,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #aiaf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #af1 #bjba,ms4   
,e%oo 7= h]self1 ,mr4 ,f]guson1 ,ms4    
,mc,collum1 ,mrs4 ,axne1 ,ms4 ,de,gette1
 ,mr4 ,mc,eachin1 ,mrs4 ,luria1 ,mr4    
,/anton1 ,ms4 ,/ev5s1 ,mr4 ,huffman1    
,mr4 ,got!im]1 ,mrs4 ,trahan1 ,ms4      
,b>ragn1 ,mr4 ,grijalva1 ,mr4 ,wittman1 
,mr4 ,gallego1 ,mr4 ,c>bajal1 ,ms4      
,wild1 ,mr4 ,suozzi1 ,mr4 ,deut*1 ,ms4  
,norton1 ,mr4 ,fitzpatrick1 ,ms4        
,br[nley1 ,mrs4 ,hayes1 ,mr4 ,takano1   
,ms4 ,blunt ,ro*e/]1 ,mr4 ,ha/+s1 ,mr4  
,kim ( ,new ,j]sey1 ,mr4 ,p]lmutt]1 ,mr4
 ,cr[1 ,miss ,rice ( ,new ,york1 ,mr4   
,/aub]1 ,mr4 ,rodney ,davis ( ,ill9ois1 
,mr4 ,payne1 ,mr4 ,rupp]sb]g]1 ,ms4     
,tlaib1 ,mr4 ,m\lton1 ,mr4 ,pascrell1   
,mrs4 ,watson ,coleman1 ,mrs4 ,beatty1  
,mr4 ,vela1 ,mr4 ,coop]1 ,ms4 ,und]wood1
 ,mr4 ,trone1 ,mr4 ,"y1 ,ms4 ,m5g1 ,ms4 
,port]1 ,ms4 ,scanlon1 ,mr4 ,res*5?al]1 
,mr4 ,van ,drew1 ,mr4 ,timmons1 ,ms4    
,craig1 ,mr4 ,neguse1 ,ms4 ,p+ree1 ,mr4 

,lyn*1 ,mr4 ,posey1 ,mr4 ,lamb1 ,mr4    
,cole1 ,mr4 ,joyce ( ,p5nsylvania1 ,mr4 
,sires1 ,mr4 ,palazzo1 ,mr4 ,graves (   
,l\isiana1 ,mr4 ,y>mu?1 ,mr4 ,bi%op (   
,georgia1 ,mrs4 ,radewag51 ,mr4 ,kildee1
 ,mr4 ,butt]field1 ,mr4 ,tonko1 ,mr4    
,/iv]s1 ,ms4 ,ross1 ,mr4 ,lev9 (        
,mi*igan1 ,ms4 ,h\lahan1 ,mrs4          
,napolitano1 ,mr4 ,rask91 ,mr4          
,mc,nerney1 ,mr4 ,mc,govern1 ,mr4       
,morelle1 ,ms4 ,bass1 ,ms4 ,bonamici1   
,ms4 ,cl>ke ( ,new ,york1 ,ms4 ,salaz>1 
,mr4 ,mrvan1 ,ms4 ,lee ( ,cali=nia1 ,mr4
 ,ru!r=d1 ,ms4 ,sn*ez1 ,mr4 ,connolly1  
,mrs4 ,lawr5ce1 ,mr4 ,mc,kinley1 ,mr4   
,price ( ,nor? ,c>ol9a1 ,mr4 ,g>am5di1  
,ms4 ,velzquez1 ,mr4 ,ad]holt1 ,ms4     
,kelly ( ,ill9ois1 ,mr4 ,jones1 ,mr4    
,phillips1 ,ms4 ,om>1 ,mr4 ,all51 ,mr4  
,g>b>9o1 ,mr4 ,gos>1 ,mr4 ,lawson (     
,florida1 ,mr4 ,ru%1 ,mr4 ,c>t] (       
,georgia1 ,mr4 ,bacon1 ,mr4 ,gro?man1   
,mr4 ,h>d] ( ,cali=nia1 ,mr4 ,vic5te    
,gonzalez ( ,texas1 ,mr4 ,mann1 ,mr4    
,upton1 ,mr4 ,coh51 ,mr4 ,cicill9e1 ,mr4

