HR 3277 IH: Enhancing Coverage for Congenital Anomalies

HR 3277 IH: A Comprehensive Bill to Improve Coverage for Congenital Anomalies

The following is a summary of the HR 3277 IH bill, which aims to enhance coverage for congenital anomalies. You can find the original bill on GovTrack.gov.

Section 1: Short Title

This section states that this Act may be cited as the “Congenital Anomaly Coverage Improvement Act”.

Section 2. Findings and Purpose

The Congress finds that:

There is a lack of comprehensive coverage for congenital anomalies under group health plans and individual health insurance coverage;

Congenital anomalies can result in significant medical expenses, burdening families and individuals; and

there is a need for improved access to care and services for individuals with these conditions.

Section 3. Definitions

This section defines key terms used throughout the bill, including “congenital anomaly” and “qualified medical professional.”

Section 4. Coverage Requirements for Congenital Anomalies

Under this section, group health plans and individual health insurance coverage are required to cover certain services related to congenital anomalies.

Imaging services:

X-rays;
Computed tomography (CT) scans;
Magnetic resonance imaging (MRI) scans; and
Ultrasounds.

Diagnostic services:

Pediatric specialists’ visits;
Surgery or hospital care;
Medications and equipment;
Therapy sessions; and
Counseling services.

Preventive services:

Screenings for certain conditions, such as heart defects or cleft palate;
Pre-natal care and maternal health services; and
Genetic testing and counseling.

Rehabilitative services:

Physical therapy;
Occupational therapy; and
Pain management services.

Section 5. Prohibited Coverage

This section prohibits group health plans and individual health insurance coverage from denying coverage for the aforementioned services based on certain pre-existing conditions or other factors.

Section 6. Study and Report on Network Adequacy

The Secretary of Health and Human Services shall conduct a study to evaluate the sufficiency and accessibility of networks of providers that perform services related to congenital anomalies under group health plans and individual health insurance coverage.