I 
110TH CONGRESS 
1ST SESSION H. R. 1655 
To amend the Public Health Service Act, the Employee Retirement Income 
Security Act of 1974, and the Internal Revenue Code of 1986 to require 
that group and individual health insurance coverage and group health 
plans provide coverage for treatment of a minor child’s congenital or 
developmental deformity or disorder due to trauma, infection, tumor, 
or disease. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 22, 2007 
Mrs. MCCARTHY of New York (for herself, Mr. TIBERI, Mrs. MALONEY of 
New York, Mr. GORDON of Tennessee, Mr. MCDERMOTT, Mr. INSLEE, 
Mr. COBLE, and Ms. HOOLEY) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committees on Education and Labor and Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend the Public Health Service Act, the Employee Re-
tirement Income Security Act of 1974, and the Internal 
Revenue Code of 1986 to require that group and indi-
vidual health insurance coverage and group health plans 
provide coverage for treatment of a minor child’s con-
genital or developmental deformity or disorder due to 
trauma, infection, tumor, or disease. 
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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 ‘‘Children’s Access to 
Reconstructive Evaluation & Surgery (CARES) Act of 
2007’’. 
SEC. 2. COVERAGE OF MINOR CHILD’S CONGENITAL OR DE-
VELOPMENTAL DEFORMITY OR DISORDER. 
(a) GROUP HEALTH PLANS.— 
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—(A) Subpart 2 of part A of title XXVII of 
the Public Health Service Act is amended by adding 
at the end the following new section: 
‘‘SEC. 2707. STANDARDS RELATING TO BENEFITS FOR 
MINOR CHILD’S CONGENITAL OR DEVELOP-
MENTAL DEFORMITY OR DISORDER. 
‘‘(a) REQUIREMENTS
FOR RECONSTRUCTIVE SUR-
GERY.— 
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insur-
ance coverage, that provides coverage for surgical 
benefits shall provide coverage for outpatient and in-
patient diagnosis and treatment of a minor child’s 
congenital or developmental deformity, disease, or 
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injury. A minor child shall include any individual 
through 21 years of age. 
‘‘(2) REQUIREMENTS.—Any coverage provided 
under paragraph (1) shall be subject to pre-author-
ization or pre-certification as required by the plan or 
issuer, and such coverage shall include any surgical 
treatment which, in the opinion of the treating phy-
sician, is medically necessary to approximate a nor-
mal appearance. 
‘‘(3) TREATMENT DEFINED.— 
‘‘(A) IN
GENERAL.—In this section, the 
term ‘treatment’ includes reconstructive sur-
gical procedures (procedures that are generally 
performed to improve function, but may also be 
performed to approximate a normal appear-
ance) that are performed on abnormal struc-
tures of the body caused by congenital defects, 
developmental abnormalities, trauma, infection, 
tumors, or disease, including— 
‘‘(i) procedures that do not materially 
affect the function of the body part being 
treated; and 
‘‘(ii) procedures for secondary condi-
tions and follow-up treatment. 
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‘‘(B) EXCEPTION.—Such term does not in-
clude cosmetic surgery performed to reshape 
normal structures of the body to improve ap-
pearance or self-esteem. 
‘‘(b) NOTICE.—A group health plan under this part 
shall comply with the notice requirement under section 
714(b) of the Employee Retirement Income Security Act 
of 1974 with respect to the requirements of this section 
as if such section applied to such plan.’’. 
(B) Section 2723(c) of such Act (42 U.S.C. 
300gg–23(c)) is amended by striking ‘‘section 2704’’ 
and inserting ‘‘sections 2704 and 2707’’. 
(2) ERISA AMENDMENTS.—(A) Subpart B of 
part 7 of subtitle B of title I of the Employee Re-
tirement Income Security Act of 1974 is amended by 
adding at the end the following new section: 
‘‘SEC. 714. STANDARDS RELATING TO BENEFITS FOR MINOR 
CHILD’S CONGENITAL OR DEVELOPMENTAL 
DEFORMITY OR DISORDER. 
‘‘(a) REQUIREMENTS
FOR RECONSTRUCTIVE SUR-
GERY.— 
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insur-
ance coverage, that provides coverage for surgical 
benefits shall provide coverage for outpatient and in-
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