As you may be aware, late this year, Congress enacted the Women's Health and Cancer Rights Act which requires health plans that cover mastectomies to also cover certain related reconstructive surgery. After a participant or beneficiary undergoes a mastectomy, a plan must also cover reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, prostheses, and treatment required as a result of physical complications for all stages of mastectomy. The new law requires that medical plans notify participants of the availability of such coverage at the earliest of the plan's next open enrollment period or January 1, 1999. The notice may be in the form of a separate letter, a summary of material modification ("SMM"), or by incorporating the notice into the existing summary plan description ("SPD") of the medical plan. If you have not yet complied with this new notice requirement and would like assistance in preparing such a notice, please contact a member of the Employee Benefits and Executive Compensation Group.
New Federal Law Mandates Coverage for Some Mastectomy-Related Surgery
This article was edited and reviewed by FindLaw Attorney Writers | Last reviewed March 26, 2008
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