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H.R. 1531 (113th): Breast Cancer Patient Protection Act of 2013

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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Apr 12, 2013.

Breast Cancer Patient Protect Act of 2013 - Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require a group or individual health plan that provides medical and surgical benefits to ensure that inpatient (and in the case of a lumpectomy, outpatient) coverage and radiation therapy are provided for breast cancer treatment. Prohibits such a plan from: (1) restricting benefits for any hospital length of stay to less than 48 hours in connection with a mastectomy or breast conserving surgery or 24 hours in connection with a lymph node dissection, insofar as the attending physician, in consultation with the patient, determines such stay to be medically necessary; or (2) requiring that a provider obtain authorization from the plan for prescribing any such length of stay.

Requires such a plan to: (1) provide notice to each participant and beneficiary regarding the coverage required under this Act, and (2) ensure that coverage is provided for secondary consultations.

Prohibits a health plan from taking specified actions to avoid the requirements of this Act.

Allows a health insurance issuer that provides individual health insurance coverage to nonrenew or discontinue an individual's coverage based on the intentional concealment of material facts regarding a health condition related to the condition for which coverage is being claimed.