I 

118TH CONGRESS 

2D SESSION H. R. 8128 

To require health insurance coverage for scalp cooling items. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 26, 2024 

Ms. DELAURO introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on 

Ways and Means, Education and the Workforce, Armed Services, Veterans’ Affairs, and Oversight and Accountability, 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 scalp cooling items. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Access to Scalp Cool5 ing Therapy Act of 2024’’. 


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1 SEC. 2. REQUIRING COVERAGE FOR SCALP COOLING ITEMS 

2 UNDER GROUP HEALTH PLANS AND GROUP 

3 AND INDIVIDUAL HEALTH INSURANCE COV4 ERAGE, SPECIFIED FEDERAL HEALTH CARE 

5 PROGRAMS, AND THE FEDERAL EMPLOYEES 

6 HEALTH BENEFITS PROGRAM. 

7 (a) GROUP HEALTH PLANS AND HEALTH INSUR8 ANCE COVERAGE.—Subpart II of part A of title XXVII 

9 of the Public Health Service Act (42 U.S.C. 300gg–11 et 

10 seq.) is amended by adding at the end the following new 

11 section: 

12 ‘‘SEC. 2730. REQUIRED COVERAGE OF SCALP COOLING 

13 ITEMS. 

14 ‘‘(a) IN GENERAL.—With respect to a plan year be15 ginning on or after January 1, 2025, a group health plan 

16 and a health insurance issuer offering group or individual 

17 health insurance coverage shall provide benefits under 

18 such plan or such coverage for scalp cooling items (as de19 fined in subsection (c)) in accordance with the require20 ment described in subsection (b). 

21 ‘‘(b) COVERAGE REQUIREMENT.—For purposes of 

22 subsection (a), the requirement described in this sub23 section is, with respect to the imposition or application of 

24 any financial requirement (as defined in subsection (c)) 

25 with respect to coverage of scalp cooling items under a 

26 group health plan or group or individual health insurance 


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1 coverage, the requirement that such financial requirement 

2 be the same as such requirement applicable to intravenous 

3 or injection anticancer drugs furnished under such plan 

4 or such coverage for which benefits are provided under 

5 such plan or such coverage. 

6 ‘‘(c) DEFINITIONS.—In this section: 

7 ‘‘(1) FINANCIAL REQUIREMENT.—The term ‘fi8 nancial requirement’ means, with respect to an item 

9 or service furnished under a group health plan or 

10 group or individual health insurance coverage, any 

11 copayment, coinsurance, deductible, annual limit, 

12 lifetime limit, or out-of-pocket maximum applied 

13 under such plan or such coverage with respect to 

14 such item or service. 

15 ‘‘(2) SCALP COOLING ITEM.—The term ‘scalp 

16 cooling item’ means a cooling cap, hypothermia cap, 

17 cold cap, or any other therapeutic device used to cool 

18 the scalp of an individual to prevent or reduce hair 

19 loss during chemotherapy.’’. 

20 (b) ERISA.—Subpart B of part 7, of subtitle B, of 

21 title I of the Employee Retirement Income Security Act 

22 of 1974 (29 U.S.C. 1185 et seq.) is amended by adding 

23 at the end the following: 


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1 ‘‘SEC. 726. REQUIRED COVERAGE OF SCALP COOLING 

2 ITEMS. 

3 ‘‘(a) IN GENERAL.—With respect to a plan year be4 ginning on or after January 1, 2025, a group health plan 

5 and a health insurance issuer offering group or individual 

6 health insurance coverage shall provide benefits under 

7 such plan or such coverage for scalp cooling items (as de8 fined in subsection (c)) in accordance with the require9 ment described in subsection (b). 

10 ‘‘(b) COVERAGE REQUIREMENT.—For purposes of 

11 subsection (a), the requirement described in this sub12 section is, with respect to the imposition or application of 

13 any financial requirement (as defined in subsection (c)) 

14 with respect to coverage of scalp cooling items under a 

15 group health plan or group or individual health insurance 

16 coverage, the requirement that such financial requirement 

17 be the same as such requirement applicable to intravenous 

18 or injection anticancer drugs furnished under such plan 

19 or such coverage for which benefits are provided under 

20 such plan or such coverage. 

21 ‘‘(c) DEFINITIONS.—In this section: 

22 ‘‘(1) FINANCIAL REQUIREMENT.—The term ‘fi23 nancial requirement’ means, with respect to an item 

24 or service furnished under a group health plan or 

25 group or individual health insurance coverage, any 

26 copayment, coinsurance, deductible, annual limit, 


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1 lifetime limit, or out-of-pocket maximum applied 

2 under such plan or such coverage with respect to 

3 such item or service. 

4 ‘‘(2) SCALP COOLING ITEM.—The term ‘scalp 

5 cooling item’ means a cooling cap, hypothermia cap, 

6 cold cap, or any other therapeutic device used to cool 

7 the scalp of an individual to prevent or reduce hair 

8 loss during chemotherapy.’’. 

9 (2) CLERICAL AMENDMENT.—The table of con10 tents in section 1 of the Employee Retirement In11 come Security Act of 1974 (29 U.S.C. 1001 et seq.) 

