S3872119th CongressWALLET

A bill to amend title XVIII of the Social Security Act to provide coverage for wigs as durable medical equipment under the Medicare program, and for other purposes.

Sponsored By: Senator Richard Blumenthal

Introduced

Summary

Medicare would cover medically necessary cranial prostheses (wigs) as durable medical equipment. It would require a written certification from a dermatologist, oncologist, or the attending physician that the prosthesis is medically necessary for a proposed course of rehabilitative treatment or for hair loss caused by conditions such as autoimmune disease, cancer, or chemotherapy.

Show full summary
  • Medicare beneficiaries: People who need cranial prostheses for medical hair loss could get coverage when a qualified clinician signs a written certification.
  • Clinicians: Dermatologists, oncologists, and attending physicians would need to document medical necessity in writing as a condition of coverage.
  • Coverage rules: Certified cranial prostheses would be treated as durable medical equipment under Medicare and prostheses without the required certification would not be covered.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Medicare would cover medical wigs

If enacted, Medicare would be allowed to cover cranial prostheses (wigs) when a qualifying clinician provides a written certification of medical necessity. The certification must come from a dermatologist, oncologist, or your attending physician and must say the wig is medically necessary as part of a proposed course of rehabilitative treatment or for hair loss from a health condition. The bill lists autoimmune disease, cancer, and chemotherapy as covered causes of hair loss. Wigs that do not have the required written certification would not be covered. This change would take effect upon enactment.

Sponsors & CoSponsors

Sponsor

Richard Blumenthal

CT • D

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

No roll call votes available for this bill.

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