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Medicare Coverage Mandated for Custom Breast Prostheses After Mastectomy.

This bill mandates Medicare coverage for custom fabricated breast prostheses following a mastectomy, including replacements. Currently, Medicare covers costly surgical reconstruction but denies reimbursement for these non-surgical, custom devices, limiting options for many patients. This change ensures greater equity and choice for breast cancer survivors, particularly benefiting older and minority women.
Key points
Medicare must cover custom-made breast prostheses after surgical breast removal, treating them equally to prostheses for other body parts.
Increased patient choice: access to a non-surgical alternative to surgical reconstruction, reducing out-of-pocket costs and surgical risks.
The changes take effect upon enactment and apply to all items and services furnished thereafter.
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Additional Information
Breast Cancer Patient Equity Act
Print number: S 3069
Sponsor: Sen. Duckworth, Tammy [D-IL]
Process start date: 2023-10-18