H. B. 2190
(By Delegates Thompson, McGraw, Jenkins and Rowe)
[Introduced January 13, 1999; referred to the
Committee on Banking and Insurance then Finance.]
A BILL to amend chapter thirty-three of the code of West
Virginia, one thousand nine hundred thirty-one, as amended,
by adding thereto a new article, designated article
fifteen-d, relating to requiring coverage by insurers of
breast reconstruction following mastectomy surgery.
Be it enacted by the Legislature of West Virginia:
That chapter thirty-three of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article fifteen-d, to
read as follows:
ARTICLE 15D. BREAST RECONSTRUCTION AFTER MASTECTOMY SURGERY
INSURANCE COVERAGE ACT.
§33-15D-1. Reconstruction after mastectomy surgery -- Individual
and group nonprofit and medical services plan contracts and nonprofit health care contracts.
All individual and group nonprofit and medical services plan
contracts and all nonprofit health care plan contracts that
provide coverage for mastectomy surgery shall provide coverage
for reconstruction of the breast on which surgery has been
performed, as well as surgery and reconstruction of the other
breast to produce a symmetrical appearance, if the patient elects
reconstruction and in the manner chosen by the patient and her
physician.
§33-15D-2. Same -- Individual health policies; exceptions.
All individual health policies that provide coverage for
mastectomy surgery, except those designed to cover only specific
diseases, hospital indemnity or accidental injury, shall provide
coverage for reconstruction of the breast on which surgery has
been performed, as well as surgery and reconstruction of the
other breast to produce a symmetrical appearance, if the patient
elects reconstruction and in the manner chosen by the patient and
her physician.
§33-15D-3. Same -- Group health policies; exceptions.
All group health policies that provide coverage for
mastectomy surgery, except those designed to cover only specific
diseases, hospital indemnity or accidental injury, shall provide
coverage for reconstruction of the breast on which surgery has been performed, as well as surgery and reconstruction of the
other breast to produce a symmetrical appearance, if the patient
elects reconstruction and in the manner chosen by the patient and
her physician.
§33-15D-4. Same -- Individual or group coverage.
All individual or group coverage subject to this article
that provides for mastectomy surgery shall provide coverage for
reconstruction of the breast on which surgery has been performed,
as well as surgery and reconstruction of the other breast to
produce a symmetrical appearance, if the patient elects
reconstruction and in the manner chosen by the patient and her
physician.
NOTE: The purpose of this bill is to require insurance
coverage of breast reconstruction following mastectomy surgery.
This article is new; therefore, strike-throughs and
underscoring have been omitted.