Sec. 6. Enforcement

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A violation of this Act shall be treated as a violation of a rule defining an unfair or deceptive act or practice under section 18(a)(1)(B) of the Federal Trade Commission Act ( 15 U.S.C. 57a(a)(1)(B) ). Except as provided in subparagraph (C), the Commission shall enforce this Act in the same manner, by the same means, and with the same jurisdiction, powers, and duties as though all applicable terms and provisions of the Federal Trade Commission Act ( 15 U.S.C. 41 et seq. ) were incorporated into and made a part of this Act.

Subject to paragraph (3), any person who violates this Act shall be subject to the penalties and entitled to the privileges and immunities provided in the Federal Trade Commission Act ( 15 U.S.C. 41 et seq. ). Notwithstanding section 4 or 6 of the Federal Trade Commission Act ( 15 U.S.C. 44 , 46), section 2 of McCarran-Ferguson Act ( 15 U.S.C. 1012 ), or any other jurisdictional limitation of the Commission, the Commission shall also enforce this Act, in the same manner provided in subparagraphs

(A)and

(B)of this paragraph, with respect to— organizations not organized to carry on business for their own profit or that of their members; and the business of insurance, and persons engaged in such business. Nothing in this section shall be construed to limit the authority of the Commission under any other provision of law. In addition to any penalty applicable under the Federal Trade Commission Act ( 15 U.S.C. 41 et seq. ), any person that violates this Act shall be liable for a civil penalty of not more than $1,000,000. The penalties provided by subparagraph

(A)shall be obtained in the same manner as civil penalties imposed under section 18(a)(1)(B) of the Federal Trade Commission Act (15 U.S.C. 57a(a(1)(B). In assessing a penalty under subparagraph (A)— each day of a continuing violation shall be considered a separate violation; and the court shall take into consideration, among other factors— the seriousness of the violation; the efforts of the person committing the violation to remedy the harm caused by the violation in a timely manner; and whether the violation was intentional. If the attorney general of a State has reason to believe that an interest of the residents of the State has been or is being threatened or adversely affected by a practice that violates this Act, the attorney general of the State may bring a civil action on behalf of the residents of the State in an appropriate district court of the United States to obtain appropriate relief. Except as provided in clause (iii), the attorney general of a State, before initiating a civil action under paragraph (1), shall provide written notification to the Commission that the attorney general intends to bring such civil action. The notification required under clause

(i)shall include a copy of the complaint to be filed to initiate the civil action. If it is not feasible for the attorney general of a State to provide the notification required under clause

(i)before initiating a civil action under paragraph (1), the attorney general shall notify the Commission immediately upon instituting the civil action. The Commission may— intervene in any civil action brought by the attorney general of a State under paragraph (1); and upon intervening— be heard on all matters arising in the civil action; and file petitions for appeal of a decision in the civil action. Nothing in this subsection may be construed to prevent the attorney general of a State from exercising the powers conferred on the attorney general by the laws of the State to conduct investigations, to administer oaths or affirmations, or to compel the attendance of witnesses or the production of documentary or other evidence. No civil action brought pursuant to this subsection shall conflict with the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1001 et seq. ). Any action brought under paragraph

(1)may be brought in— the district court of the United States that meets applicable requirements relating to venue under section 1391 of title 28, United States Code; or another court of competent jurisdiction. In an action brought under paragraph (1), process may be served in any district in which— the defendant is an inhabitant, may be found, or transacts business; or venue is proper under section 1391 of title 28, United States Code. If an attorney general lacks appropriate jurisdiction to bring a civil action under paragraph (1), any other officer of a State who is authorized by the State to do so may bring a civil action under paragraph (1), subject to the same requirements and limitations that apply under this subsection to civil actions brought by attorneys general. The authority provided by subparagraph

(A)shall supplant, and not supplement, the authorities of State attorneys general under paragraph (1). Nothing in this subsection may be construed to prohibit an authorized official of a State from initiating or continuing any proceeding in a court of the State for a violation of any civil or criminal law of the State. In an action brought under this section to enforce section 2, it shall be an affirmative defense, on which the defendant has the burden of persuasion by a preponderance of the evidence, that the conduct alleged to be a violation of section 2 was nonpretextual and reasonably necessary to— prevent a violation of, or comply with, Federal or State law; protect patient safety; or protect patient access. Nothing in this subsection shall be construed to prohibit a defendant from raising any other affirmative defense available.

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Sec. 6

Enforcement

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