 ,khanna1 ,mrs4 ,h>tzl]1 ,ms4 ,bu%1 ,mr4
 ,bo/1 ,ms4 ,/rickl&1 ,ms4 ,mann+1 ,mr4 
,br5dan ,f4 ,boyle ( ,p5nsylvania1 ,mr4 
,gue/1 ,mr4 ,simpson1 ,mr4 ,o',hall]an1 
,ms4 ,moore ( ,wiscons91 ,mr4 ,bab91    
,ms4 ,titus1 ,ms4 ,johnson ( ,texas1    
,mr4 ,pocan1 ,mr4 ,kri%namoor?i1 ,mr4   
,sean ,patrick ,maloney ( ,new ,york1   
,ms4 ,del,bene1 ,mr4 ,ryan1 ,mr4 ,/ew>t1
 ,mr4 ,hag$orn1 ,ms4 ,jayapal1 ,mr4     
,emm]1 & ,mr4 ,moore ( ,utah7 introduc$ 
! foll[+ bill2 :i* 0 ref]r$ to !        
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committees on ,ways &    
,means1 & ,education & ,labor1 = a p]iod
 to be subsequ5tly det]m9$ by ! ,speak]1
 9 ea* case = consid]ation ( su*        
provisions z fall )9 ! jurisdiction ( ! 
committee conc]n$  ,a ,,bill  ,to       
provide heal? insurance b5efits =       
outpati5t & inpati5t items & s]vices    
relat$ to ! diagnosis & treatm5t ( a    
cong5ital anomaly or bir? defect4  #a4  
,%ort title ,?is ,act may be cit$ z !   
,ensur+ ,la/+ ,smiles ,act4  #b4        

,cov]age ( cong5ital anomaly or bir?    
defect  7a7 ,public ,heal? ,s]vice ,act 
,am5dm5ts ,"p ,d ( title ,,xxvii ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg-#aaa et seq47 is am5d$
 by add+ at ! end ! foll[+ new section3 
#bgii;,a-#aa4 ,/&>ds relat+ to b5efits =
 cong5ital anomaly or bir? defect  7a7  
,requirem5ts = c>e & ,recon/ructive     
,treatm5t  7#a7 ,9 g5]al ,a gr\p heal?  
plan1 & a heal? insurance issu] (f]+    
gr\p or individual heal? insurance      
cov]age1 %all provide cov]age =         
outpati5t & inpati5t items & s]vices    
relat$ to ! diagnosis & treatm5t ( a    
cong5ital anomaly or bir? defect4  7#b7 
,requirem5ts  7,a7 ,9 g5]al ,cov]age    
provid$ "u p>agraph 7#a7 %all include   
any m$ically necess>y item or s]vice to 
functionally improve1 repair1 or re/ore 
any body "p to a*ieve normal body       
function+ or appe>ance1 z det]m9$ by !  
treat+ physician 7z def9$ 9 section     
#ahfa7r7 ( ! ,social ,security ,act71   
due to cong5ital anomaly or bir? defect4

  7,b7 ,f9ancial requirem5ts & treatm5t 
requirem5ts ,any cov]age provid$ "u     
p>agraph 7#a7 "u a gr\p heal? plan or   
individual or gr\p heal? insurance      
cov]age (f]$ by a heal? insurance issu] 
may be subject to cov]age limits 7su* z 
m$ical necessity1 pre-au?orization1 or  
pre-c]tification7 & co/-%>+ requirem5ts 
7su* z co9surance1 copaym5ts1 &         
d$uctibles71 z requir$ by ! plan or     
issu]1 t are no m re/rictive ?an !      
pr$om9ant cov]age limits & co/-%>+      
requirem5ts1 respectively1 appli$ to    
sub/antially all m$ical & surgical      
b5efits cov]$ by ! plan 7or cov]age74   
7#c7 ,treatm5t def9$ ,9 ?is section3    
7,a7 ,9 g5]al ,except z provid$ 9       
subp>agraph 7,b71 ! t]m treatm5t        
includes1 ) respect to a gr\p heal? plan
 or gr\p or individual heal? insurance  
cov]age (f]$ by a heal? insurance issu]1
 inpati5t & outpati5t items & s]vices   
p]=m$ to improve1 repair1 or re/ore     
bodily function 7or p]=m$ to approximate
 a normal appe>ance71 due to a cong5ital

