Support Bill For Breast Prosthetic Coverage

Announcement! Custom Breast Prosthetic Coverage Bill Introduced in the U.S. House

Collin Brecher, VGM Government Relations

More than 260,000 women will be diagnosed with invasive breast cancer in 2018. Of those, approximately 144,000 will undergo a mastectomy. Currently, following surgery, these women will decide if they are willing to endure reconstruction surgery, choose an “off-the-shelf” prosthesis, or elect to do nothing. Congressman Rod Blum (R-IA) and Congresswoman Judy Chu (D-CA) have introduced a bill in the U.S. House to provide Medicare coverage for custom breast prostheses to women who have undergone a mastectomy.

The Breast Cancer Patient Equity Act, H.R. 6980, will address a gap in coverage to expand access for women who need another option. Some women may not be candidates for reconstruction, which can cost tens of thousands of dollars, while others may not want additional surgery. Custom breast prosthesis is also beneficial for women who are challenged with off-the-shelf prosthesis due to an irregular chest wall, finding symmetry to match their remaining breast or matching skin tone. Medicare currently covers both reconstruction and off-the-shelf options, which is the driving force behind the need for this legislation.

“I am proud to introduce this bipartisan bill with my colleague Democrat Rep. Chu to provide women with coverage of more options following a mastectomy,” said Blum. “As breast cancer rates continue to rise and we work towards finding a cure, it is important to help the women who are fighting this battle and ensure they have options following this life-changing procedure.”

Rep. Rod Blum (R-IA)

“Women who have undergone a mastectomy deserve to have every reconstructive option. Yet, currently, Medicare only covers two: the most basic – off-the-shelf breast prostheses – and the most comprehensive – reconstruction,” said Chu. “This bill would correct that by requiring Medicare to cover a third option: custom prostheses. This is important for women who want breasts that are the appropriate size and skin color but do not want to undergo reconstructive surgery. Medicare should not be limiting reasonable options that allow women to live normal lives after cancer. I’m proud to have worked on this bill with my colleague, Rep. Rod Blum, and I hope we can bring this action to a vote quickly so we can help more women return to feeling like themselves on their own terms.”

Rep. Judy Chu (D-CA)

Essentially Women, a member service organization that supports independent providers of post-mastectomy supplies and People for Quality Care an organization that supports increased patient access have supported this effort from the beginning. “We are thrilled at the overwhelming support that this effort has received with grassroots advocates, breast cancer coalitions, and on Capitol Hill. Essentially Women wants every woman to have the ability to choose whichever option best fits their medical and physical needs,” said Nikki Jensen, Vice President of Essentially Women.

With the month of October serving as Breast Cancer Awareness month, now is a great time to engage with lawmakers on this bipartisan legislation to get their support.

Get involved today by visiting www.peopleforqualitycare.org/makemewholeagain for more information and engage with the campaign by using #MakeMeWholeAgain on your social media platforms!

Click the “Support Here’ button below to send a message to your member of Congress to support H.R. 6980!

A Senate companion bill is expected to be introduced in the near future, so stay tuned for additional updates and calls to action from the Make Me Whole Again team!

Article from Essentially Women

One on One: Mary Walsh-Aframe, founder, The Women’s Image Center

  Mary Walsh-Aframe founder of The Women's Image Center [Photo Credit: T&G Staff/Christine Peterson]

Mary Walsh-Aframe founder of The Women's Image Center [Photo Credit: T&G Staff/Christine Peterson]

One on One: Mary Aframe, founder, The Women’s Image Center

Posted Jul 23, 2017  
A former dental hygienist, Mary Aframe became certified in prosthetics/orthotics and founded The Women’s Image Center with locations in Worcester and Leominster about 18 years ago. The business specializes in assisting women undergoing image changes related to cancer treatment by selling products in its boutique such as wigs, scarves and hats for hair loss, compression garments and lymphedema sleeves and silicone forms to custom prosthetic technology for women who have undergone a mastectomy, lumpectomy or breast reconstruction.

Ms. Aframe is a Worcester-area native and an alumna of Quinsigamond Community College. She is a certified mastectomy fitter by the American Board of Orthotics and Prosthetics. The center’s seven employees travel between the sites and hours are by appointment only with evenings available.

How did you move into this field?

I grew up with a sister who has alopecia and my two sisters had hair replacement businesses in Boston so I was familiar with it. I always had a drive to be an entrepreneur and find a way to help women make their lives better so it sort of came together.

Usually, women went to a hairdresser for wigs and a pharmacy for prosthesis, neither of which were very private. I wanted to create a place with a nurturing environment where they could privately come in and get what they require to move on with their lives.

