I
107TH CONGRESS
1ST SESSION
H. R. 887
To amend the Internal Revenue Code of 1986 to require group health plans
to provide coverage for reconstructive surgery following mastectomy, con-
sistent with the Women’s Health and Cancer Rights Act of 1998.
IN THE HOUSE OF REPRESENTATIVES
MARCH 6, 2001
Mrs. KELLY (for herself, Mr. OBERSTAR, Mrs. MALONEY of New York, Mr.
BASS, Mr. BENTSEN, Mr. HILLIARD, Mr. FROST, Mr. BALDACCI, Mr.
MCNULTY, Mr. DOYLE, Mr. COOKSEY, Mr. MOAKLEY, Ms. NORTON, Mr.
UDALL of New Mexico, Mr. BRADY of Pennsylvania, Mr. WHITFIELD,
Mr. ENGLISH, Ms. MCCARTHY of Missouri, Ms. EDDIE BERNICE JOHN-
SON of Texas, Mr. ACKERMAN, Ms. DELAURO, Mr. GILMAN, Ms. BERK-
LEY, Mr. KLECZKA, Mr. LANTOS, Mr. WALSH, Mr. MCINTYRE, Mr.
PAYNE, Mr. BONIOR, Mr. EVANS, Mr. CUMMINGS, Mr. CAPUANO, Ms.
MCCOLLUM, Mr. WEINER, Mr. BARRETT, Mrs. THURMAN, Mr.
KUCINICH, Mrs. MORELLA, Mr. MCGOVERN, Ms. SLAUGHTER, Ms. CAR-
SON of Indiana, Mr. BACA, and Mr. NADLER) introduced the following
bill; which was referred to the Committee on Ways and Means
A BILL
To amend the Internal Revenue Code of 1986 to require
group health plans to provide coverage for reconstructive
surgery following mastectomy, consistent with the Wom-
en’s Health and Cancer Rights Act of 1998.
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 ‘‘Women’s Health and
Cancer Rights Conforming Amendments of 2001’’.
SEC. 2. CONFORMING THE INTERNAL REVENUE CODE OF
1986 TO REQUIREMENTS IMPOSED BY THE
WOMEN’S HEALTH AND CANCER RIGHTS ACT
OF 1998.
(a) IN GENERAL.—Subchapter B of chapter 100 of
the Internal Revenue Code of 1986 (relating to other re-
quirements) is amended by inserting after section 9812
the following new section:
‘‘SEC. 9813. REQUIRED COVERAGE FOR RECONSTRUCTIVE
SURGERY FOLLOWING MASTECTOMIES.
‘‘(a) IN GENERAL.—A group health plan that pro-
vides medical and surgical benefits with respect to a mas-
tectomy shall provide, in a case of a participant or bene-
ficiary who is receiving benefits in connection with a mas-
tectomy and who elects breast reconstruction in connection
with such mastectomy, coverage for—
‘‘(1) all stages of reconstruction of the breast
on which the mastectomy has been performed,
‘‘(2) surgery and reconstruction of the other
breast to produce a symmetrical appearance, and
‘‘(3) prostheses and physical complications of
mastectomy, including lymphedemas,
in a manner determined in consultation with the attending
physician and the patient. Such coverage may be subject
to annual deductibles and coinsurance provisions as may
be deemed appropriate and as are consistent with those
established for other benefits under the plan. Written no-
tice of the availability of such coverage shall be delivered
to the participant upon enrollment and annually there-
after.
‘‘(b) PROHIBITIONS.—A group health plan may not—
‘‘(1) deny to a patient eligibility, or continued
eligibility, to enroll or to renew coverage under the
terms of the plan, solely for the purpose of avoiding
the requirements of this section, and
‘‘(2) penalize or otherwise reduce or limit the
reimbursement of an attending provider, or provide
incentives (monetary or otherwise) to an attending
provider, to induce such provider to provide care to
an individual participant or beneficiary in a manner
inconsistent with this section.
‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to prevent a group health plan
from negotiating the level and type of reimbursement with
a provider for care provided in accordance with this sec-
tion.’’
(b) CLERICAL AMENDMENT.—The table of sections
for chapter 100 of such Code is amended inserting after
the item relating to section 9812 the following new item:
‘‘Sec. 9813. Required coverage for reconstructive surgery fol-
lowing mastectomies.’’
(c) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendments made by
this section shall apply with respect to plan years be-
ginning on or after the date of enactment of this
Act.
(2) SPECIAL
RULE
FOR
COLLECTIVE
BAR-
GAINING
AGREEMENTS.—In the case of a group
health plan maintained pursuant to 1 or more collec-
tive bargaining agreements between employee rep-
resentatives and 1 or more employers, any plan
amendment made pursuant to a collective bargaining
agreement relating to the plan which amends the
plan solely to conform to any requirement added by
this section shall not be treated as a termination of
such collective bargaining agreement.
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