HOUSE BILL NO. 697

By Representatives Eckles, Chumney, Sherry Jones, Beavers, Hassell, Brooks, Davis, Cooper, Rinks, Fitzhugh, Lewis, Towns, Miller, McKee, Hood, Langster, Arriola, Brown, Armstrong, Pruitt, Haley, Davidson, McMillan, Windle, Brenda Turner, Rhinehart, Robinson, Head, Ridgeway, Kent, Ferguson, Dunn, Bowers, Sharp, Whitson, Godsey, Caldwell, Stulce, Curtiss, West, Williams, Cross, Bone, Huskey, John DeBerry, Pleasant, Phelan, White, Fowlkes, Kernell, Ronnie Cole, Bird, Tidwell, Halteman Harwell, Sargent, Ulysses Jones, Pinion, Walker, Fraley, Larry Turner, Boner, Roach, Ralph Cole, Sands, Winningham, Westmoreland, Givens, Phillips, Odom, Stamps, Maddox, Jackson, Patton, McDonald, Hargett, Clabough, Ford, Newton, Kerr and Mr. Speaker Naifeh

Substituted for: Senate Bill No. 237

By Senators Harper, Crutchfield, Ford, Atchley, Burks, Carter, Cohen, Cooper, Crowe, Davis, Dixon, Elsea, Fowler, Gilbert, Graves, Haun, Haynes, Henry, Herron, Jordan, Koella, Kurita, Kyle, Leatherwood, McNally, Miller, Person, Ramsey, Rochelle, Springer, Williams, Womack and Mr. Speaker Wilder

AN ACT to amend Tennessee Code Annotated, Title 56, Chapter 7, Part 25, relative to coverage for certain reconstruction surgery.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:

SECTION 1. Tennessee Code Annotated, Title 56, Chapter 7, Part 25, is amended by adding the following language as a new, appropriately designated section:

Section ___. (a)(1) Any individual, franchise, blanket or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, health maintenance organization, or managed care organization which provides coverage for mastectomy surgery shall provide coverage for all stages of reconstructive breast surgery on the diseased breast as a result of a mastectomy, but not including a lumpectomy, as well as any surgical procedure on the non-diseased breast deemed necessary to establish symmetry between the two breasts in the manner chosen by the patient and physician. The surgical procedure performed on a nondiseased breast to establish symmetry with the diseased breast must occur within five (5) years of the date the reconstructive breast surgery was performed on a diseased breast.

(2) Coverage for reconstructive breast surgery shall be subject to applicable copayments, coinsurance and deductibles.

(b) This section applies to any policy, plan, or contract entered into or renewed on or after July 1, 1997.

SECTION 2. This act shall take effect upon becoming a law, the public welfare requiring it.