Page:United States Statutes at Large Volume 112 Part 4.djvu/466

 112 STAT. 2681-437 PUBLIC LAW 105-277—OCT. 21, 1998 "(2) surgery and reconstruction of the other breast to produce a symmetrical appearance; and "(3) prostheses and physical complications of mastectomy, including lymphedemas; in a manner determined in consultation with the attending physician and the patient. Such coverage may be subject to annual deductibles and coinsurance provisions as may be deemed appropriate and as are consistent with those established for other benefits under the plan or coverage. Written notice of the availability of such coverage shall be delivered to the participant upon enrollment and annually thereafter. "(b) NOTICE.— A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan shall provide notice to each participant and beneficiary under such plan regarding the coverage required by this section in accordance with regulations promulgated by the Secretary. Such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan or issuer and shall be transmitted— "(1) in the next mailing made by the plan or issuer to the participant or beneficiary; "(2) as part of any yearly informational packet sent to the participant or beneficiary; or "(3) not later than January 1, 1999; whichever is earlier. " (c) PROHIBITIONS.— ^A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not— "(1) deny to a patient eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section; and "(2) penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide incentives (monetary or otherwise) to an attending provider, to induce such provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section. "(d) RULE OF CONSTRUCTION.— Nothing in this section shall be construed to prevent a group health plan or a health insurance issuer offering group health insurance coverage from negotiating the level and t)^e of reimbursement with a provider for care provided in accordance with this section. "(e) PREEMPTION, RELATION TO STATE LAWS. — "(1) IN GENERAL.—Nothing in this section shall be construed to preempt siny State law in effect on the date of enactment of this section with respect to health insurance coverage that requires coverage of at least the coverage of reconstructive breast surgery otherwise required under this section. "(2) ERISA. — Nothing in this section shall be construed to affect or modify the provisions of section 514 with respect to group health plans.". (b) CLERICAL AMENDMENT.—The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 note) is amended by inserting after the item relating to section 712 the following new item: "Sec. 713. Required coverage reconstructive surgery following mastectomies.".

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