S. 3069 Introduced Into Senate

Published in Government Relations on October 19, 2023

S. 3069 Introduced Into Senate

On Oct. 18, U.S. Senators Tammy Duckworth (D-IL) and Lisa Murkowski (R-AK) re-introduced legislation to ensure breast cancer patients and survivors who have experienced a mastectomy are able to access custom breast prosthetics under Medicare. The Breast Cancer Patient Equity Act would provide coverage for custom fabricated breast prostheses—which, unlike other prosthetic devices, are not currently covered by Medicare—to the more than 100,000 women who undergo mastectomies annually. 

“We can do so much more to help patients and survivors of breast cancer fully recover and achieve the best quality of life,” said Sen. Duckworth. “It is absurd that the breast is the only human body part not currently covered by Medicare as a customized replacement, which is one of the reasons why I’m proud to reintroduce this legislation with Senator Murkowski to finally change that and help expand access and options for women who have already been through so much.”

“Battling breast cancer is a traumatizing experience for the many women who go through it—and right now, many who undergo mastectomies have poor choices when it comes to reconstructive surgeries. That’s why I’m proud to join Senator Duckworth on the Breast Cancer Patient Equity Act, which would provide more choices for women who undergo mastectomies,” said Sen. Murkowski. “This bill will not just expand coverage under Medicare for thousands of women, but it will also aid in the emotional and physical healing for women who battled breast cancer.”

A copy of the bill text is available here.

"We’re fortunate to have such strong support from Sen. Duckworth and Sen. Murkowski. They understand there’s so much more to recovering from breast cancer than being done with chemotherapy and radiation treatment," said Nikki Jensen, vice president of Essentially Women. "Being able to move forward with the breast replacement option that’s most appropriate for the patient is an important part of recovery."

For most women, a flat-backed, off-the-shelf breast prosthesis will be suitable and fit well. However, after mastectomy surgery, not all women will have a flat chest wall to allow a good fit for off-the-shelf prosthesis. Further, it can be difficult for some women, particularly women of color, to find prostheses that match their skin tone.

In recent years, technological advancements have enabled the creation and precise fitting of custom breast prostheses. Custom prostheses are typically made from higher-end silicone products produced in a unique mold designed to fit the chest like a puzzle piece. Through laser scans of the chest, which may have bumps, scarring, or dips due to surgery, many women find that custom breast prostheses provide a superior fit and comfort. Unfortunately, these patients and survivors may struggle to access custom breast prostheses due to lack of coverage.

The need for grassroots advocates to step forward and ask their own senators and representatives in Congress to support this bicameral legislation is essential in ensuring that Medicare beneficiaries are able to select custom breast prosthesis if that’s the right choice for them.

Learn more and take action here


TAGS

  1. essentially women
  2. legislation
  3. let her decide
  4. mastectomy
  5. vgm government
  6. women's health

From Our Experts

North Carolina Medicaid Rate Floor Extended Through 2029 thumbnail North Carolina Medicaid Rate Floor Extended Through 2029 Earlier this year, it was announced that the North Carolina General Assembly has approved the state budget, securing an additional full two-year extension of the Medicaid fee schedule floor. This protection will now remain in effect until June 30, 2029, guaranteeing that reimbursement rates will continue to be set at 100% of the lesser of the supplier's usual and customary rate or the maximum allowable Medicaid fee-for-service rate. State Medicaid Work Requirements: The Impact on Medicaid beneficiaries and their DME Suppliers thumbnail State Medicaid Work Requirements: The Impact on Medicaid beneficiaries and their DME Suppliers Pursuant to the work and community engagement requirements included in H.R.1, the Centers for Medicare & Medicaid Services (CMS) has issued an interim final rule mandating a framework for Medicaid departments to follow when evaluating Medicaid beneficiary eligibility. Beginning no later than January 1, 2027, states must require certain adult Medicaid enrollees to demonstrate at least 80 hours per month of qualifying activity, which may include employment, education, or community... Healthcare Coalition Urges Congress to Advance Supplemental Oxygen Reform thumbnail Healthcare Coalition Urges Congress to Advance Supplemental Oxygen Reform Washington, D.C. — A broad coalition of suppliers, manufacturers, clinicians, and patient advocates is calling on Congress to advance the Supplemental Oxygen Access Reform (SOAR) Act (H.R. 2902 / S. 1406) to protect patient access to life-sustaining oxygen therapy. Summer Advocacy Campaign-Make Your Voice Heard thumbnail Summer Advocacy Campaign-Make Your Voice Heard Summer is the perfect time to connect with your legislators while they are back in their home states and districts. Whether you're building a new relationship or strengthening an existing one, meeting with elected officials is one of the most effective ways to advance policies that protect patient access to home medical equipment and services. Wrapping Up a Successful VGM Heartland Conference & State Leader Summit thumbnail Wrapping Up a Successful VGM Heartland Conference & State Leader Summit One of our busiest and without a doubt, one of our favorite weeks of the year is the VGM Heartland Conference. This year kicked off with a special opportunity to bring together DME state association leaders from across the country for a dedicated pre-conference State Leader Summit. The focus was simple but impactful: collaboration, idea sharing, and real conversations about the challenges and opportunities facing our industry today. CMS Announces Phase 1: Bid Preparation for Round 2028 Competitive Bidding Program thumbnail CMS Announces Phase 1: Bid Preparation for Round 2028 Competitive Bidding Program Be sure to review all materials if you are considering a bid submission for Round 2028. CRT Bill H.R. 1703 Advances Through Full Energy & Commerce Committee thumbnail CRT Bill H.R. 1703 Advances Through Full Energy & Commerce Committee Earlier this week, we shared that H.R. 1703 advanced through the House Energy & Commerce Health Subcommittee. We are pleased to report that the bill has continued to gain momentum and has now successfully passed out of the full Energy & Commerce Committee unanimously following today's markup. Important Update: Prior Auth Exemption Process – Deadline Extended to May 26, 2026 thumbnail Important Update: Prior Auth Exemption Process – Deadline Extended to May 26, 2026 CMS has just announced that the deadline to opt out of the prior authorization exemption and continue submitting prior authorization requests has been extended to Tuesday, May 26. This extension only applies to suppliers that received a letter from the DME MACs in early March regarding their prior authorization exemption status.