Requires health insurance coverage for scalp cooling items starting January 1, 2025.
Applies to group health plans, individual health insurance coverage, specified federal health care programs, and the Federal Employees Health Benefits Program.
Defines “scalp cooling items” as cooling caps, hypothermia caps, cold caps, or any other device used to cool the scalp to prevent or reduce hair loss during chemotherapy.
Financial requirements for scalp cooling items must be the same as those for intravenous or injection anticancer drugs.
Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to include these provisions.
Medicare will cover scalp cooling items as defined, with payment equal to 80 percent of the lesser of the actual charge or an amount determined by the Secretary.
Medicaid is amended to include coverage for scalp cooling items, effective for medical assistance furnished on or after January 1, 2025.
The Children’s Health Insurance Program (CHIP) will include coverage for scalp cooling items starting January 1, 2025.
The Federal Employees Health Benefits Program (FEHBP) must include coverage for scalp cooling items.
TRICARE is amended to cover scalp cooling items.
The Department of Veterans Affairs (VA) is required to provide scalp cooling items to veterans receiving chemotherapy.
