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Children's Deformities Act

Plastic Surgeons Support Senate Introduction of Children’s Deformities Act

WASHINGTON, D.C. — The American Society of Plastic Surgeons (ASPS) strongly supports the introduction of the Treatment of Children’s Deformities Act in the U.S. Senate on October 28, 1999. Senator John McCain (R-AZ), with Senator Olympia Snowe (R-MA) serving as co-sponsor, introduced the new legislation.

The Treatment of Children’s Deformities Act was first introduced in the House of Representatives near the end of the last congressional session and was re-introduced on January 6, 1999 by Rep. Sue Kelly (R-NY) as H.R. 49. The bi-partisan legislation is the result of efforts by ASPS and groups representing other medical specialties and patients to highlight the problem of insurance denials for treatment of children’s deformities.

There are now 45 co-sponsors of Rep. Sue Kelly’s bill in the House. The Senate introduction is expected to enhance the measure’s chances of passage in this Congress.

“ASPS is proud to stand with the co-sponsors of this bill to fight for the right of children born with an abnormal appearance,” said ASPS President C. Lin Puckett, M.D.

The bill would require insurance companies to cover reconstructive surgical procedures for those children with congenital or developmental deformities, diseases or injuries. Coverage would be required for surgical procedures designed to improve the function of abnormal body structures, or to restore those body structures to a more normal appearance.

“We are thrilled that members of the 106th Congress recognize the importance of highlighting this issue. Hopefully, the introduction of the Senate bill will result in passage of this much-needed legislation,” said Phillip Haeck, MD, ASPS Government Relations Committee Chair.

Currently, 15 states have laws that address insurance coverage for children’s deformities or craniofacial disorders. Most recently, Texas passed a law requiring coverage for treatment of children’s deformities.

According to an ASPS survey, 53.5 percent of surgeons surveyed indicated that they have had at least one pediatric patient in the last two years who has been totally or partially denied coverage, or has had difficulty obtaining approval for insurance coverage for craniofacial and/or congenital defects procedures. Of those patients, 74 percent have been denied coverage for an initial procedure, and 53 percent have been denied for subsequent procedures.

The childhood deformities, disfigurements and congenital defects procedures most often denied insurance coverage are associated with: 1) cleft-lip repair; 2) nose reshaping for congenital deformities related to cleft-lip and craniofacial deformity; and 3) repair of abnormally small outer ear (microtia).

ASPS is working with the following organizations to raise awareness of insurance denials for treatment of children’s deformities: American Society of Maxillofacial Surgeons, American Cleft Palate-Craniofacial Association, American Society of Craniofacial Surgery, American Association of Pediatric Plastic Surgeons, American Academy of Pediatrics, American Association of Neurological Surgeons, American Medical Association, American Academy of Child and Adolescent Psychiatry, American Association of Plastic Surgeons, American College of Surgeons, American Pediatric Surgical Association, American Society for Surgery of the Hand.

“This legislation is a necessary step in returning the focus of health care where it should be, on the needs of the patient,” said Dr. Puckett.

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Dr. Max Gouverne

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Dr. Max Gouverne, MD
Cosmetic Surgery

5642 Esplanade Drive
Corpus Christi, TX 78414

Phone (361) 993-2222 Monday–Thursday:
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Friday: 8 a.m.–12 p.m.