summary
Introduced
04/12/2013
04/12/2013
In Committee
07/08/2013
07/08/2013
Crossed Over
Passed
Dead
01/03/2015
01/03/2015
Introduced Session
113th Congress
Bill Summary
Breast Cancer Patient Protect Act of 2013 - Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require a group or individual health plan 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 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, insofar as the attending physician, in consultation with the patient, determines such stay to be medically necessary; or (2) requiring that a provider obtain authorization from the plan for prescribing any such length of stay. Requires such a plan to: (1) provide notice to each participant and beneficiary regarding the coverage required under this Act, and (2) ensure that coverage is provided for secondary consultations. Prohibits a health plan from taking specified actions to avoid the requirements of this Act. Allows a health insurance issuer that provides individual health insurance coverage to nonrenew or discontinue an individual's coverage based on the intentional concealment of material facts regarding a health condition related to the condition for which coverage is being claimed.
AI Summary
This bill, the Breast Cancer Patient Protection Act of 2013, mandates that group and individual health plans provide coverage for breast cancer treatment, including inpatient hospital stays of at least 48 hours for mastectomies or breast-conserving surgeries (like lumpectomies) and 24 hours for lymph node dissections, if deemed medically necessary by the attending physician in consultation with the patient. It also requires coverage for radiation therapy and prohibits plans from requiring prior authorization for these medically necessary hospital stays or from penalizing providers for adhering to these requirements. Furthermore, the bill ensures coverage for secondary consultations with specialists to confirm diagnoses and requires health plans to notify beneficiaries about these coverage rights. A provision is included to allow health insurance issuers to nonrenew or discontinue individual coverage only in cases of intentional concealment of material health facts related to the condition for which coverage is sought, and even then, the individual has the right to an independent external review before the coverage is terminated.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (84)
Rosa DeLauro (D)*,
Sanford Bishop (D),
Madeleine Bordallo (D),
Bruce Braley (D),
Corrine Brown (D),
Lois Capps (D),
André Carson (D),
Kathy Castor (D),
Judy Chu (D),
David Cicilline (D),
Yvette Clarke (D),
Lacy Clay (D),
Steve Cohen (D),
Gerry Connolly (D),
John Conyers (D),
Jim Cooper (D),
Diana DeGette (D),
John Dingell (D),
Donna Edwards (D),
Keith Ellison (D),
Eliot Engel (D),
Sam Farr (D),
Lois Frankel (D),
Rodney Frelinghuysen (R),
Marcia Fudge (D),
Raúl Grijalva (D),
Janice Hahn (D),
Alcee Hastings (D),
Brian Higgins (D),
Jim Himes (D),
Rubén Hinojosa (D),
Rush Holt (D),
Steve Israel (D),
Sheila Jackson-Lee (D),
Eddie Johnson (D),
Hank Johnson (D),
Marcy Kaptur (D),
James Langevin (D),
John Larson (D),
Barbara Lee (D),
Sander Levin (D),
John Lewis (D),
Frank LoBiondo (R),
David Loebsack (D),
Zoe Lofgren (D),
Nita Lowey (D),
Carolyn Maloney (D),
Ed Markey (D),
Jim McGovern (D),
Mike McIntyre (D),
Gwen Moore (D),
James Moran (D),
Jerry Nadler (D),
Grace Napolitano (D),
Richard Neal (D),
Ed Pastor (D),
Donald Payne (D),
Chellie Pingree (D),
Mark Pocan (D),
David Price (D),
Nick Rahall (D),
Charles Rangel (D),
Lucille Roybal-Allard (D),
Dutch Ruppersberger (D),
Bobby Rush (D),
Tim Ryan (D),
Kilili Sablan (D),
Linda Sánchez (D),
John Sarbanes (D),
Jan Schakowsky (D),
Adam Schiff (D),
Allyson Schwartz (D),
David Scott (D),
José Serrano (D),
Brad Sherman (D),
Louise Slaughter (D),
Jackie Speier (D),
Mark Takano (D),
Niki Tsongas (D),
Chris Van Hollen (D),
Debbie Wasserman Schultz (D),
Frederica Wilson (D),
John Yarmuth (D),
Don Young (R),
Last Action
Referred to the Subcommittee on Health, Employment, Labor, and Pensions. (on 07/08/2013)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location | Created |
|---|---|---|
| State Bill Page | https://www.congress.gov/bill/113th-congress/house-bill/1531/all-info | 04/25/2013 |
| BillText | http://gpo.gov/fdsys/pkg/BILLS-113hr1531ih/pdf/BILLS-113hr1531ih.pdf | 04/27/2013 |
| Bill | http://gpo.gov/fdsys/pkg/BILLS-113hr1531ih/pdf/BILLS-113hr1531ih.pdf.pdf | 04/19/2013 |
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