 anomaly or bir? defect1 & includes     
treatm5t to any & all miss+ or abnormal 
body p>ts 7includ+ tee?1 ! oral cavity1 
& _! associat$ /ructures7 t w\ld o!rwise
 be provid$ "u ! plan or cov]age = any  
o!r injury or sickness1 includ+-- 7i7   
any items or s]vices1 includ+ inpati5t &
 outpati5t c>e1 recon/ructive s]vices & 
proc$ures1 & complications !re(2  7ii7  
adjunctive d5tal1 or?odontic1 or        
pro/hodontic support f bir? until !     
m$ical or surgical treatm5t ( ! defect  
or anomaly has be5 complet$1 includ+    
ongo+ or subsequ5t treatm5t requir$ to  
ma9ta9 function or approximate a normal 
appe>ance2  7iii7 proc$ures t mat]ially 
improve1 repair1 or re/ore bodily       
function2 &  7iv7 proc$ures = second>y  
conditions & foll[-up treatm5t associat$
 ) ! und]ly+ cong5ital anomaly or bir?  
defect4  7,b7 ,exception ,! t]m treatm5t
 %all n include cosmetic surg]y p]=m$ to
 re%ape normal /ructures ( ! body to    
improve appe>ance or self-e/eem4  7b7   
,notice ,a gr\p heal? plan "u ?is "p    

%all comply ) ! notice requirem5t "u    
section #gad7;c7 ( ! ,employee          
,retirem5t ,income ,security ,act (     
#aigd ) respect to ! requirem5ts ( ?is  
section z if su* section appli$ to su*  
plan4  4  7b7 ,,erisa am5dm5ts  7#a7 ,9 
g5]al ,subp>t ,b ( "p #g ( subtitle ,b (
 title ,i ( ! ,employee ,retirem5t      
,income ,security ,act ( #aigd is am5d$ 
by add+ at ! end ! foll[+3  #gbf4 ,/&>ds
 relat+ to b5efits = cong5ital anomaly  
or bir? defect  7a7 ,requirem5ts = c>e &
 ,recon/ructive ,treatm5t  7#a7 ,9 g5]al
 ,a gr\p heal? plan1 & a heal? insurance
 issu] (f]+ gr\p heal? insurance        
cov]age1 %all provide cov]age =         
outpati5t & inpati5t items & s]vices    
relat$ to ! diagnosis & treatm5t ( a    
cong5ital anomaly or bir? defect4  7#b7 
,requirem5ts  7,a7 ,9 g5]al ,cov]age    
provid$ "u p>agraph 7#a7 %all include   
any m$ically necess>y item or s]vice to 
functionally improve1 repair1 or re/ore 
any body "p to a*ieve normal body       
function+ or appe>ance1 z det]m9$ by !  

treat+ physician 7z def9$ 9 section     
#ahfa7r7 ( ! ,social ,security ,act71   
due to cong5ital anomaly or bir? defect4
  7,b7 ,f9ancial requirem5ts & treatm5t 
requirem5ts ,any cov]age provid$ "u     
p>agraph 7#a7 "u a gr\p heal? plan or   
gr\p heal? insurance cov]age (f]$ by a  
heal? insurance issu] may be subject to 
cov]age limits 7su* z m$ical necessity1 
pre-au?orization1 or pre-c]tification7 &
 co/-%>+ requirem5ts 7su* z co9surance1 
copaym5ts1 & d$uctibles71 z requir$ by !
 plan or issu]1 t are no m re/rictive   
?an ! pr$om9ant cov]age limits & co/-%>+
 requirem5ts1 respectively1 appli$ to   
sub/antially all m$ical & surgical      
b5efits cov]$ by ! plan 7or cov]age74   
7#c7 ,treatm5t def9$ ,9 ?is section3    
7,a7 ,9 g5]al ,except z provid$ 9       
subp>agraph 7,b71 ! t]m treatm5t        
includes1 ) respect to a gr\p heal? plan
 or gr\p heal? insurance cov]age (f]$ by
 a heal? insurance issu]1 inpati5t &    
outpati5t items & s]vices p]=m$ to      
improve1 repair1 or re/ore bodily       

