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 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

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


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.