Detailed Summary

Children's Access to Reconstructive Evaluation and Surgery Act or the CARES Act - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to require a group health plan that covers surgical benefits to also cover outpatient and inpatient diagnosis and treatment of a child's congenital or developmental deformity, disease, or injury. Requires that such coverage: (1) be subject to pre-authorization or pre-certification requirements of the plan or issuer; and (2) include any surgical treatment deemed by the treating physician to be medically necessary to approximate a normal appearance. Defines "treatment" to include reconstructive surgical procedures that are performed on abnormal structures of the body caused by congenital defects, abnormalities, trauma, infection, tumors, or disease, including: (1) procedures that do not materially affect the function of the body part being treated; and (2) procedures for secondary conditions and follow-up treatment. Excludes cosmetic surgery performed to reshape normal structures of the body to improve appearance or self-esteem.

Status of the Legislation

Latest Major Action: 6/11/2007: Referred to Senate committee. Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Points in Favor

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Points Against

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