S-0887.2  _______________________________________________

                         SENATE BILL 5465

          _______________________________________________

State of Washington      55th Legislature     1997 Regular Session

By Senators Jacobsen, Wood and Prentice

Read first time 01/27/97.  Referred to Committee on Financial Institutions, Insurance & Housing.

Providing treatment to restore physical function.

    AN ACT Relating to treatment to restore physical function; and amending RCW 48.20.395, 48.21.230, 48.44.330, and 48.46.280.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

    Sec. 1.  RCW 48.20.395 and 1985 c 54 s 5 are each amended to read as follows:

    (1) Any disability insurance contract providing hospital ((and)) expenses, medical expenses ((and)), or health care services delivered ((or)), issued, or renewed in this state after July 24, 1983, shall provide coverage for reconstructive breast surgery resulting from a mastectomy which resulted from disease, illness, or injury.

    (2) Any disability insurance contract providing hospital ((and)) expenses, medical expenses ((and)), or health care services delivered ((or)), issued, or renewed in this state after January 1, 1986, shall provide coverage for all stages of one reconstructive breast reduction on the nondiseased breast to make it equal in size with the diseased breast after definitive reconstructive surgery on the diseased breast has been performed.

(3) Any disability insurance contract providing hospital expenses,  medical expenses, or health care services delivered, issued, or renewed in this state after July 30, 1997, shall provide coverage for treatment for male erectile dysfunction resulting from disease, illness, or injury or from surgery or other treatment for disease, illness, or injury.

    Sec. 2.  RCW 48.21.230 and 1985 c 54 s 6 are each amended to read as follows:

    (1) Each group disability insurance contract issued or renewed after July 24, 1983, which insures for hospital or medical care shall provide coverage for reconstructive breast surgery resulting from a mastectomy which resulted from disease, illness, or injury.

    (2) Each group disability insurance contract issued or renewed after January 1, 1986, which insures for hospital or medical care shall provide coverage for all stages of one reconstructive breast reduction on the nondiseased breast to make it equal in size with the diseased breast after definitive reconstructive surgery on the diseased breast has been performed.

(3) Each group disability insurance contract issued or renewed after July 30, 1997, that insures for hospital or medical care shall provide coverage for male erectile dysfunction resulting from disease, illness, or injury or from surgery or other treatment for disease, illness, or injury.

    Sec. 3.  RCW 48.44.330 and 1985 c 54 s 7 are each amended to read as follows:

    (1) Each contract for health care entered into or renewed after July 24, 1983, between a health care services contractor and the person or persons to receive the care shall provide coverage for reconstructive breast surgery resulting from a mastectomy which resulted from disease, illness, or injury.

    (2) Each contract for health care entered into or renewed after January 1, 1986, between a health care services contractor and the person or persons to receive the care shall provide coverage for all stages of one reconstructive breast reduction on the nondiseased breast to make it equal in size with the diseased breast after definitive reconstructive surgery on the diseased breast has been performed.

(3) Each contract for health care entered into or renewed after July 30, 1997, between a health care services contractor and the person or persons to receive the care shall provide coverage for male erectile dysfunction resulting from disease, illness, or injury or from surgery or other treatment for disease, illness, or injury.

    Sec. 4.  RCW 48.46.280 and 1985 c 54 s 8 are each amended to read as follows:

    (1) Any health care service plan issued, amended, or renewed after July 24, 1983, shall provide coverage for reconstructive breast surgery resulting from a mastectomy which resulted from disease, illness, or injury.

    (2) Any health care service plan issued, amended, or renewed after January 1, 1986, shall provide coverage for all stages of one reconstructive breast reduction on the nondiseased breast to make it equal in size with the diseased breast after definitive reconstructive surgery on the diseased breast has been performed.

(3) Any health care service plan issued, amended, or renewed after July 30, 1997, shall provide coverage for treatment for male erectile dysfunction resulting from disease, illness, or injury or from surgery or other treatment for disease, illness, or injury.

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