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Committee hears testimony on requiring insurance coverage for scalp‑cooling during chemotherapy
Summary
Witnesses including survivors, oncologists and device makers urged the Health and Government Operations Committee to require private insurers to cover scalp‑cooling (cold cap) systems to reduce chemo‑related hair loss; lawmakers asked about cost, scope, and whether the Maryland Health Care Commission would review any mandate.
House Bill 11-87 would require health insurers to cover scalp‑cooling systems (commonly called cold caps), a treatment some patients use to reduce chemotherapy‑induced hair loss.
Sponsor Delegate Latoya Congola said scalp cooling can preserve patients’ dignity and confidence and noted bipartisan interest. Multiple cancer survivors and advocates testified they paid thousands out of pocket to keep their hair during treatment and described the therapy’s emotional benefit. Amy Tanner, a breast cancer patient, said her cold‑capping cost was $2,500 and that insurance would have made the treatment feasible for more patients. Liz Lord, who founded a nonprofit fund, said her group has provided more than $165,000 in financial assistance for cold caps to over 200 patients but is nearing the limit of its resources.
Physicians told the committee cold capping can be clinically effective for certain chemotherapy regimens but is not appropriate for all patients or all drugs. Mark Goldstein, a board‑certified oncologist, said ‘‘not all chemotherapy agents cause hair loss, but many do,’’ and that eligibility depends on agents and protocols. Committee members asked how many Maryland patients would qualify and how coverage as a mandate would be implemented. Witnesses said roughly 10,000–12,000 Maryland residents receive chemotherapy annually, though not all would be candidates; the committee asked the sponsor to collect written estimates from the 23 Maryland centers that currently offer FDA‑cleared scalp‑cooling devices.
Questions about funding and process surfaced: because the bill would mandate coverage, it could affect premiums and typically requires review by the Maryland Health Care Commission (MHCC) or related rate‑setting processes. The committee also noted New York passed a similar law in December 2024 that goes into effect January 2026 and asked for data from New York’s sponsor.
Industry testimony stressed growing clinical acceptance and coding progress. A manufacturer representative said professional societies, including the American Medical Association and the American Society of Clinical Oncology, support scalp cooling for eligible patients and that new Category 1 CPT codes will take effect in January 2026 to standardize billing. Witnesses described typical total patient costs per course ranging from about $1,200 on the low end (for shorter regimens) to $2,500–$3,000 for longer courses; providers said devices are typically leased to centers and patients pay a per‑treatment fee when centers do not have reimbursement policies.
Ending: The chair asked the sponsor to collect utilization data from the 23 Maryland cancer centers that offer scalp‑cooling devices and noted the committee may refer the bill to the MHCC for fiscal review if it moves forward.
