Health Education Labor and Pensions Bill VII

S. 576

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 2001'.

`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.'.

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