 9 ! (ficial capacity (
 ! (ficial by any individual :o has     
compli$ ) ! proc$ures "u ?is p>agraph1 =
 injunctive relief t is au?oriz$ "u ?is 
subsection4 ,9 su* a suit ! c\rt may    
aw>d to ! prevail+ p>ty ^? co/s au?oriz$
 by section #gbb ( ! ,revis$ ,/atutes   
7#db ,u4,s4,c4 #aihh74  7,c7            
,applicability  ,) respect to a p>ticul>
 program or activity1 subp>agraph 7,a7  
applies to conduct t occurs--  7i7 aft] 
! date ( enactm5t ( ?is ,act2 &  7ii7 on
 or aft] ! day on :i* a ,/ate fir/      
receives or uses ,f$]al f9ancial        
assi/ance = t program or activity4  7#d7
  ,def9ition ( program or activity  ,9  
?is subsection1 ! t]m program or        
activity has ! mean+ giv5 ! t]m 9       
section #fjf ( ! ,civil ,rights ,act (  

#aifd 7#db ,u4,s4,c4 #bjjj;d-#d;a74  7c7
  ,inflation adju/m5t  7#a7  ,9 g5]al   
,subject to p>agraphs 7#b7 & 7#c71 !    
,secret>y1 n lat] ?an ,septemb] #a ( ea*
 cal5d> ye>1 %all adju/ ! doll> am\nts  
ref]r$ to 9 subsections 7a77#c7 &       
7b77#b77;,b77i7 by ! p]c5t increase1 if 
any1 9 ! consum] price index = all urban
 consum]s 7,unit$ ,/ates city av]age71  
or a successor index1 z det]m9$ by !    
,bureau ( ,labor ,/ati/ics1 or a        
successor ag5cy1 = ! mo/ rec5t #ab-mon? 
p]iod = :i* data is available4  7#b7    
,r\nd+  ,any adju/m5t "u p>agraph 7#a7 t
 is n a multiple ( #aj %all be r\nd$ to 
! ne>e/ multiple ( #aj4  7#c7           
,publication  ,! ,secret>y %all publi% !
 adju/$ am\nts "u p>agraph 7#a7 9 !     
,f$]al ,regi/]1 & on ! (ficial website (
 ! ,dep>tm5t ( ,labor1 n lat] ?an       
,octob] #a1 ( ! applicable cal5d> ye> = 
! increase "u su* p>agraph4  7#d7       
,effective date  ,ea* adju/m5t "u       
p>agraph 7#a7 %all take effect on       
,janu>y #a ( ! fir/ cal5d> ye> beg9n+   

aft] ! date ( ! increase "u su*         
p>agraph4  7d7  ,arbitration & class    
action  ,not)/&+ any o!r provision (    
law1 no pr$ispute arbitration agreem5t  
or pr$ispute jo9t-action waiv] %all be  
valid or en=ceable ) respect to any     
alleg$ violation ( ?is title4  #bjd4    
,regulations  7a7  ,9 g5]al  ,!         
,secret>y may prescribe su* regulations 
z may be necess>y to c>ry out ?is title4
  7b7  ,consultation  ,9 prescrib+ any  
regulations au?oriz$ "u ?is section1 !  
,secret>y--  7#a7 %all consult ) !      
,secret>y ( ,heal? & ,human ,s]vices2 & 
7#b7 may consult )-- 7,a7 o!r ,f$]al    
ag5cies t h exp]tise 9 artificial       
intellig5ce or heal? c>e2 &  7,b7 o!r   
,f$]al ag5cies t h jurisdiction ov]     
labor & employm5t issues1 includ+ !     
,equal ,employm5t ,opportunity          
,commission1 ! ,dep>tm5t ( ,ju/ice1 & ! 
,national ,labor ,relations ,bo>d4      
,,iii  ,g5]al provisions  #cja4         
,educational mat]ials = cov]$ entities &
 heal? c>e pr(essionals  ,n lat] ?an #a 

