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The Ensuring Lasting Smiles Act requires group health plans and health insurance issuers to cover outpatient and inpatient items and services related to the diagnosis and treatment of congenital anomalies or birth defects affecting the eyes, ears, teeth, mouth, or jaw. Coverage includes reconstructive procedures, dental and orthodontic support, and follow-up treatment to restore normal function or appearance, as determined medically necessary by a treating physician. Cost-sharing requirements must be no more restrictive than those applied to other medical and surgical benefits. The bill excludes cosmetic surgery performed on normal body structures unrelated to a congenital anomaly or birth defect.
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