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108th CONGRESS
1st Session
H. R. 1499
To require health insurance coverage for certain reconstructive
surgery.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 27, 2003
Mr. Ross introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Education and the Workforce, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as
fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To require health insurance coverage for certain reconstructive
surgery.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Reconstructive Surgery Act of
2003''.
SEC. 2. COVERAGE OF RECONSTRUCTIVE SURGERY.
(a) Group Health Plans.--
(1) Public health service act amendments.--
(A) In general.--Section 2706 of the Public Health
Service Act (42 U.S.C. 300gg-6) is amended to read as
follows:
``SEC. 2706. COVERAGE OF RECONSTRUCTIVE SURGERY.
``(a) Requirement.--A group health plan and a health insurance
issuer offering group health insurance coverage in connection with a
group health plan that provides coverage for surgery shall provide
coverage for reconstructive surgery.
``(b) Definition.--In subsection (a), the term `reconstructive
surgery' means any medically necessary and appropriate surgery
performed to correct or repair abnormal structures of the body caused
by congenital defects, developmental abnormalities, trauma, infection,
tumors, or disease to--
``(1) improve functions; or
``(2) give the patient a normal appearance, to the extent
possible, in the judgment of the physician performing the
surgery.
``(c) Rule of Construction.--
``(1) In general.--Nothing in this section shall be
construed to require a group health plan or health insurance
issuer in connection with a group health plan to provide
coverage for cosmetic surgery.
``(2) Definition.--In paragraph (1), the term `cosmetic
surgery' means surgery that is performed to alter or reshape
normal structures of the body in order to improve
appearance.''.
(B) Conforming amendment.--Section 2723(c) of the
Public Health Service Act (42 U.S.C. 300gg-23(c)) is
amended by striking ``section 2704'' and inserting
``sections 2704 and 2706''.
(2) ERISA amendments.--
(A) In general.--Section 713 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C.
1185b) is amended to read as follows:
``SEC. 713. COVERAGE FOR RECONSTRUCTIVE SURGERY.
``(a) Requirement.--A group health plan and a health insurance
issuer offering group health insurance coverage in connection with a
group health plan that provides coverage for surgery shall provide
coverage for reconstructive surgery.
``(b) Definition.--In subsection (a), the term `reconstructive
surgery' means any medically necessary and appropriate surgery
performed to correct or repair abnormal structures of the body caused
by congenital defects, developmental abnormalities, trauma, infection,
tumors, or disease to--
``(1) improve functions; or
``(2) give the patient a normal appearance, to the extent
possible, in the judgment of the physician performing the
surgery.
``(c) Rule of Construction.--
``(1) In general.--Nothing in this section shall be
construed to require a group health plan or health insurance
issuer in connection with a group health plan to provide
coverage for cosmetic surgery.
``(2) Definition.--In paragraph (1), the term `cosmetic
surgery' means surgery that is performed to alter or reshape
normal structures of the body in order to improve
appearance.''.
(B) Conforming amendments.--
(i) Section 731(c) of such Act (29 U.S.C.
1191(c)) is amended by striking ``section 711''
and inserting ``sections 711 and 713''.
(ii) Section 732(a) of such Act (29 U.S.C.
1191a(a)) is amended by striking ``section
711'' and inserting ``sections 711 and 713''.
(iii) The table of contents in section 1 of
such Act is amended by inserting after the item
relating to section 712 the following new item:
``Sec. 713. Coverage for reconstructive surgery.''.
(b) Individual Market.--Section 2752 of the Public Health Service
Act (42 U.S.C. 300gg-52) is amended to read as follows:
``SEC. 2752. COVERAGE FOR RECONSTRUCTIVE SURGERY.
``The provisions of section 2706 shall apply to health insurance
coverage offered by a health insurance issuer in the individual market
in the same manner as they apply to health insurance coverage offered
by a health insurance issuer in connection with a group health plan in
the small or large group market.''.
(c) Effective Dates.--
(1) Group health plans.--Subject to paragraph (3), the
amendments made by subsection (a) shall apply with respect to
group health plans for plan years beginning on or after January
1, 2004.
(2) Health insurance coverage.--The amendment made by
subsection (b) shall apply with respect to health insurance
coverage offered, sold, issued, renewed, in effect, or operated
in the individual market on or after such date.
(3) Collective bargaining agreements.--In the case of a
group health plan maintained pursuant to 1 or more collective
bargaining agreements between employee representatives and 1 or
more employers ratified before the date of enactment of this
Act, the amendments made by subsection (a) shall not apply to
plan years beginning before the later of--
(A) the date on which the last collective
bargaining agreements relating to the plan terminates
(determined without regard to any extension thereof
agreed to after the date of enactment of this Act), or
(B) January 1, 2004.
For purposes of subparagraph (A), any plan amendment made
pursuant to a collective bargaining agreement relating to the
plan which amends the plan solely to conform to any requirement
added by subsection (a) shall not be treated as a termination
of such collective bargaining agreement.
(d) Coordinated Regulations.--Section 104(1) of Health Insurance
Portability and Accountability Act of 1996 (Public Law 104-191) is
amended by striking ``this subtitle (and the amendments made by this
subtitle and section 401)'' and inserting ``the provisions of part 7 of
subtitle B of title I of the Employee Retirement Income Security Act of
1974, and the provisions of parts A and C of title XXVII of the Public
Health Service Act''.
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