ye> aft] ! date ( enactm5t ( ?is ,act1 !
 ,secret>y ( ,heal? & ,human ,s]vices1 9
 consultation ) ! ,secret>y ( ,labor1   
%all develop & dissem9ate education     
mat]ials =--  7#a7 cov]$ entities )     
respect to ! compliance ( su* entities )
 ! requirem5ts "u ?is ,act2 &  7#b7     
heal? c>e pr(essionals to in=m su*      
pr(essionals ( _! rights & protections  
"u ?is ,act4  #cjb4  ,/ate en=cem5t  7a7
  ,9 g5]al  ,9 any case 9 :i* a ,/ate   
attorney g5]al or a ,/ate privacy       
regulator has reason to believe t an    
int]e/ ( ! resid5ts ( a ,/ate has be5 or
 is adv]sely affect$ by any cov]$ entity
 t violates any provision ( ?is ,act1 ! 
,/ate attorney g5]al or ,/ate privacy   
regulator1 z p>5s patriae1 may br+ a    
civil action on behalf ( ! resid5ts ( ! 
,/ate 9 an appropriate ,/ate c\rt or an 
appropriate di/rict c\rt ( ! ,unit$     
,/ates to--  7#a7 enjo9 fur!r violation 
( su* provision by ! cov]$ entity2  7#b7
 compel compliance ) su* provision2     
7#c7 obta9 damages1 civil p5alties1     

re/itution1 or o!r comp5sation on behalf
 ( ! resid5ts ( ! ,/ate2 or  7#d7 obta9 
reasonable attorney's fees & o!r        
litigation co/s reasonably incurr$4  7b7
  ,rights ( ag5cy  ,be=e initiat+ a     
civil action "u subsection 7a71 ! ,/ate 
attorney g5]al or ,/ate privacy         
regulator1 z ! case may be1 %all notify 
! ,secret>y 9 writ+ ( su* civil action4 
,^u receiv+ su* notice1 ! ,secret>y     
may--  7#a7 int]v5e 9 su* action2 &     
7#b7 ^u int]v5+--  7,a7 be he>d on all  
matt]s aris+ 9 su* civil action2 &  7,b7
 file petitions = appeal ( a decision 9 
su* action4  7c7  ,preemptive action by 
ag5cy  ,9 any case 9 :i* a civil action 
is in/itut$ by or on behalf ( !         
,secret>y = a violation ( ?is ,act1 a   
,/ate attorney g5]al or ,/ate privacy   
regulator may n1 dur+ ! p5d5cy ( su*    
action1 in/itute a civil action aga9/   
any def5dant nam$ 9 ! compla9t 9 !      
action in/itut$ by or on behalf ( !     
,secret>y = a violation t is alleg$ 9   
su* compla9t4 ,9 a case br\ght by !     

,secret>y t affects ! int]e/s ( a ,/ate1
 ! ,/ate attorney g5]al or ,/ate privacy
 regulator may int]v5e z ( "r pursuant  
to ! ,f$]al ,rules ( ,civil ,proc$ure4  
7d7  ,pres]vation ( ,/ate p[]s  ,except 
z provid$ 9 subsection 7c71 no provision
 ( ?is ,act %all be con/ru$ z alt]+1    
limit+1 or affect+ ! au?ority ( a ,/ate 
attorney g5]al or ,/ate privacy         
regulator to--  7#a7 br+ an action or   
o!r regulatory proce$+ aris+ solely "u !
 laws 9 effect 9 t ,/ate2 or  7#b7      
ex]cise ! p[]s conf]r$ on ! ,/ate       
attorney g5]al or ,/ate privacy         
regulator by ! laws ( ! ,/ate1 includ+ !
 ability to conduct inve/igations1      
adm9i/] oa?s or affirmations1 or compel 
! att5dance ( witnesses or ! production 
( docum5t>y or o!r evid5ce4  7e7        
,def9ition ( ,secret>y  ,9 ?is section1 
! t]m ,secret>y means-- 7#a7 ) respect  
to a violation ( title ,i1 ! ,secret>y (
 ,heal? & ,human ,s]vices2 &  7#b7 )    
respect to a violation ( title ,,ii1 !  
,secret>y ( ,labor4  #cjc4  ,rule (     

con/ruction  ,no?+ 9 ?is ,act %all      
protect a heal? c>e pr(essional f a     
m$ical malpractice or neglig5ce claim = 
heal? c>e s]vices provid$ ?r\gh ov]rid+ 
an ,,ai_/,,cdss output4  #cjd4          
,non-preemption  ,no?+ 9 ?is ,act %all  
preempt a ,/ate law or collective b>ga9+
 agreem5t4