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Committee on Education and LaborHealth, Employment, Labor, and PensionsCommittee on Energy and CommerceHealthCommittee on Ways and MeansIntroducedMarch 5th, 2009
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Children's Access to Reconstructive Evaluation & Surgery (CARES) Act of 2009
To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require that group and individual health insurance coverage and group health plans provide coverage for treatment of a minor child's congenital or developmental deformity or disorder due to trauma, infection, tumor, or disease.
Children's Access to Reconstructive Evaluation & Surgery (CARES) Act of 2009 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to require a group health plan that covers surgical benefits to also cover outpatient and inpatient diagnosis and treatment of a congenital or developmental deformity, disease, or injury of a minor child (defined as child under the age of 22). Requires that such coverage: (1) be subject to pre-authorization or pre-certification requirements of the plan or issuer; and (2) include any surgical treatment deemed by the treating physician to be medically necessary to approximate a normal appearance. Defines "treatment" to include reconstructive surgical procedures that are performed on abnormal structures of the body caused by congenital defects, abnormalities, trauma, infection, tumors, or disease, including: (1) procedures that do not materially affect the function of the body part being treated; and (2) procedures for secondary conditions and follow-up treatment. Excludes cosmetic surgery performed to reshape normal structures of the body to improve appearance or self-esteem.