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 Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means, Education and the Workforce, Armed Services, Vet-
erans’ Affairs, and Oversight and Accountability, for a period to be sub-
sequently 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. 
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 ‘‘Access to Scalp Cool-
ing Therapy Act of 2024’’. 
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SEC. 2. REQUIRING COVERAGE FOR SCALP COOLING ITEMS 
UNDER GROUP HEALTH PLANS AND GROUP 
AND INDIVIDUAL HEALTH INSURANCE COV-
ERAGE, SPECIFIED FEDERAL HEALTH CARE 
PROGRAMS, AND THE FEDERAL EMPLOYEES 
HEALTH BENEFITS PROGRAM. 
(a) GROUP HEALTH PLANS AND HEALTH INSUR-
ANCE COVERAGE.—Subpart II of part A of title XXVII 
of the Public Health Service Act (42 U.S.C. 300gg–11 et 
seq.) is amended by adding at the end the following new 
section: 
‘‘SEC. 2730. REQUIRED COVERAGE OF SCALP COOLING 
ITEMS. 
‘‘(a) IN GENERAL.—With respect to a plan year be-
ginning on or after January 1, 2025, a group health plan 
and a health insurance issuer offering group or individual 
health insurance coverage shall provide benefits under 
such plan or such coverage for scalp cooling items (as de-
fined in subsection (c)) in accordance with the require-
ment described in subsection (b). 
‘‘(b) COVERAGE REQUIREMENT.—For purposes of 
subsection (a), the requirement described in this sub-
section is, with respect to the imposition or application of 
any financial requirement (as defined in subsection (c)) 
with respect to coverage of scalp cooling items under a 
group health plan or group or individual health insurance 
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coverage, the requirement that such financial requirement 
be the same as such requirement applicable to intravenous 
or injection anticancer drugs furnished under such plan 
or such coverage for which benefits are provided under 
such plan or such coverage. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) FINANCIAL REQUIREMENT.—The term ‘fi-
nancial requirement’ means, with respect to an item 
or service furnished under a group health plan or 
group or individual health insurance coverage, any 
copayment, coinsurance, deductible, annual limit, 
lifetime limit, or out-of-pocket maximum applied 
under such plan or such coverage with respect to 
such item or service. 
‘‘(2) SCALP COOLING ITEM.—The term ‘scalp 
cooling item’ means a cooling cap, hypothermia cap, 
cold cap, or any other therapeutic device used to cool 
the scalp of an individual to prevent or reduce hair 
loss during chemotherapy.’’. 
(b) ERISA.—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: 
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‘‘SEC. 726. REQUIRED COVERAGE OF SCALP COOLING 
ITEMS. 
‘‘(a) IN GENERAL.—With respect to a plan year be-
ginning on or after January 1, 2025, a group health plan 
and a health insurance issuer offering group or individual 
health insurance coverage shall provide benefits under 
such plan or such coverage for scalp cooling items (as de-
fined in subsection (c)) in accordance with the require-
ment described in subsection (b). 
‘‘(b) COVERAGE REQUIREMENT.—For purposes of 
subsection (a), the requirement described in this sub-
section is, with respect to the imposition or application of 
any financial requirement (as defined in subsection (c)) 
with respect to coverage of scalp cooling items under a 
group health plan or group or individual health insurance 
coverage, the requirement that such financial requirement 
be the same as such requirement applicable to intravenous 
or injection anticancer drugs furnished under such plan 
or such coverage for which benefits are provided under 
such plan or such coverage. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) FINANCIAL REQUIREMENT.—The term ‘fi-
nancial requirement’ means, with respect to an item 
or service furnished under a group health plan or 
group or individual health insurance coverage, any 
copayment, coinsurance, deductible, annual limit, 
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lifetime limit, or out-of-pocket maximum applied 
under such plan or such coverage with respect to 
such item or service. 
‘‘(2) SCALP COOLING ITEM.—The term ‘scalp 
cooling item’ means a cooling cap, hypothermia cap, 
cold cap, or any other therapeutic device used to cool 
the scalp of an individual to prevent or reduce hair 
loss during chemotherapy.’’. 