How do you get certified?

The regulations have changed from 18 years ago, but the two women who are fitters here got certified this year. They had to train under a certified fitter for 250 to 500 hours and pass a national exam as well as have graduate credits.

Can you describe the 3D technology that you use and what it does?

The American Breast Care 3-D white scanner, through computer assisted design (CAD), allows you to duplicate whatever breast tissue is lost to mastectomy or lumpectomy. The silicon prosthetic fits into the woman’s chest wall post-surgery like a puzzle piece and allows women to be symmetrical and have more options for clothing. It is lighter and cooler and matches skin tone better.

Before, the process involved making a plaster cast of the woman’s chest and using the mold to create the prosthetic. And, then you had to wait six to eight weeks for it to arrive.

What other services do you have?

We have a catalog business (www.womensimagecatalog.com) and our tried-and-true products are offered at a lesser price.

And we have these gift boxes, Ready, Set, Go, filled with treats for women going through chemotherapy. The boxes have things like a pillow, teas, lotion, cards, a journal. ... It’s like a hug in a box.

What about insurance?

We handle all the billing and back and forth and paperwork for insurance here so that the women don’t have to deal with it. We accept a lot of insurances and have a bank here in case someone is underinsured and cannot afford something. We make sure they get what they need. This work is more of a vocation than a job for me.

Are you active in other organizations?

I volunteer with the American Cancer Society’s Look Good, Feel Better program and on the board of Pink Revolution and a member of Essentially Women’s Buying Group.

Every year, Pink Revolution has a big event, “Lighting the Way,” at Hanover Theatre. It’s an evening of support where survivors come together. We want women to not feel alone as they go through treatment and also afterwards. This year’s event is Oct. 11.

I’m also following a bill (#HR295) through Congressman Jim McGovern’s office to get wigs re-categorized as durable medical equipment so that they can be covered under Medicare.

How do people hear about your boutique?

Referrals aren’t needed but we do get them from oncology departments at local hospitals and surgeons, doctors, nurse practitioners, etc. We’ve been in the area for a long time so we’ve developed great relationships with these people. We also have word-of-mouth business.

Have you personally experienced cancer and did it spark your interest in this field?

No, not yet. I just happened to find my little corner of the world and developed a great little business that has grown over the years. It feels good to help women get what they need and help to make their lives more comfortable. It’s fulfilling to be a resource for them.

-Compiled by correspondent Susan Gonsalves

This article has been modified from the original posted on Telegram.com

News: Worcester woman inspires bill to help cancer patients

Mary Aframe

Founder and owner of The Women's Image Center inspired a bill for Medicare coverage of wigs

By Kaylee Johnston, Special to the Telegram & Gazette
      
WORCESTER - Impassioned by a Worcester business owner, U.S. Rep. James P. McGovern, D-Worcester, proposed a bill amending Title XVIII of the Social Security Act to assist chemotherapy patients on Medicare with coverage for wigs as “durable medical equipment.”

Bill H.R. 2925, referred to the House Committees on Energy and Commerce and the House Committees Ways and Means on June 15, was inspired by Mary Aframe, founder of the Women’s Image Center located in Worcester and Leominster.

“Hair loss is extremely difficult, and then to hear insurance doesn’t cover the wig, it’s just devastating,” Ms. Aframe said. “You look good, you feel better. It really helps with the psychological impact of the diagnosis.”

The Women’s Image Center, a certified mastectomy fitter accredited by the American Board of Orthotics and Prosthetics, Inc., offers a variety of products to assist women going through cancer treatments cope with the physical changes.

Ms. Aframe founded the center 18 years ago after driving by a sign in Fitchburg announcing the opening of a new cancer center. With her knowledge of the wig industry from her sisters who owned hair replacement businesses in Boston, and her scientific background from her time as a dental hygienist, Ms. Aframe became certified in prosthetics and opened up a small shop.

Some of the products available through the center include wigs, lymphedema management garments and breast prosthesis. They handle insurance billing directly.

“I’ll be at my boutique and it’ll be a daughter or son buying the wig because the mom can’t afford it, and it’s heartwarming, but it should be covered,” she said.

According to Aframe, she had been in contact with McGovern for about 14 years discussing this potential bill, and it finally took shape recently after Ms. Aframe appeared on WBZ radio to talk about Medicare’s coverage for cancer patients.


After her appearance on WBZ with host Laurie Kirby, the conversation sparked up again and brought Ms. Aframe to contact Dr. Robert Quinlan of UMass Memorial as the medical expert to help finalize the wording for the bill.


