Enforcement

(a) Attorney General The Attorney General may commence a civil action on behalf of the United States in any district court of the United States against any State that violates, or against any government official (including a person described in section 8(c)) who implements or enforces a limitation or requirement that violates, section 5 or 6. The court shall declare unlawful the limitation or requirement if it is determined to be in violation of this Act. (b) Private right of action (1) In general Any individual or entity adversely affected by an alleged violation of this Act, including any person or health care provider, may commence a civil action against any government official (including a person described in section (c)) that implements or enforces a limitation or requirement that violates section 5 or 6. The court shall declare unlawful the limitation or requirement if it is determined to be in violation of this Act. (2) Health care provider A health care provider may commence an action for relief on its own behalf, on behalf of the provider’s staff, and on behalf of the provider’s patients who are or may be adversely affected by an alleged violation of this Act. (c) Pre-Enforcement challenges A suit under subsection (a) or (b) may be brought to prevent enforcement or implementation of a State limitation or requirement that is inconsistent with section 5 or 6. (d) Declaratory and equitable relief In any action under this section, the court may award appropriate declaratory and equitable relief, including temporary, preliminary, or permanent injunctive relief. (e) Costs In any action under this section, the court shall award costs of litigation, as well as reasonable attorney’s fees, to any prevailing plaintiff. A plaintiff shall not be liable to a defendant for costs or attorney’s fees in any non-frivolous action under this section. (f) Jurisdiction The district courts of the United States shall have jurisdiction over proceedings under this Act and shall exercise the same without regard to whether the party aggrieved shall have exhausted any administrative or other remedies that may be provided for by law. (g) Abrogation of State immunity Neither a State that enforces or maintains, nor a government official (including a person described in section 8(c)) who is permitted to implement or enforce any limitation or requirement that violates section 5 or 6 shall be immune under the Tenth Amendment to the Constitution of the United States, the Eleventh Amendment to the Constitution of the United States, or any other source of law, from an action in a Federal or State court of competent jurisdiction challenging that limitation or requirement, unless such immunity is required by clearly established Federal law, as determined by the Supreme Court of the United States.