(2) CLERICAL AMENDMENT.—The table of con-
tents in section 1 of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1001 et seq.) 
is amended by inserting after the item relating to 
section 725 the following: 
‘‘Sec. 726. Required coverage of scalp cooling items.’’. 
(c) IRC.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 is amend-
ed by adding at the end the following: 
‘‘SEC. 9826. REQUIRED COVERAGE OF SCALP COOLING 
ITEMS. 
‘‘(a) IN GENERAL.—With respect to a plan year be-
ginning on or after January 1, 2025, a group health plan 
and a health insurance issuer offering group or individual 
health insurance coverage shall provide benefits under 
such plan or such coverage for scalp cooling items (as de-
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fined in subsection (c)) in accordance with the require-
ment described in subsection (b). 
‘‘(b) COVERAGE REQUIREMENT.—For purposes of 
subsection (a), the requirement described in this sub-
section is, with respect to the imposition or application of 
any financial requirement (as defined in subsection (c)) 
with respect to coverage of scalp cooling items under a 
group health plan or group or individual health insurance 
coverage, the requirement that such financial requirement 
be the same as such requirement applicable to intravenous 
or injection anticancer drugs furnished under such plan 
or such coverage for which benefits are provided under 
such plan or such coverage. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) FINANCIAL REQUIREMENT.—The term ‘fi-
nancial requirement’ means, with respect to an item 
or service furnished under a group health plan or 
group or individual health insurance coverage, any 
copayment, coinsurance, deductible, annual limit, 
lifetime limit, or out-of-pocket maximum applied 
under such plan or such coverage with respect to 
such item or service. 
‘‘(2) SCALP COOLING ITEM.—The term ‘scalp 
cooling item’ means a cooling cap, hypothermia cap, 
cold cap, or any other therapeutic device used to cool 
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the scalp of an individual to prevent or reduce hair 
loss during chemotherapy.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for subchapter B of chapter 100 of the Inter-
nal Revenue Code of 1986 is amended by adding at 
the end the following new item: 
‘‘Sec. 9826. Required coverage of scalp cooling items.’’. 
(d) MEDICARE.— 
(1) COVERAGE.— 
(A) IN GENERAL.—Section 1861 of the So-
cial Security Act (42 U.S.C. 1395x) is amend-
ed— 
(i) in subsection (s)(2)— 
(I) in subparagraph (GG), by 
striking ‘‘and’’ at the end; 
(II) in subparagraph (HH), by 
striking the period and inserting ‘‘; 
and’’; and 
(III) by adding at the end the 
following new subparagraph: 
‘‘(II) scalp cooling items (as de-
fined in subsection (lll));’’; and 
(ii) by adding at the end the following 
new subsection: 
‘‘(lll) SCALP COOLING ITEMS.—The term ‘scalp cool-
ing item’ means a cooling cap, hypothermia cap, cold cap, 
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or any other therapeutic device used to cool the scalp of 
an individual to prevent or reduce hair loss during chemo-
therapy furnished on or after January 1, 2025.’’ 
(B) EXCLUSION
MODIFICATION.—Section 
1862(a)(1) of the Social Security Act (42 
U.S.C. 1395y(a)(1)) is amended— 
(i) in subparagraph (O), by striking 
‘‘and’’ at the end; 
(ii) in subparagraph (P), by striking 
the semicolon and inserting ‘‘, and’’; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(Q) in the case of scalp cooling 
items (as defined in section 1861(lll)), 
which are not furnished to prevent or 
reduce 
hair 
loss 
during 
chemo-
therapy;’’. 
(2) PAYMENT.—Section 1833(a)(1) of the So-
cial Security Act (42 U.S.C. 1395l(a)(1)) is amend-
ed— 
(A) by striking ‘‘and (DD)’’ and inserting 
‘‘ (DD)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘and (EE) with respect 
to scalp cooling items (as defined in section 
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1861(lll)), the amount paid shall be equal to 80 
percent of the lesser of the actual charge or an 
amount determined appropriate by the Sec-
retary;’’. 
