This bill, known as the "BACK OFF Act," introduces new grounds for inadmissibility and deportability for aliens engaging in "birth tourism." An alien is deemed inadmissible or deportable if they are not a lawful permanent resident and are seeking to enter or remain in the United States to give birth and undermine U.S. sovereignty by obtaining citizenship for their child, or are likely to give birth within 10 months of entry. These new grounds for inadmissibility and deportability cannot be waived, and affected aliens are ineligible for parole into the United States. To enforce these provisions, the bill mandates medical examinations for biological female nonimmigrant visa applicants of childbearing age seeking visas for business or pleasure. The purpose of these examinations is to determine if the alien is likely to give birth in the U.S. during their stay, which could lead to visa denial or withholding. Furthermore, immigration officers are authorized to temporarily detain suspected aliens of childbearing age for medical examination if they are suspected of being inadmissible or deportable due to birth tourism. The legislation establishes new criminal penalties for individuals who facilitate birth tourism, including those who forge documents, provide fraudulent documents, or assist with visa applications for this purpose. It also creates specific offenses for healthcare theft or fraud related to birth tourism, imposing imprisonment of not less than 10 years and significant fines. Additionally, individuals who knowingly provide housing, transportation, food, medical care, or financial support to aliens for the purpose of birth tourism face criminal charges. The bill introduces expedited removal procedures for aliens found inadmissible or deportable due to birth tourism, with limited judicial review. It also includes provisions targeting "recalcitrant countries," allowing for the suspension of visa issuance and admission for citizens of countries that refuse to accept the return of removed aliens within 14 days. Finally, a Birth Tourism Taskforce is established within the Department of Homeland Security to investigate and refer cases for criminal prosecution, and to produce training materials for local law enforcement.