,i #aagth ,,congress #b;d ,session ,h4 ,r4 #gcbb ,,in ,,the ,,house ,,of ,,representatives ,march #ca1 #bjbb,ms4 ,de,lauro introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,ways and ,means1 ,armed ,services1 ,veterans' ,affairs1 and ,oversight and ,reform1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to require coverage for scalp cooling items under group health plans and group and individual health insurance coverage1 specified ,federal health care programs1 and the ,federal ,employees ,health ,benefits ,program4 #a4 ,short title ,this ,act may be cited as the ,access to ,scalp ,cooling ,therapy ,act of #bjbb4 #b4 ,requiring coverage for scalp cooling items under group health plans and group and individual health insurance coverage1 specified ,federal health care programs1 and the ,federal ,employees ,health ,benefits ,program 7a7 ,group health plans and health insurance coverage ,subpart ,,ii of part ,a of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aa et seq47 is amended by adding at the end the following new section3 #bgcj4 ,required coverage of scalp cooling items 7a7 ,in general ,with respect to a plan year beginning on or after ,january #a1 #bjbc1 a group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide benefits under such plan or such coverage for scalp cooling items 7as defined in subsection 7c77 in accordance with the requirement described in subsection 7b74 7b7 ,coverage requirement ,for purposes of subsection 7a71 the requirement described in this subsection is1 with respect to the imposition or application of any financial requirement 7as defined in subsection 7c77 with respect to coverage of scalp cooling items under a group health plan or group or individual health insurance coverage1 the requirement that such financial requirement be the same as such requirement applicable to intravenous or injection anticancer drugs furnished under such plan or such coverage for which benefits are provided under such plan or such coverage4 7c7 ,definitions ,in this section3 7#a7 ,financial requirement ,the term financial requirement means1 with respect to an item or service furnished under a group health plan or group or individual health insurance coverage1 any copayment1 coinsurance1 deductible1 annual limit1 lifetime limit1 or out-of-pocket maximum applied under such plan or such coverage with respect to such item or service4 7#b7 ,scalp cooling item ,the term scalp cooling item means a cooling cap1 hypothermia cap1 cold cap1 or any other therapeutic device used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy4 4 7b7 ,medicare 7#a7 ,coverage 7,a7 ,in general ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7i7 in subsection 7s77#b7-- 7,i7 in subparagraph 7,,gg71 by striking and at the end2 7,,ii7 in subparagraph 7,,hh71 by striking the period and inserting 2 and2 and 7,,iii7 by adding at the end the following new subparagraph3 7,,ii7 scalp cooling items 7as defined in subsection 7lll772 2 and 7ii7 by adding at the end the following new subsection3 7lll7 ,scalp cooling items ,the term scalp cooling item means a cooling cap1 hypothermia cap1 cold cap1 or any other therapeutic device used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy furnished on or after ,january #a1 #bjbc4 4 7,b7 ,exclusion modification ,section #ahfb7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey7a77#a77 is amended-- 7i7 in subparagraph 7,o71 by striking and at the end2 7ii7 in subparagraph 7,p71 by striking the semicolon and inserting 1 and2 and 7iii7 by adding at the end the following new subparagraph3 7,q7 in the case of scalp cooling items 7as defined in section #ahfa7lll771 which are not furnished to prevent or reduce hair loss during chemotherapy2 4 7#b7 ,payment ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7,a7 by striking and 7,,dd7 and inserting 7,,dd72 and 7,b7 by inserting before the semicolon at the end the following3 and 7,,ee7 with respect to scalp cooling items 7as defined in section #ahfa7lll771 the amount paid shall be equal to #hj percent of the lesser of the actual charge or an amount determined appropriate by the ,secretary24 7c7 ,medicaid 7#a7 ,in general ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended-- 7,a7 in section #aijb7;a77#aj77;,a71 by striking and 7#cj7 and inserting 7#cj71 and 7#ca72 and 7,b7 in section #aije7;a7-- 7i7 in paragraph 7#cj71 by striking and at the end2 7ii7 by redesignating paragraph 7#ca7 as paragraph 7#cb72 and 7iii7 by inserting after paragraph 7#cj7 the following new paragraph3 7#ca7 cooling caps1 hypothermia caps1 cold caps1 and any other therapeutic devices used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy4 4 7#b7 ,effective date 7,a7 ,in general ,subject to subparagraph 7,b71 the amendments made by this subsection shall apply with respect to medical assistance furnished in calendar quarters beginning on or after ,january #a1 #bjbc4 7,b7 ,exception for ,state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act 7or a waiver of such plan71 which the ,secretary of ,health and ,human ,services determines requires ,state legislation in order for the respective plan 7or waiver7 to meet any requirement imposed by the amendments made by this subsection1 the respective plan 7or waiver7 shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of enactment of this subsection4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4 7d7 ,,chip 7#a7 ,in general ,section #bajc of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7 is amended-- 7,a7 in subsection 7a71 by striking paragraphs 7#e71 7#f71 7#g7 and 7#h7 of2 and 7,b7 in subsection 7c71 by adding at the end the following new paragraph3 7#aa7 ,coverage of scalp cooling items ,the child health assistance provided to a targeted low-income child shall include cooling caps1 hypothermia caps1 cold caps1 and any other therapeutic devices used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy4 4 7#b7 ,effective date 7,a7 ,in general ,subject to subparagraph 7,b71 the amendments made by this subsection shall take effect with respect to child health assistance provided on or after ,january #a1 #bjbc4 7,b7 ,exception for ,state legislation ,in the case of a ,state child health plan under title ,,xxi of the ,social ,security ,act 7or a waiver of such plan71 which the ,secretary of ,health and ,human ,services determines requires ,state legislation in order for the respective plan 7or waiver7 to meet any requirement imposed by the amendments made by this section1 the respective plan 7or waiver7 shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of enactment of this section4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4 7e7 ,,fehbp ,section #hijb of title #e1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7p7 ,a contract may not be made or a plan approved which does not provide for the coverage required under section #bgcj of the ,public ,health ,service ,act4 4 7f7 ,,tricare ,section #ajgg7;a7 of title #aj1 ,united ,states ,code1 is amended by adding at the end the following new paragraph3 7#ai7 ,a cooling cap1 hypothermia cap1 cold cap1 or any other therapeutic device used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy4 4 7g7 ,,va 7#a7 ,in general ,chapter #ag of title #ch1 ,united ,states ,code1 is amended by inserting after section #agbj;,i the following new section3 #agbj;,j4 ,provision of scalp cooling items ,the ,secretary shall make available to a veteran who receives chemotherapy pursuant to this chapter a cooling cap1 hypothermia cap1 cold cap1 or any other therapeutic device used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #agbj;,i the following new item3 #agbj;,j4 ,provision of scalp cooling items4 4