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  • Acts
  • 1998
  • Chapter 140 AN ACT PROVIDING FOR CERTAIN INSURANCE BENEFITS FOR CANCER PATIENTS.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:


SECTION 1. Chapter 32A of the General Laws is hereby amended by inserting after section 17D, as appearing in the 1996 Official Edition, the following section:-

Section 17E. (a) For the purposes of this section, the following words shall have the following meanings:

"Prosthesis", an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs, breasts, scalp hair or glass eyes.

"Scalp hair prosthesis", an artificial substitute for scalp hair.

(b) The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission, if such group coverage provides for any other prosthesis, coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that such coverage shall be subject to a written statement by the treating physician that the scalp hair prosthesis is medically necessary; and provided, further, that such coverage shall be subject to the same limitations and guidelines as other prostheses. Scalp hair prosthesis coverage pursuant to this section shall not exceed an amount of $350 per year.

SECTION 2. Chapter 175 of the General Laws is hereby amended by inserting after section 47S, as so appearing, the following section:-

Section 47T. (a) For the purposes of this section, the following words shall have the following meanings:

"Prosthesis", an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs, breasts, scalp hair or glass eyes.

"Scalp hair prosthesis", an artificial substitute for scalp hair.

(b) Any blanket or general policy of insurance described in subdivision (A), (C) or (D) of section 110 which provides hospital expense and surgical expense insurance, which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, or any policy of accident and sickness insurance as described in section 108 which provides hospital expense and surgical expense insurance, which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth, or any employees' health and welfare fund which provides hospital expense and surgical expense benefits and which is issued or renewed to any person or group of persons in the commonwealth, if such policy or fund provides coverage for any other prosthesis, shall provide coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that such coverage shall be subject to a written statement by the treating physician that the scalp hair prosthesis is medically necessary; and provided, further, that such coverage shall be subject to the same limitations and guidelines as other prostheses. Scalp hair prosthesis coverage pursuant to this section shall not exceed an amount of $350 per year.

SECTION 3. Chapter 176A of the General Laws is hereby amended by inserting after section 8S, as so appearing, the following section:-

Section 8T. (a) For the purpose of this section, the following words shall have the following meanings:

"Prosthesis", an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs, breasts, scalp hair or glass eyes.

"Scalp hair prosthesis", an artificial substitute for scalp hair.

(b) Any contracts, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed in the commonwealth and which provides coverage for any other prosthesis, shall provide, as a benefit to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment within the commonwealth, coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that such coverage shall be subject to a written statement by the treating physician that the scalp hair prosthesis is medically necessary; and provided, further, that such coverage shall be subject to the same limitations and guidelines as other prostheses. Scalp hair prosthesis coverage pursuant to this section shall not exceed an amount of $350 per year.

SECTION 4. Chapter 176B of the General Laws is hereby amended by inserting after section 4Q, as so appearing, the following section:-

Section 4R. (a) For the purposes of this section, the following words shall have the following meanings:

"Prosthesis", an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs, breasts, scalp hair or glass eyes.

"Scalp hair prosthesis", an artificial substitute for scalp hair.

(b) Any subscription certificate under an individual or group medical service agreement, except certificates which provide supplemental coverage to medicare or other governmental programs, that shall be delivered, issued or renewed within the commonwealth, and which provides coverage for any other prosthesis, shall provide, as benefits to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment within the commonwealth, coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that such coverage shall be subject to a written statement by the treating physician that the scalp hair prosthesis is medically necessary; and provided, further, that such coverage shall be subject to the same limitations and guidelines as other prostheses. Scalp hair prosthesis coverage pursuant to this section shall not exceed an amount of $350 per year.

SECTION 5. Chapter 176G of the General Laws is hereby amended by inserting after section 4I, as so appearing, the following section:-

Section 4J. (a) For the purposes of this section, the following words shall have the following meanings:

"Prosthesis", an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs, breasts, scalp hair or glass eyes.

"Scalp hair prosthesis", an artificial substitute for scalp hair.

(b) A group health maintenance contract which provides coverage for any other prosthesis, shall provide coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that such coverage shall be subject to a written statement by the treating physician that the scalp hair prosthesis is medically necessary; and provided, further, that such coverage shall be subject to the same limitations and guidelines as other prostheses. Scalp hair prosthesis coverage pursuant to this section shall not exceed an amount of $350 per year.

Approved May 29, 1998.