Coverage for wearable cardioverter defibrillators

Sec. 28.5. (a) This section applies to an individual contract or a group contract that is entered into, amended, or renewed after June 30, 2023. (b) As used in this section, "wearable cardioverter defibrillator" means a device that: (1) is worn externally on an individual's body; (2) continually monitors and analyzes the individual's heart rhythm; and (3) delivers a shock to the heart when an abnormal heart rhythm is detected. (c) An individual contract or a group contract must provide coverage for a wearable cardioverter defibrillator, including the cost of the wearable cardioverter defibrillator, any necessary accessory, and ongoing monitoring services. (d) The coverage required under subsection (c) must be in accordance with a: (1) local coverage determination; or (2) national coverage determination; as defined in 42 U.S.C. 1395ff(f) for Medicare purposes. (e) The coverage required by this section may not be subject to an annual or lifetime limitation. As added by P.L.190-2023, SEC.32.