This bill would require that breast reconstruction be provided under all health insurance plans in the State of Alabama, including those covering public employees and the Medicaid program. This bill would permit an insured individual to choose the type of breast reconstruction desired and a particular surgeon to perform the reconstruction, who may be outside of the health insurance benefit plan network. For private health insurance, this bill would also set terms for cost-sharing obligations for enrollees and insurer payments to out-of-network providers. This bill would provide that an insured individual or a health care professional may bring a civil action if the insurer fails to comply with this act, with enforcement powers given to the Attorney General and the Commissioner of the Department of Insurance.

Statutes affected:
Introduced: 27-50A-1, 10A-20-6