1. Short title This Act may be cited as the Comprehensive Breast Reconstruction Act of 2020 . 2. Providing for health coverage of nipple-areolar complex tattooing in connection with reconstructive surgery following mastectomy; extending coverage of breast reconstructive services following mastectomy under Medicare and Medicaid (a) Private health insurance coverage and group health plans (1) In general Section 713(a) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185b(a) ) is amended— (A) in paragraph (2), by striking at the end and ; (B) in paragraph (3), by adding at the end and ; (C) by inserting after paragraph (3) the following new paragraph: (4) tattooing of the nipple-areolar complex pursuant to or as part of such reconstruction if such tattooing is performed by a physician, physician extender (as defined in section 1834(x) of the Social Security Act), or State-licensed tattoo artist (as defined in such section), as prescribed by a physician; ; and (D) by adding at the end of the flush matter following paragraph (4), as inserted by subparagraph (C), the following: Tattooing of the nipple-areolar complex described in paragraph (4) shall be deemed to be medically reasonable and necessary. . (2) Effective dates (A) In general Subject to subparagraph (B), the amendments made by this section shall apply with respect to plan years beginning after the date of enactment of this Act. (B) Special rule for collective bargaining agreements In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified before the date of enactment of this Act, the amendments made by this section shall not apply to plan years beginning before the later of— (i) the date on which the last collective bargaining agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after the date of enactment of this Act)