Legislative Updates

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Essentially Women members have two important pieces of federal legislation moving in the 116th Congress, the Breast Cancer Patient Equity Act and the Lymphedema Treatment Act. For information regarding the Lymphedema Treatment Act, visit lymphedematreatmentact.org.

Breast Cancer Patient Equity Act

S. 562 and H.R. 1370

The Breast Cancer Patient Equity Act, S. 562/H.R. 1370 has been reintroduced into Congress.  This bicameral, bipartisan bill will require Medicare to recognize custom breast prosthesis as an eligible benefit after mastectomy surgery.  For most women, current options are reconstructive surgery or off-the-shelf prosthesis.  We know some women are not candidates for reconstructive surgery due to a variety of medical reasons, and others choose not to undergo reconstructive surgery. For many women an off-the-shelf prosthetic that fits inside a pocketed mastectomy bra is the best option; however, there are limitations.  Some of those considerations are:

  • Chest wall contour:  if a patient doesn’t have a flat chest wall after a mastectomy an off-the-shelf prosthesis may not fit well
  • Matching skin tone:  off-the-shelf prosthetics usually only come in 2 skin colors.  Custom breast prosthesis come in more than 36 skin colors
  • Finding symmetry following a unilateral mastectomy (one breast removed) is a challenge.  A custom prosthetic can be created to match her profile to keep symmetry.  Finding an off-the-shelf prosthetic to match an existing breast is difficult. 

Allowing women to choose the outcome that best meets their needs will be beneficial for the road to recovery and moving forward.  The Breast Cancer Patient Equity Act is about making sure women have the appropriate choices after mastectomy surgery.  Statistics indicate one in eight women will be diagnosed with breast cancer in her lifetime.  Nobody thinks it will be them and nobody knows what option they may choose until faced with a diagnosis.  

The breast is one of the few body parts not covered by Medicare as a custom replacement – we should be able to do better.  Many private insurance companies follow Medicare guidelines, that’s why this legislation is so important.  Women of all ages and insurance coverages will be impacted.

As of August 2019, there are 31 House members who have signed on in support and 4 Senators.  To move this bill forward we need to have at least 218 House members and 51 Senators, which represents a majority in each chamber. 

HERE’S WHAT YOU CAN DO: 
What we need now is for people like you, people who want to see this legislation passed, to reach out to your elected officials to let them know this is important to you – as their constituent. Here are a few things you can do:

  • Take ActionSend a letter to your elected officials asking them to support the Breast Cancer Patient Equity Act. (The email has already been written so it’s really easy!) 
  • Call your elected officials to request that they sign on to the legislation. Let them know how breast cancer and access to custom breast prosthesis has affected your life.
  • Like and Follow the Let Her Decide campaign on Facebook and Twitter, and invite your friends too!
  • Tell all of your customers about this important bill and how they can help by taking action. (Hint: Have counter cards ready to give to all of your customers.)
  • Contact local breast cancer support groups and ask if you can come speak about the Breast Cancer Patient Equity Act and Let Her Decide Campaign.

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