Women's Health and Cancer Rights Act Statutory Text
As passed in H.R. 4328, the Omnibus Appropriations bill FY 99
Conference Report 105-825; Public Law: 105-277 (10/21/98)
TITLE IX--WOMEN'S HEALTH AND CANCER RIGHTS
SEC. 901. SHORT TITLE.
This title may be cited as the ``Women's Health and Cancer Rights Act of 1998''.
SEC. 902. AMENDMENTS TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.
(a) In General.--Subpart B of part 7 of subtitle B of
title I of the Employee Retirement Income Security Act of
1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end
the following new section:
SEC. 713. REQUIRED COVERAGE FOR RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMIES.
- In General.--A group health plan, and a health
insurance issuer providing health insurance coverage in
connection with a group health plan, that provides medical
and surgical benefits with respect to a mastectomy shall
provide, in a case of a participant or beneficiary who is
receiving benefits in connection with a mastectomy and who
elects breast reconstruction in connection with such
mastectomy, coverage for--
- all stages of reconstruction of the breast on which the
mastectomy has been performed;
- surgery and reconstruction of the other breast to
produce a symmetrical appearance; and
- prostheses and physical complications all stages of
mastectomy, including lymphedemas;
in a manner determined in consultation with the attending
physician and the patient. Such coverage may be subject to
annual deductibles and coinsurance provisions as may be
deemed appropriate and as are consistent with those
established for other benefits under the plan or coverage.
Written notice of the availability of such coverage shall
be delivered to the participant upon enrollment and
annually thereafter.
- Notice.--A group health plan, and a health
insurance issuer providing health insurance coverage in
connection with a group health plan shall provide notice to
each participant and beneficiary under such plan regarding
the coverage required by this section in accordance with
regulations promulgated by the Secretary. Such notice shall
be in writing and prominently positioned in any literature or
correspondence made available or distributed by the plan or
issuer and shall be transmitted--
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- in the next mailing made by the plan or issuer to
the participant or beneficiary;
- as part of any yearly informational packet sent to
the participant or beneficiary; or
- not later than January 1, 1999;
whichever is earlier.
- Prohibitions.--A group health plan, and a health
insurance issuer offering group health insurance coverage in
connection with a group health plan, may not--
- deny to a patient eligibility, or continued
eligibility, to enroll or to renew coverage under the terms
of the plan, solely for the purpose of avoiding the
requirements of this section; and
- penalize or otherwise reduce or limit the
reimbursement of an attending provider, or provide incentives
(monetary or otherwise) to an attending provider, to induce
such provider to provide care to an individual participant or
beneficiary in a manner inconsistent with this section.
- Rule of Construction.--Nothing in this section
shall be construed to prevent a group health plan or a health
insurance issuer offering group health insurance coverage
from negotiating the level and type of reimbursement with a
provider for care provided in accordance with this section.
- Preemption, Relation to State Laws.--
- In general.--Nothing in this section shall be
construed to preempt any State law in effect on the date of
enactment of this section with respect to health insurance
coverage that requires coverage of at least the coverage of
reconstructive breast surgery otherwise required under this
section.
- Erisa.--Nothing in this section shall be construed
to affect or modify the provisions of section 514 with
respect to group health plans.''.
- Clerical Amendment.--The table of contents in section
1 of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1001 note) is amended by inserting after the item
relating to section 712 the following new item:
Sec. 713. Required coverage reconstructive surgery
following mastectomies.''.
(c) Effective Dates.--
- In general.--The amendments made by this section
shall apply with respect to plan years beginning on or after
the date of enactment of this Act.
- Special rule for 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, 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 this section shall not be treated as a
termination of such collective bargaining agreement.
SEC. 903. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
(a) Group Market.--Subpart 2 of part A of title XXVII of
the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is
amended by adding at the end the following new section:
SEC. 2706. REQUIRED COVERAGE FOR RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMIES.
The provisions of section 713 of the Employee
Retirement Income Security Act of 1974 shall apply to group
health plans, and health insurance issuers providing health
insurance coverage in connection with group health plans, as
if included in this subpart.''.
(b) Individual Market.--Subpart 3 of part B of title
XXVII of the Public Health Service Act (42 U.S.C. 300gg-51 et
seq.) is amended by adding at the end the following new
section:
SEC. 2752. REQUIRED COVERAGE FOR RECONSTRUCTIVE SURGERY
FOLLOWING MASTECTOMIES.
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.--
- Group plans.--
- In general.--The amendment made by subsection (a)
shall apply to group health plans for plan years beginning on
or after the date of enactment of this Act.
- Special rule for 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, 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 the amendment made by subsection (a)
shall not be treated as a termination of such collective
bargaining agreement.
- Individual plans.--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 the date of enactment of this
Act.
This Act may be cited as the Department of Labor, Health
and Human Services, and Education, and Related Agencies
Appropriations Act, 1999''.
(g) For programs, projects or activities in the Department
of Transportation and Related Agencies Appropriations Act,
1999, provided as follows, to be effective as if it had been
enacted into law as the regular appropriations Act:
AN ACT Making appropriations for the Department of
Transportation and related agencies for the fiscal year
ending September 30, 1999, and for other purposes.
Last Modified on Friday, September 17, 2004
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