To enact sections 1751.64, 3923.66, 3923.67, and 5164.11 of the Revised Code regarding insurance and Medicaid coverage of scalp cooling systems for individuals receiving cancer chemotherapy treatments.
Summary
HB818 would require coverage for scalp cooling systems, sometimes called cold caps, when a health plan or Medicaid covers cancer chemotherapy treatment. The bill applies to individual and group health insuring corporation policies, individual and group sickness and accident insurance policies, public employee benefit plans, and the Medicaid program. In each of those settings, if chemotherapy is covered, the plan would also have to cover the expense of a scalp cooling system used to reduce hair loss during treatment.
The bill defines a scalp cooling system as a reusable medical device intended to cool the scalp to prevent or reduce chemotherapy-related hair loss. It also authorizes the Medicaid director to adopt rules needed to implement the Medicaid coverage requirement. The measure is drafted as a mandate on insurers and public benefit plans rather than as a discretionary benefit, and it would amend the Revised Code by adding new sections governing coverage obligations.
Impact
HB818 would expand Ohio insurance and Medicaid law by creating a new mandatory benefit for scalp cooling systems in chemotherapy cases. It would affect health insuring corporations, sickness and accident insurers, public employee benefit plans, and Medicaid, requiring them to pay for the device when they already cover cancer chemotherapy treatment. The bill would likely increase coverage options for cancer patients and could raise costs for affected plans and the Medicaid program, while also establishing a new statutory definition for the device and giving the Medicaid director rulemaking authority.
Sentiment
The available record shows the bill was introduced and referred to the House Insurance Committee, but there are no recorded committee transcripts or votes in the provided materials. Based on the bill’s subject matter, the proposal appears consumer- and patient-protective, aimed at improving access to a treatment-related supportive device for people undergoing chemotherapy. Because no debate or roll-call history is provided, there is no documented opposition or support in the record beyond the bill’s introduction.
Contention
The main likely point of contention is cost: insurers, public employee plans, and Medicaid would be required to cover an additional benefit, which could prompt concerns about premium impacts, administrative burden, or program spending. Another possible issue is whether scalp cooling systems should be treated as a medically necessary covered service or as a quality-of-life benefit. No specific objections or supporters are identified in the provided transcripts or votes, so any contention is inferred from the mandate itself rather than from recorded debate.
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