″(Dr. Quinlan) has had some patients say, ‘I’ll have the mastectomy, I don’t want to lose my hair,’” Ms. Aframe said. “One of the other doctors was telling me, ’At the end of the treatment, when it’s all done I’ll say to the women, ‘What’s the most difficult part?’ and he told me 85 percent said it’s the hair loss. For a lot of women your hair is like your crown.”

According to the American Cancer Society, if hair loss is going to occur, it most often begins within two weeks of chemotherapy and progressively worsens after one to two months.

“Every cancer patient deserves access to quality healthcare that will help them undergo treatment with the support and dignity they need,” McGovern said in a press release. “This bill will help to change that and ensure that every cancer patient who loses their hair can afford a wig and undergo treatment with the dignity and respect they deserve.”

Wigs made from real hair require more care and can cost between $800 and $3,000. Synthetic wigs are easy to manage and range from $30 to $500.

Many private insurance companies offer wig coverage. Massachusetts law (ch. 32A,17E; ch. 175, 47T; ch. 176A, 8T; ch. 176B, 4R; ch. 176G, 4J) provides coverage of $350 maximum per calendar year for all those under Massachusetts health insurance going through treatment.

“I feel like on a couple of levels it can help women all across the country going through treatment to feel stronger and confident,” Ms. Aframe said. “Feeling confident in your skin post-treatment is paramount. It will make a difference.”

-Article originally posted on the Telegram & Gazette here

 

We Need Your Support!

Motivate Congress To Allow Medicare Beneficiaries To Receive Coverage For Wigs

Please take action and follow the link below to send a message directly to Rep. Jim McGovern (D-MA) to urge Congress to cover wigs for Medicare Beneficiaries. The bill, H.R. 2925 would allow wigs to be covered as durable medical equipment which opens access for Medicare beneficiaries that a dermatologist, oncologist, or attending physician can certify medical necessity as a part of rehabilitative treatment.

 

 Or Click on link below:

https://thewomensimagecenter.rallycongress.net/

Thank you for your support!

Bill Helps Cancer Patients Pay for Wigs After Chemotherapy; Legislation Inspired by Worcester Resident

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Rep. McGovern Introduces Bill to Help Cancer Patients
Bill Helps Cancer Patients Pay for Wigs After Chemotherapy;
Legislation Inspired by Worcester Resident
June 22, 2017


 WASHINGTON, D.C. – Congressman Jim McGovern (D-MA) introduced a new bill in the House of Representatives to help patients who are undergoing chemotherapy. Most private insurance plans already cover wigs for those undergoing treatment that causes hair loss. The bill would help cancer patients on Medicare, who are undergoing treatments, to pay for wigs not currently covered.
 
“Every cancer patient deserves access to quality healthcare that will help them undergo treatment with the support and dignity they need. For cancer patients who experience hair loss, a wig can mean so much, but is not always covered by their insurance,” Congressman Jim McGovern (D-MA) said. “This bill will help to change that and ensure that every cancer patient who loses their hair can afford a wig and undergo treatment with the dignity and respect they deserve. I urge all of my colleagues in Congress to support this important bill.”
 
Congressman McGovern’s bill was inspired by a meeting with Mary Aframe, who runs the Women’s Image Center located in Worcester and Leominister. The Women’s Image Center helps promote confidence in women undergoing image changes related to cancer treatment. Aframe has worked tirelessly to help raise awareness about the many women undergoing chemotherapy who have trouble affording wigs. Aframe said she has heard from many women who are looking for a wig due to hair loss after cancer treatment – specifically breast cancer. Many are on Medicare and struggle to afford a wig, sometimes even choosing different treatment paths to avoid hair loss.
 
According to the National Cancer Institute, nearly 40 percent of men and women will be diagnosed with cancer at some point. Nationally, expenditures for cancer care totaled nearly $125 billion in 2010. In 2017 alone, Massachusetts is expected to see 37,00 new cases of cancer, according to the American Cancer Society.
 
“This bill is so desperately needed. A wig is not only medically necessary as a part of a woman's physical recovery, but also for the emotional recovery that comes with going through cancer treatment, said Mary Aframe. “Feeling confident in your new skin during and post treatment is paramount to overcoming the challenges and changes women face after a cancer diagnosis”
 
Most private insurance plans already cover wigs for patients undergoing cancer treatments. Congressman McGovern’s bill would re-categorize wigs as durable medical equipment to allow Medicare to provide coverage if a doctor certifies that they are medically necessary. Wigs can cost thousands of dollars and are out of reach for many patients without help from their insurance provider.
 
The new bill, H.R. 2925, has been referred to the House Committees on Energy and Commerce and Ways and Means, where it awaits further consideration.