Friday, June 22, 2007

Reconstructive Surgery Act (HR2820)
Press Release

Legislation Introduced In Congress To Guarantee
Insurance Coverage for Reconstructive Medical Care

Washington, DC; June 21, 2007-- Representative Mike Ross of Arkansas today introduced legislation to guarantee insurance coverage for craniofacial patients. This legislation, HR 2820, was proposed because insurance companies will sometime label needed reconstructive care as “cosmetic” and deny coverage for this or other reasons. The Reconstructive Surgery Act of 2007 seeks to guarantee that insurance companies cover medically necessary care.

Approximately 100,000 children are born each year with some degree of craniofacial disfigurement. In addition both children and adults can develop such conditions through trauma and disease.

The American Medical Association has developed clear and simple guidelines regarding the differences between cosmetic and reconstructive. The legislation proposed by Congressman Ross incorporates the AMA definitions. The legislation also is virtually identical to the language in federal law requiring coverage for reconstruction after mastectomies.

Anecdotal experience indicates that when this denial of coverage is challenged legally, the insurers generally settle and pay for coverage. But because of financial burdens associated with the craniofacial conditions, many families are unable to afford such representation. The result has been patients either going without surgeries and other treatments or incurring a significant financial obligation.

Legislation has been passed in at least 16 states that to some degree require insurers to cover reconstructive surgeries. No evidence has been presented that this has resulted in significant premium increases.

For additional information on craniofacial conditions, please visit the AmeriFace website at http://www.ameriface.org or the
cleftAdvocate website at www.cleftadvocate.org.

CONTACT: Debbie Oliver at debbie@ameriface.org or (888) 486-1209.



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