Custom breast forms legislation introduced in both chambers

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Friday, March 1, 2019

WASHINGTON – A bill has been introduced in the House of Representatives and the Senate that would expand Medicare coverage to include custom breast prostheses for women recovering from mastectomy surgery, VGM reports.

H.R. 1370 and S. 562, both bi-partisan, were co-sponsored by Reps. Judy Chu, D-Calif., and Jackie Walorski, R-Ind., and Sens. Tammy Duckworth, D-Ill., and Lisa Murkowski, R-Alaska, respectively.

“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 coverage for women.”

Essentially Women and People for Quality Care, divisions of VGM, helped to initiate the introduction of the bills with their campaign #LetHerDecide. The multi-year grassroots effort called on those affected by breast cancer to advocate for the legislation so women can have more options following a mastectomy.

Medicare already has a billing code and fee schedule for custom breast prostheses but doesn’t recognize them for coverage eligibility, Essentially Women says.

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

A similar bill was introduced in the House last year, but it did not pass.