THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY DeLUCA, BROWN, DONATUCCI, GEIST, KORTZ, McILVAINE SMITH, MURT AND WALKO, FEBRUARY 27, 2009

REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 27, 2009  

AN ACT

Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An

act relating to insurance; amending, revising, and

consolidating the law providing for the incorporation of

insurance companies, and the regulation, supervision, and

protection of home and foreign insurance companies, Lloyds

associations, reciprocal and inter-insurance exchanges, and

fire insurance rating bureaus, and the regulation and

supervision of insurance carried by such companies,

associations, and exchanges, including insurance carried by

the State Workmen's Insurance Fund; providing penalties; and

repealing existing laws," providing for cranial hair vacuum

prosthesis coverage standards for health insurance policies.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  The act of May 17, 1921 (P.L.682, No.284), known

as The Insurance Company Law of 1921, is amended by adding a

section to read:

Section 635.4.  Cranial Hair Vacuum Prosthesis Insurance

Coverage.--(a)  A health insurance policy shall provide that the

health insurance benefits applicable under the policy include

coverage for the cost of a medically necessary cranial hair

vacuum prosthesis when prescribed by a physician for a person

who sustains hair loss as a result of alopecia totalis or

alopecia universalis.

(b)  If a health insurance policy provides coverage or

benefits to a resident of this Commonwealth, it shall be deemed

to be delivered in this Commonwealth within the meaning of this

section, regardless of whether the insurer issuing or delivering

the policy is located within or outside this Commonwealth.

(c)  Benefits for a cranial hair vacuum prosthesis shall be

subject to any annual deductible, copayment and coinsurance

provisions of a health insurance policy to the extent that other

medical services covered by the policy are subject to those

provisions. A benefit limit of one thousand five hundred dollars

once every three years shall apply to cranial hair vacuum

prostheses covered under this section.

(d)  This section shall apply to any health insurance policy

offered, issued or renewed on or after the effective date of

this section in this Commonwealth: Provided, That this section

shall not include the following policies: accident only, fixed

indemnity, limited benefit, credit, dental, vision, specified

disease, Medicare supplement, CHAMPUS (Civilian Health and

Medical Program of the Uniformed Services) supplement, long-term

care, disability income, workers' compensation or automobile

medical payment.

(e)  As used in this section:

(1)  "Alopecia totalis" means an autoimmune disease resulting

in complete scalp hair loss.

(2)  "Alopecia universalis" means an autoimmune disease

resulting in complete body hair loss.

(3)  "Cranial hair vacuum prosthesis" means a custom designed

system utilizing specialized materials to replace hair loss due

to alopecia totalis or alopecia universalis.

(4)  "Health insurance policy" means any group health,

sickness or accident policy or subscriber contract or

certificate issued by an entity subject to one of the following:

(i)  This act.

(ii)  The act of December 29, 1972 (P.L.1701, No.364), known

as the "Health Maintenance Organization Act."

(iii)  40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health services

plan corporations).

(5)  "Insurer" means an entity that issues a health insurance

policy.

Section 2.  This act shall take effect in 60 days.