Breast Cancer Patient Equity Act bill re-introduced in Congress

Published in Mastectomy on March 01, 2019

Waterloo, Iowa – March 1, 2019 – Representatives on both sides of the aisle re-introduced the Breast Cancer Patient Equity Act bill that, if passed, will expand Medicare coverage to include custom breast prosthesis as an option for women recovering from mastectomy surgery.

The bipartisan bills S. 562 and H.R. 1370 were co-sponsored by Senators Tammy Duckworth (D-IL) and Lisa Murkowsi (R-AK) in the Senate, along with Representatives Judy Chu (D-CA) and Jackie Walorski (R-IN) in the House.

“We can do so much more to help survivors of breast cancer return to health and achieve the best quality of life,” Duckworth said. “This legislation is an important step in continuing to expand health care coverage for women, and I’ll keep working to ensure survivors and all women have access to the health care they need.”

“Breast cancer patients and survivors should have access to the latest in custom breast prostheses to help improve their quality of life,” said Walorski. “I am honored to work across the aisle to expand women’s access to life-changing health care and innovative technology under Medicare. As we continue working toward a cure, this bipartisan bill will ensure Medicare beneficiaries battling breast cancer have the option to choose the prosthetics that work best for them.”

The introduction of the Breast Cancer Patient Equity Act was an initiative of Essentially Women and People for Quality Care, divisions of VGM Group, through their #LetHerDecide campaign. The multi-year grassroots effort called on those affected by breast cancer to advocate for the legislation so women can have the choice between reconstructive surgery, off-the-shelf prosthesis, going flat or custom breast prosthesis following a mastectomy. 

“Women are unique and come in all shapes, sizes and skin tones,” said Nikki Jensen, vice president of Essentially Women. “Providing Medicare coverage for custom breast prosthesis gives women the options they need, and will let them decide what’s right for them.”

The female breast is one of the only body parts not covered by Medicare as a custom replacement. A similar bill to the Breast Cancer Patient Equity Act was introduced in 2018, however it didn’t gain enough support to pass. According to Jensen, Medicare already has a billing code and fee schedule, but doesn’t recognize custom breast prosthesis for coverage eligibility.

 “Since many insurance companies follow Medicare guidelines, this legislation has the potential to impact women of all ages throughout the country,” said Jensen. “Passage of the Breast Cancer Patient Equity Act provides them with the opportunity to choose the solution that meets their needs as they begin life after breast cancer.” 

Armed with a toolkit to help supporters contact their legislators, Jensen and other stakeholders are optimistic that, unlike 2018, the proposed legislation will make it through both chambers of Congress and end up before the President to sign into law before the end of 2019.

“We ask that anyone affected by breast cancer or if you just feel this is the right thing to do, please contact your elected officials and show support for bills S. 562 and H.R. 1370 today.”

For more information and to take action, visit www.letherdecide.org.

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1. breast cancer
2. custom breast prosthesis
3. let her decide