I 
111TH CONGRESS 
1ST SESSION H. R. 1142 
To amend title XIX of the Social Security Act to require States to provide 
hair prostheses under the Medicaid Program for individuals diagnosed 
with alopecia areata. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 24, 2009 
Ms. ESHOO introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to require 
States to provide hair prostheses under the Medicaid 
Program for individuals diagnosed with alopecia areata. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Alopecia Areata Med-
icaid Improvement and Parity Act’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
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(1) Alopecia areata is a highly unpredictable, 
autoimmune skin disease resulting in the loss of hair 
on the scalp and elsewhere on the body. 
(2) Approximately 5,000 Medicaid recipients 
suffer from the most severe forms of the condition, 
alopecia areata universalis or alopecia areata totalis, 
which are characterized by the total, or near total, 
loss of all body and scalp hair. 
(3) Adults with alopecia areata universalis and 
totalis have lost jobs, been harassed or accused of 
belonging to extremist cults because of their hair 
loss. Children with the condition have been moved to 
special education classes and ostracized by their 
peers. 
(4) Dermatologists consider it entirely appro-
priate and necessary that patients with alopecia 
areata be reimbursed for a hair prosthesis. Der-
matologists also state that the need for a hair pros-
thesis is much the same as the need for a leg pros-
thesis and is sometimes the best therapeutic alter-
native available. 
(5) Twelve States already provide Medicaid cov-
erage for hair prostheses for people with alopecia 
areata because these devices are considered medi-
cally necessary when prescribed by a physician. 
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SEC. 3. IMPROVEMENT OF ALOPECIA AREATA COVERAGE 
UNDER MEDICAID. 
(a) IN GENERAL.—Section 1902(a)(10) of the Social 
Security Act (42 U.S.C. 1396a(a)(10)) is amended— 
(1) by striking ‘‘and’’ at the end of subpara-
graph (F); 
(2) by adding ‘‘and’’ at the end of subpara-
graph (G); and 
(3) by inserting after subparagraph (G) the fol-
lowing new subparagraph: 
‘‘(H) that if medical assistance is included 
for inpatient hospital services for an individual, 
then the plan must include making medical as-
sistance available to the individual for annual 
coverage of one scalp hair prosthesis if the indi-
vidual is diagnosed with alopecia areata 
universalis or alopecia areata totalis or if the 
individual’s attending physician certifies in writ-
ing the medical necessity of that proposed 
course of rehabilitative treatment;’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply with respect to items furnished 
on or after January 1, 2010, without regard to whether 
or not final regulations to carry out such amendments 
have been promulgated by such date. 
Æ 
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