Report Title:

Health Insurance; Coverage for Reconstructive Surgery

Description:

Requires health insurance coverage for certain types of reconstructive surgery, including craniofacial surgery.

HOUSE OF REPRESENTATIVES

H.B. NO.

1958

TWENTY-THIRD LEGISLATURE, 2006

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO HEALTH.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432D-      Coverage for reconstructive surgery. (a) A health maintenance organization or carrier that provides health insurance coverage for surgery, whether under a group contract or individual contract, shall provide coverage for reconstructive surgery, including medically necessary treatment for pre-operative and post-operative care deemed necessary by the treating physician or team of physicians.

(b) Nothing in this section shall be construed to require a health maintenance organization or carrier to provide coverage for cosmetic surgery.

(c) For the purposes of this section:

"Cosmetic surgery" means surgery that is performed to alter or reshape normal structures of the body to improve appearance.

"Reconstructive surgery" means any medically necessary and appropriate surgery performed to correct or repair abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease, such as craniofacial surgery, to:

(1) Improve functions; or

(2) Give the patient a normal appearance,

to the extent possible, in the judgment of the physician performing the surgery."

SECTION 2. New statutory material is underscored.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

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