A bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations.
Breast Cancer Patient Protect Action of 2005 - Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require a group health plan or a health issuer offering group health insurance coverage that provides medical and surgical benefits to ensure that inpatient (and in the case of a lumpectomy, outpatient) coverage and radiation therapy are provided for breast cancer treatment. Prohibits such a plan or issuer from: (1) restricting benefits for any hospital length of stay to less than 48 hours in connection with a mastectomy or breast conserving surgery or 24 hours in connection with a lymph node dissection; or (2) requiring that a provider obtain authorization from the plan or issuer for prescribing any such length of stay.
Requires such a plan or issuer to: (1) provide notice to each participant and beneficiary regarding the coverage required under this Act; and (2) ensure that full coverage is provided for secondary consultations by specialists in the appropriate medical fields to confirm or refute a diagnosis of cancer.
Applies such requirements to health insurance issuers offering coverage in the individual market.
Sponsor introductory remarks on measure. (CR H5958)
Introduced in Senate
Sponsor introductory remarks on measure. (CR S4263)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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