Association petitions support for breast bill

Thursday, August 26, 2010

HOUSTON - Frustrated with the slow progress of a bill that would require Medicare to pay for custom breast forms, the American Association of Breast Care Professionals (AABCP) in July launched an online petition.

"We are hoping to get 10,000 signatures so that we can bring it to Congress and say, 'See, there's support for this,'" said Rhonda Turner, executive director of AABCP. "We are hoping our members, as well as the breast care community at large, manufacturers and consumers will (sign the petition)."

Introduced April 22, S. 3255, the Custom Fabricated Breast Prosthesis Act of 2010, sponsored by Sens. Blanche Lincoln, D-Ark., and Olympia Snowe, R-Maine, has a mere three co-sponsors so far.

"We were hoping for a little more out of the gate on both sides of the aisle," admitted Turner. "It's going to take a little more phone banking, a little more conversation."

Although Medicare has a code and an allowable for custom breast forms, local coverage determinations (LCDs) down code them as "not medically necessary." Therefore, the custom forms get reimbursed at the non-custom price, about $400 vs. $3,000.

While a preliminary Hill visit at the end of 2009 indicated that most lawmakers at the time were open to the idea, the past six to eight months has seen a change in the political climate, she said.

"People are (leery) of anything that would potentially add to the deficit," said Tuner. "Something like this needs a little more education than maybe a year ago."

The bill is still waiting for a score from the Congressional Budget Office.

Despite its slow start, Turner remains optimistic. Most people support coverage of the forms, she said. Ironically, that can be a bit of an obstacle at times.

"We are still getting a great deal of misunderstanding and incredulity that custom breast forms are not paid for," she said. "People make the assumption that Medicare pays for it because there is a code and because there is an allowable."