function 7or p]=m$ to approximate a     
normal appe>ance71 due to a cong5ital   
anomaly or bir? defect1 & includes      
treatm5t to any & all miss+ or abnormal 
body p>ts 7includ+ tee?1 ! oral cavity1 
& _! associat$ /ructures7 t w\ld o!rwise
 be provid$ "u ! plan or cov]age = any  
o!r injury or sickness1 includ+-- 7i7   
any items or s]vices1 includ+ inpati5t &
 outpati5t c>e1 recon/ructive s]vices & 
proc$ures1 & complications !re(2  7ii7  
adjunctive d5tal1 or?odontic1 or        
pro/hodontic support f bir? until !     
m$ical or surgical treatm5t ( ! defect  
or anomaly has be5 complet$1 includ+    
ongo+ or subsequ5t treatm5t requir$ to  
ma9ta9 function or approximate a normal 
appe>ance2  7iii7 proc$ures t mat]ially 
improve1 repair1 or re/ore bodily       
function2 &  7iv7 proc$ures = second>y  
conditions & foll[-up treatm5t associat$
 ) ! und]ly+ cong5ital anomaly or bir?  
defect4  7,b7 ,exception ,! t]m treatm5t
 %all n include cosmetic surg]y p]=m$ to
 re%ape normal /ructures ( ! body to    

improve appe>ance or self-e/eem4  7b7   
,notice ,a gr\p heal? plan "u ?is "p    
%all comply ) ! notice requirem5t "u    
section #gad7;c7 ) respect to !         
requirem5ts ( ?is section z if su*      
section appli$ to su* plan4  4  7#b7    
,te*nical am5dm5ts  7,a7 ,section       
#gcb7;a7 ( su* ,act 7#bi ,u4,s4,c4      
#aaia;a7a77 is am5d$ by /rik+ section   
#gaa & ins]t+ sections #gaa & #gbf4     
7,b7 ,! table ( cont5ts 9 section #a (  
su* ,act is am5d$ by ins]t+ aft] ! item 
relat+ to section #gbe ! foll[+ new     
item3  ,sec4 #gbf4 ,/&>ds relat+ to     
b5efits = cong5tial anomaly or bir?     
defect4  4  7c7 ,int]nal ,rev5ue ,code  
am5dm5ts  7#a7 ,9 g5]al ,sub*apt] ,b (  
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 
#aihf is am5d$ by add+ at ! end !       
foll[+3  #ihbf4 ,/&>ds relat+ to b5efits
 = cong5ital anomaly or bir? defect  7a7
 ,requirem5ts = c>e & ,recon/ructive    
,treatm5t  7#a7 ,9 g5]al ,a gr\p heal?  
plan %all provide cov]age = outpati5t & 
inpati5t items & s]vices relat$ to !    

diagnosis & treatm5t ( a cong5ital      
anomaly or bir? defect4  7#b7           
,requirem5ts  7,a7 ,9 g5]al ,cov]age    
provid$ "u p>agraph 7#a7 %all include   
any m$ically necess>y item or s]vice to 
functionally improve1 repair1 or re/ore 
any body "p to a*ieve normal body       
function+ or appe>ance1 z det]m9$ by !  
treat+ physician 7z def9$ 9 section     
#ahfa7r7 ( ! ,social ,security ,act71   
due to cong5ital anomaly or bir? defect4
  7,b7 ,f9ancial requirem5ts & treatm5t 
requirem5ts ,any cov]age provid$ "u     
p>agraph 7#a7 "u a gr\p heal? plan may  
be subject to cov]age limits 7su* z     
m$ical necessity1 pre-au?orization1 or  
pre-c]tification7 & co/-%>+ requirem5ts 
7su* z co9surance1 copaym5ts1 &         
d$uctibles71 z requir$ by ! plan1 t are 
no m re/rictive ?an ! pr$om9ant cov]age 
limits & co/-%>+ requirem5ts1           
respectively1 appli$ to sub/antially all
 m$ical & surgical b5efits cov]$ by !   
plan4  7#c7 ,treatm5t def9$ ,9 ?is      
section3 7,a7 ,9 g5]al ,except z provid$