12 is amended by inserting after the item relating to 

13 section 725 the following: 

‘‘Sec. 726. Required coverage of scalp cooling items.’’. 

14 (c) IRC.— 

15 (1) IN GENERAL.—Subchapter B of chapter 

16 100 of the Internal Revenue Code of 1986 is amend17 ed by adding at the end the following: 

18 ‘‘SEC. 9826. REQUIRED COVERAGE OF SCALP COOLING 

19 ITEMS. 

20 ‘‘(a) IN GENERAL.—With respect to a plan year be21 ginning on or after January 1, 2025, a group health plan 

22 and a health insurance issuer offering group or individual 

23 health insurance coverage shall provide benefits under 

24 such plan or such coverage for scalp cooling items (as deVerDate Sep 11 2014 23:38 Jun 22, 2024 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8128.IH H8128

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1 fined in subsection (c)) in accordance with the require2 ment described in subsection (b). 

3 ‘‘(b) COVERAGE REQUIREMENT.—For purposes of 

4 subsection (a), the requirement described in this sub5 section is, with respect to the imposition or application of 

6 any financial requirement (as defined in subsection (c)) 

7 with respect to coverage of scalp cooling items under a 

8 group health plan or group or individual health insurance 

9 coverage, the requirement that such financial requirement 

10 be the same as such requirement applicable to intravenous 

11 or injection anticancer drugs furnished under such plan 

12 or such coverage for which benefits are provided under 

13 such plan or such coverage. 

14 ‘‘(c) DEFINITIONS.—In this section: 

15 ‘‘(1) FINANCIAL REQUIREMENT.—The term ‘fi16 nancial requirement’ means, with respect to an item 

17 or service furnished under a group health plan or 

18 group or individual health insurance coverage, any 

19 copayment, coinsurance, deductible, annual limit, 

20 lifetime limit, or out-of-pocket maximum applied 

21 under such plan or such coverage with respect to 

22 such item or service. 

23 ‘‘(2) SCALP COOLING ITEM.—The term ‘scalp 

24 cooling item’ means a cooling cap, hypothermia cap, 

25 cold cap, or any other therapeutic device used to cool 


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1 the scalp of an individual to prevent or reduce hair 

2 loss during chemotherapy.’’. 

3 (2) CLERICAL AMENDMENT.—The table of sec4 tions for subchapter B of chapter 100 of the Inter5 nal Revenue Code of 1986 is amended by adding at 

6 the end the following new item: 

‘‘Sec. 9826. Required coverage of scalp cooling items.’’. 

7 (d) MEDICARE.— 

8 (1) COVERAGE.— 

9 (A) IN GENERAL.—Section 1861 of the So10 cial Security Act (42 U.S.C. 1395x) is amend11 ed— 

12 (i) in subsection (s)(2)— 

13 (I) in subparagraph (GG), by 

14 striking ‘‘and’’ at the end; 

15 (II) in subparagraph (HH), by 

16 striking the period and inserting ‘‘; 

17 and’’; and 

18 (III) by adding at the end the 

19 following new subparagraph: 

20 ‘‘(II) scalp cooling items (as de21 fined in subsection (lll));’’; and 

22 (ii) by adding at the end the following 

23 new subsection: 

24 ‘‘(lll) SCALP COOLING ITEMS.—The term ‘scalp cool25 ing item’ means a cooling cap, hypothermia cap, cold cap, 


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1 or any other therapeutic device used to cool the scalp of 

2 an individual to prevent or reduce hair loss during chemo3 therapy furnished on or after January 1, 2025.’’ 

4 (B) EXCLUSION MODIFICATION.—Section 

5 1862(a)(1) of the Social Security Act (42 

6 U.S.C. 1395y(a)(1)) is amended— 

7 (i) in subparagraph (O), by striking 

8 ‘‘and’’ at the end; 

9 (ii) in subparagraph (P), by striking 

10 the semicolon and inserting ‘‘, and’’; and 

11 (iii) by adding at the end the fol12 lowing new subparagraph: 

13 ‘‘(Q) in the case of scalp cooling 

14 items (as defined in section 1861(lll)), 

15 which are not furnished to prevent or 

16 reduce hair loss during chemo17 therapy;’’. 

18 (2) PAYMENT.—Section 1833(a)(1) of the So19 cial Security Act (42 U.S.C. 1395l(a)(1)) is amend20 ed— 

21 (A) by striking ‘‘and (DD)’’ and inserting 

22 ‘‘ (DD)’’; and 

23 (B) by inserting before the semicolon at 

24 the end the following: ‘‘and (EE) with respect 

25 to scalp cooling items (as defined in section 


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1 1861(lll)), the amount paid shall be equal to 80 

2 percent of the lesser of the actual charge or an 

3 amount determined appropriate by the Sec4 retary;’’. 

