Brief⁽¹⁾

S.B. 14, would create new health insurance law regarding coverage for reconstructive breast surgery. The bill requires individual and group health insurance companies, health maintenance organizations (HMOs), and others providing health care benefits which provide medical and surgical benefits with respect to a mastectomy, to provide coverage for:

• reconstruction of the breast on which the mastectomy was performed;



• surgery and reconstruction of the other breast to produce a symmetrical appearance; and



• prostheses and physical complications in all stages of mastectomy.

Coverage required by the bill may be subject to annual deductibles and coinsurance provisions as they apply to other covered services. Insurers, health plans, and HMOs are required to give notice of this new coverage to their insureds, enrollees, and subscribers.

Background

S.B. 14 was recommended by the Special Committee on Financial Institutions and Insurance that held extensive hearings in the 1998 interim on coverage for reconstructive breast surgery (see Committee Reports to the 1999 Kansas Legislature, Part I, pp. 3-4 through 3-11).

S.B. 14 parallels in state law the requirements of the federal Women's Health and Cancer Rights Act of 1998. The federal law applies to all individual and group policies, as does S.B. 14, but also includes those persons covered under the federal Employee Retirement Income Security Act (ERISA) and otherwise exempt from state regulation.

The bill was supported by the American Cancer Society and the Kansas Insurance Department. The Kansas Chamber of Commerce and Industry opposed the bill.

1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/bill_search.html.