H. B. 2342


(By Delegate R. M. Thompson)

[Introduced January 16, 2003 ; referred to the

Committee on Banking and Insurance then the Judiciary.]





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 for 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.