 9 subp>agraph 7,b71 ! t]m treatm5t     
includes1 ) respect to a gr\p heal?     
plan1 inpati5t & outpati5t items &      
s]vices p]=m$ to improve1 repair1 or    
re/ore bodily function 7or p]=m$ to     
approximate a normal appe>ance71 due to 
a cong5ital anomaly or bir? defect1 &   
includes treatm5t to any & all miss+ or 
abnormal body p>ts 7includ+ tee?1 ! oral
 cavity1 & _! associat$ /ructures7 t    
w\ld o!rwise be provid$ "u ! plan = any 
o!r injury or sickness1 includ+-- 7i7   
any items or s]vices1 includ+ inpati5t &
 outpati5t c>e1 recon/ructive s]vices & 
proc$ures1 & complications !re(2  7ii7  
adjunctive d5tal1 or?odontic1 or        
pro/hodontic support f bir? until !     
m$ical or surgical treatm5t ( ! defect  
or anomaly has be5 complet$1 includ+    
ongo+ or subsequ5t treatm5t requir$ to  
ma9ta9 function or approximate a normal 
appe>ance2  7iii7 proc$ures t mat]ially 
improve1 repair1 or re/ore bodily       
function2 &  7iv7 proc$ures = second>y  
conditions & foll[-up treatm5t associat$

 ) ! und]ly+ cong5ital anomaly or bir?  
defect4  7,b7 ,exception ,! t]m treatm5t
 %all n include cosmetic surg]y p]=m$ to
 re%ape normal /ructures ( ! body to    
improve appe>ance or self-e/eem4  7b7   
,notice ,a gr\p heal? plan "u ?is "p    
%all comply ) ! notice requirem5t "u    
section #gad7;c7 ( ! ,employee          
,retirem5t ,income ,security ,act (     
#aigd ) respect to ! requirem5ts ( ?is  
section z if su* section appli$ to su*  
plan4  4  7#b7 ,cl]ical am5dm5t ,! table
 ( sections = su* sub*apt] is am5d$ by  
add+ at ! end ! foll[+ new item3  ,sec4 
#ihbf4 ,/&>ds relat+ to b5efits =       
cong5ital anomaly or bir? defect4  4    
7d7 ,rule ( con/ruction ,a gr\p heal?   
plan or heal? insurance issu] %all      
provide ! b5efits describ$ 9 section    
#bgii;,a-#aa ( ! ,public ,heal? ,s]vice 
,act 7z add$ by subsection 7a771 section
 #gbf ( ! ,employee ,retirem5t ,income  
,security ,act ( #aigd 7z add$ by       
subsection 7b771 & section #ihbf ( !    
,int]nal ,rev5ue ,code ( #aihf 7z add$  

by subsection 7c77 "u ! t]ms ( su* plan 
or heal? insurance cov]age (f]$ by su*  
issu]4  7e7 ,cl>ify+ am5dm5t reg>d+     
application to gr&fa!r$ plans ,section  
#abea7;a77#d77;,a7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjaa7;a77#d77;,a771 is am5d$
 by add+ at ! end ! foll[+3  7v7        
,section #bgii;,a-#aa 7relat+ to /&>ds  
relat+ to b5efits = cong5ital anomaly or
 bir? defect71 z add$ by section #b7;a7 
( ! ,ensur+ ,la/+ ,smiles ,act4  4  7f7 
,effective date ,! am5dm5ts made by ?is 
section %all apply ) respect to gr\p    
heal? plans = plan ye>s beg9n+ on or    
aft] ,janu>y #a1 #bjbb1 & ) respect to  
heal? insurance cov]age (f]$1 sold1     
issu$1 r5ew$1 9 effect1 or op]at$ 9 !   
individual m>ket on or aft] su* date4   
7g7 ,coord9at$ regulations ,section     
#ajd7a7 ( ! ,heal? ,insurance           
,portability & ,acc\ntability ,act (    
#aiif is am5d$ by /rik+ ?is subtitle 7& 
! am5dm5ts made by ?is subtitle &       
section #dja7 & ins]t+ ! provisions ( "p

 #g ( subtitle ,b ( title ,i ( !        
,employee ,retirem5t ,income ,security  
,act ( #aigd1 ! provisions ( p>ts ,a1   
,c1 & ,d ( title ,,xxvii ( ! ,public    
,heal? ,s]vice ,act1 & *apt] #ajj ( !   
,int]nal ,rev5ue ,code ( #aihf4