| (Washington, D.C.) U.S. Rep. Mike Ross (AR-04) Friday reintroduced
the Reconstructive Surgery Act of 2005, legislation which would ensure
nationwide insurance coverage for medically necessary reconstructive surgeries.
Ross wrote the bill after learning of the challenges a constituent faced
in getting the reconstructive surgery necessary to overcome her own disorder.
Approximately 100,000 children are born each year with some degree of
craniofacial disfigurement. Additionally, both children and adults
can develop such conditions through trauma and disease. Unfortunately,
these individuals are often denied insurance coverage because their health
insurers classify needed operations as “cosmetic.” Legislation has
been passed in 16 states that to some degree requires insurance companies
to cover reconstructive surgeries.
The American Medical Association (AMA) has developed clear and simple
guidelines regarding the differences between cosmetic and reconstructive
surgery. The legislation proposed by Ross, which incorporates the
AMA definitions, would provide insurance coverage to individuals who suffer
from congenital defects, developmental abnormalities, trauma, infection,
tumor or disease that leads to disfigurement that medically impairs them.
The legislation also mirrors language in federal law requiring coverage
for reconstruction after mastectomies.
“Individuals are forced to fight their insurance companies so they can
receive the life-saving surgeries they need,” said Ross. “The fact
that these surgeries have been grouped in the same ‘cosmetic’ category
as surgeries that simply make people look better or younger is a tragedy.
This legislation is another step in ensuring that individuals living with
these conditions will receive the necessary medical care.”
Ross was inspired to draft the bill by a constituent, Wendelyn Osborne.
The Arkadelphia resident was the 16th person documented with the rare bone
disease, Craniometaphyseal Dysplasia, which causes an overgrowth of her
craniofacial bone that never deteriorates.
“Wendelyn’s condition requires periodic surgeries to correct the growth
and abnormalities caused by the disease,” said Ross. “Unfortunately,
Wendelyn has had to fight for any type of disease-related procedure as
well as access to qualified physicians. Wendelyn’s condition is rare,
but her experience in seeking medical care is not.”
For additional information on craniofacial conditions, please visit
the website of the Children’s Craniofacial Association at www.ccakids.org
or Cleft Advocate at www.cleftadvocate.org. |
