To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require that group and individual health insurance coverage and group health plans provide coverage for hair prostheses for individuals with scalp hair loss as a result of alopecia areata.
Last action on Jul 11, 2002Sponsor introductory remarks on measure. (CR E1236)
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Summary
Amends the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code to require group health plans and health insurance issuers offering coverage in connection with such plans to provide coverage for scalp hair prostheses for participants or beneficiaries who have scalp hair loss as a result of alopecia areata, if the attending physician certifies the medical necessity of that proposed course of rehabilitative treatment. Provides that such coverage is not subject to dollar limits, deductibles, and coinsurance provisions that are less favorable than those for other prosthesis coverage under the plan; but authorizes the plan or issuer to pay for only 80 percent of the customary and usual costs of the prosthesis exclusive of any deductible.
Amends the Public Health Service Act to apply this Act's requirement to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to coverage offered in the small or large group market.