5 (e) MEDICAID.— 

6 (1) IN GENERAL.—Title XIX of the Social Se7 curity Act (42 U.S.C. 1396 et seq.) is amended— 

8 (A) in section 1902(a)(10)(A), by striking 

9 ‘‘and (30)’’ and inserting ‘‘(30), and (31)’’; and 

10 (B) in section 1905(a)— 

11 (i) in paragraph (30), by striking 

12 ‘‘and’’ at the end; 

13 (ii) by redesignating paragraph (31) 

14 as paragraph (32); and 

15 (iii) by inserting after paragraph (30) 

16 the following new paragraph: 

17 ‘‘(31) cooling caps, hypothermia caps, cold caps, 

18 and any other therapeutic devices used to cool the 

19 scalp of an individual to prevent or reduce hair loss 

20 during chemotherapy.’’. 

21 (2) EFFECTIVE DATE.— 

22 (A) IN GENERAL.—Subject to subpara23 graph (B), the amendments made by this sub24 section shall apply with respect to medical asVerDate Sep 11 2014 00:38 Jun 23, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H8128.IH H8128

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1 sistance furnished in calendar quarters begin2 ning on or after January 1, 2025. 

3 (B) EXCEPTION FOR STATE LEGISLA4 TION.—In the case of a State plan under title 

5 XIX of the Social Security Act (or a waiver of 

6 such plan), which the Secretary of Health and 

7 Human Services determines requires State leg8 islation in order for the respective plan (or 

9 waiver) to meet any requirement imposed by 

10 the amendments made by this subsection, the 

11 respective plan (or waiver) shall not be re12 garded as failing to comply with the require13 ments of such title solely on the basis of its fail14 ure to meet such an additional requirement be15 fore the first day of the first calendar quarter 

16 beginning after the close of the first regular 

17 session of the State legislature that begins after 

18 the date of enactment of this subsection. For 

19 purposes of the previous sentence, in the case 

20 of a State that has a 2-year legislative session, 

21 each year of the session shall be considered to 

22 be a separate regular session of the State legis23 lature. 

24 (f) CHIP.— 


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1 (1) IN GENERAL.—Section 2103 of the Social 

2 Security Act (42 U.S.C. 1397cc) is amended— 

3 (A) in subsection (a), by striking ‘‘para4 graphs (5), (6), (7) and (8) of’’; and 

5 (B) in subsection (c), by adding at the end 

6 the following new paragraph: 

7 ‘‘(11) Coverage of scalp cooling items.—The 

8 child health assistance provided to a targeted low-in9 come child shall include cooling caps, hypothermia 

10 caps, cold caps, and any other therapeutic devices 

11 used to cool the scalp of an individual to prevent or 

12 reduce hair loss during chemotherapy.’’. 

13 (2) EFFECTIVE DATE.— 

14 (A) IN GENERAL.—Subject to subpara15 graph (B), the amendments made by this sub16 section shall take effect with respect to child 

17 health assistance provided on or after January 

18 1, 2025. 

19 (B) EXCEPTION FOR STATE LEGISLA20 TION.—In the case of a State child health plan 

21 under title XXI of the Social Security Act (or 

22 a waiver of such plan), which the Secretary of 

23 Health and Human Services determines re24 quires State legislation in order for the respec25 tive plan (or waiver) to meet any requirement 


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1 imposed by the amendments made by this sec2 tion, the respective plan (or waiver) shall not be 

3 regarded as failing to comply with the require4 ments of such title solely on the basis of its fail5 ure to meet such an additional requirement be6 fore the first day of the first calendar quarter 

7 beginning after the close of the first regular 

8 session of the State legislature that begins after 

9 the date of enactment of this section. For pur10 poses of the previous sentence, in the case of a 

11 State that has a 2-year legislative session, each 

12 year of the session shall be considered to be a 

13 separate regular session of the State legislature. 

14 (g) FEHBP.—Section 8902 of title 5, United States 

15 Code, is amended by adding at the end the following new 

16 subsection: 

17 ‘‘(p) A contract may not be made or a plan ap18 proved which does not provide for the coverage re19 quired under section 2730 of the Public Health 

20 Service Act.’’. 

21 (h) TRICARE.—Section 1077(a) of title 10, United 

22 States Code, is amended by adding at the end the fol23 lowing new paragraph: 

24 ‘‘(19) A cooling cap, hypothermia cap, cold cap, 

25 or any other therapeutic device used to cool the 


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1 scalp of an individual to prevent or reduce hair loss 

2 during chemotherapy.’’. 

3 (i) VA.— 

4 (1) IN GENERAL.—Chapter 17 of title 38, 

5 United States Code, is amended by inserting after 

6 section 1720I the following new section: 

7

‘‘Sec. 1720J. Provision of scalp cooling items. 

8 ‘‘The Secretary shall make available to a vet9 eran who receives chemotherapy pursuant to this 

10 chapter a cooling cap, hypothermia cap, cold cap, or 

11 any other therapeutic device used to cool the scalp 

12 of an individual to prevent or reduce hair loss during 

13 chemotherapy.’’. 

14 (2) CLERICAL AMENDMENT.—The table of sec15 tions at the beginning of such chapter is amended 

16 by inserting after the item relating to section 1720I 

17 the following new item: 

18

‘‘1720J. Provision of scalp cooling items.’’. 

Æ 


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