(e) MEDICAID.— 
(1) IN GENERAL.—Title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) is amended— 
(A) in section 1902(a)(10)(A), by striking 
‘‘and (30)’’ and inserting ‘‘(30), and (31)’’; and 
(B) in section 1905(a)— 
(i) in paragraph (30), by striking 
‘‘and’’ at the end; 
(ii) by redesignating paragraph (31) 
as paragraph (32); and 
(iii) by inserting after paragraph (30) 
the following new paragraph: 
‘‘(31) cooling caps, hypothermia caps, cold caps, 
and any other therapeutic devices used to cool the 
scalp of an individual to prevent or reduce hair loss 
during chemotherapy.’’. 
(2) EFFECTIVE DATE.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the amendments made by this sub-
section shall apply with respect to medical as-
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sistance furnished in calendar quarters begin-
ning on or after January 1, 2025. 
(B) EXCEPTION
FOR
STATE
LEGISLA-
TION.—In the case of a State plan under title 
XIX of the Social Security Act (or a waiver of 
such plan), which the Secretary of Health and 
Human Services determines requires State leg-
islation in order for the respective plan (or 
waiver) to meet any requirement imposed by 
the amendments made by this subsection, the 
respective plan (or waiver) shall not be re-
garded as failing to comply with the require-
ments of such title solely on the basis of its fail-
ure to meet such an additional requirement be-
fore the first day of the first calendar quarter 
beginning after the close of the first regular 
session of the State legislature that begins after 
the date of enactment of this subsection. For 
purposes of the previous sentence, in the case 
of a State that has a 2-year legislative session, 
each year of the session shall be considered to 
be a separate regular session of the State legis-
lature. 
(f) CHIP.— 
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(1) IN GENERAL.—Section 2103 of the Social 
Security Act (42 U.S.C. 1397cc) is amended— 
(A) in subsection (a), by striking ‘‘para-
graphs (5), (6), (7) and (8) of’’; and 
(B) in subsection (c), by adding at the end 
the following new paragraph: 
‘‘(11) Coverage of scalp cooling items.—The 
child health assistance provided to a targeted low-in-
come child shall include cooling caps, hypothermia 
caps, cold caps, and any other therapeutic devices 
used to cool the scalp of an individual to prevent or 
reduce hair loss during chemotherapy.’’. 
(2) EFFECTIVE DATE.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the amendments made by this sub-
section shall take effect with respect to child 
health assistance provided on or after January 
1, 2025. 
(B) EXCEPTION
FOR
STATE
LEGISLA-
TION.—In the case of a State child health plan 
under title XXI of the Social Security Act (or 
a waiver of such plan), which the Secretary of 
Health and Human Services determines re-
quires State legislation in order for the respec-
tive plan (or waiver) to meet any requirement 
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imposed by the amendments made by this sec-
tion, the respective plan (or waiver) shall not be 
regarded as failing to comply with the require-
ments of such title solely on the basis of its fail-
ure to meet such an additional requirement be-
fore the first day of the first calendar quarter 
beginning after the close of the first regular 
session of the State legislature that begins after 
the date of enactment of this section. For pur-
poses of the previous sentence, in the case of a 
State that has a 2-year legislative session, each 
year of the session shall be considered to be a 
separate regular session of the State legislature. 
(g) FEHBP.—Section 8902 of title 5, United States 
Code, is amended by adding at the end the following new 
subsection: 
‘‘(p) A contract may not be made or a plan ap-
proved which does not provide for the coverage re-
quired under section 2730 of the Public Health 
Service Act.’’. 
(h) TRICARE.—Section 1077(a) of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(19) A cooling cap, hypothermia cap, cold cap, 
or any other therapeutic device used to cool the 
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scalp of an individual to prevent or reduce hair loss 
during chemotherapy.’’. 
(i) VA.— 
(1) IN
GENERAL.—Chapter 17 of title 38, 
United States Code, is amended by inserting after 
section 1720I the following new section: 
‘‘Sec. 1720J. Provision of scalp cooling items. 
‘‘The Secretary shall make available to a vet-
eran who receives chemotherapy pursuant to this 
chapter a cooling cap, hypothermia cap, cold cap, or 
any other therapeutic device used to cool the scalp 
of an individual to prevent or reduce hair loss during 
chemotherapy.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 1720I 
the following new item: 
‘‘1720J. Provision of scalp cooling items.’’. 
Æ 
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