WeVote
Log In

Bill

Bill

H 685

An act relating to health insurance coverage for scalp cooling systems

2025-2026 Regular Session Introduced by Emilie Krasnow

Health insurers in Vermont would be required to cover scalp cooling systems and related services for eligible cancer patients.

Read first time and referred to the Committee on Health Care
0
WeVote Research Nonpartisan
Bill Summary · H 685

Overview

H 685 (Session 2025-2026, Vermont) proposes health insurance coverage for scalp cooling systems. The bill aims to require health insurers to provide coverage for the use of scalp cooling devices, typically employed to reduce chemotherapy-induced hair loss in patients undergoing cancer treatment.

Purpose and intent

  • Ensure access to scalp cooling technology as a covered medical service for eligible patients.
  • Promote quality of life and potential psychosocial benefits by mitigating hair loss associated with certain cancer treatments. -Reduce out-of-pocket costs for patients who elect scalp cooling as part of their cancer care.

Key provisions and changes

  • Insurance coverage mandate: Requires health insurers regulated in Vermont to cover scalp cooling systems and related services/assets necessary for their use.
  • Scope of coverage: Coverage likely includes the device (scalp cooling apparatus) and potentially associated supplies or clinical services necessary to operate the therapy in conjunction with chemotherapy.
  • Eligibility considerations: Coverage may be conditioned on medical necessity or a therapy recommended by a licensed clinician as part of cancer treatment; specifics on eligibility criteria would typically align with existing standards for covered medical devices/systems.
  • cost-sharing: The bill may specify reasonable cost-sharing parameters (e.g., copays, coinsurance, or deductible considerations) consistent with other covered durable medical equipment or therapy devices, subject to standard policy limitations.
  • Provider requirements: May require insurers to provide prior authorization processes or documentation similar to other durable medical equipment and therapies.
  • Definitions: Likely includes a defined term for “scalp cooling system” and related services to avoid ambiguity in coverage decisions.

Affected parties

  • Patients undergoing chemotherapy who may benefit from scalp cooling to reduce hair loss.
  • Health insurers operating within Vermont, including private plans and potentially state-regulated plans.
  • Healthcare providers (oncologists, nurses, and medical equipment suppliers) who prescribe, administer, or supply scalp cooling systems and related services.
  • Employers and plan sponsors that administer or fund group health plans in Vermont, depending on plan type and applicable exemptions.

Procedural and timeline aspects

  • Current status: Read first time and referred to the Committee on Health Care (as of 2026-01-14).
  • Next steps: Committee hearings, potential amendments, and eventual floor votes in the Vermont General Assembly. If advanced, the bill would progress through additional readings and potentially become law subject to negotiations and governor approval.
  • Effective date: The bill will specify an effective date upon passage (often tied to a future date or upon passage); exact timing would be stated in the final bill text.

Potential impacts

  • Access: Increases access to scalp cooling for eligible patients by reducing financial barriers.
  • Equity: Helps ensure that women and men undergoing chemotherapy have broader options to manage side effects that affect quality of life.
  • Costs for insurers: Could increase short-term costs for insurers due to coverage of devices and related services, potentially offset by improved patient outcomes or reduced ancillary costs.
  • Clinical practice: May standardize coverage decisions for scalp cooling, encouraging clinicians to discuss this option with patients when clinically appropriate.

If you’d like, I can tailor this summary to a specific audience (e.g., policymakers, patients, insurers) or compare it to existing Vermont coverage laws for similar medical devices.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.