,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #efb  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #bf1 #bjai,ms4
 ,duckwor? 7= h]self1 ,ms4 ,murk[ski1   
,ms4 ,klobu*>1 & ,mr4 ,br[n7 introduc$ !
 foll[+ bill2 :i* 0 read twice & ref]r$ 
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to provide cov]age =     
cu/om fabricat$ brea/ pro/heses foll[+ a
 ma/ectomy4  #a4 ,%ort title2 f9d+s  7a7
 ,%ort title ,?is ,act may be cit$ z !  
,brea/ ,canc] ,pati5t ,equity ,act4  7b7
 ,f9d+s ,congress f9ds ! foll[+3  7#a7  
,!re are curr5tly m ?an #c1ejj1jjj wom5 
) a hi/ory ( brea/ canc] 9 ! ,unit$     
,/ates1 _m ( :om exp]i5ce unrecon/ruct$ 
brea/ loss4  7#b7 ,9 #bjah1 m ?an       
#bfj1jjj wom5 7 diagnos$ ) invasive     
brea/ canc] t requir$ surg]y1 ) _m hav+ 
to und]go surgical brea/ removal4  7#c7 
,9 #bjah1 m ?an #dj1jjj wom5 9 ! ,unit$ 
,/ates are expect$ to die f brea/ canc]4
  7#d7 ,annually1 !re are #add1jjj wom5 
9 ! ,unit$ ,/ates :o und]go ma/ectomies1

 a surgical removal ( ! brea/4  7#e7 ,! 
numb] ( brea/ ma/ectomies 9 ! ,unit$    
,/ates has increas$ among y\ng] wom51   
ages #ah to #cd ye>s old1 at a rate (   
#cj p]c5t & at a rate ( #ae p]c5t = wom5
 ages #ce to #dd ye>s old4  7#f7 ,!     
results ( brea/ recon/ruction surg]y c  
v>y &1 z ) any surgical proc$ure1 !re   
are inh]5t risks associat$ ) su* surg]y4
 ,additionally1 recon/ruction ( ! brea/ 
us+ implants requires lifelong foll[ up 
to ensure ! heal? ( ! pati5t4  7#g7     
,:ile ! numb] ( wom5 *oos+ to und]go    
surgical brea/ recon/ruction cont9ues to
 increase1 _m wom5 cont9ue to lack !    
viable option ( cu/om fabricat$         
pro/hetic brea/s to re/ore ! lo/ brea/4 
7#h7 ,bo? old] wom5 & m9ority wom5 are  
less likely to be (f]$ or und]go        
surgical brea/ recon/ruction & are      
disproportionately disadvantag$ by a    
lack ( access to ! option ( cu/om       
fabricat$ pro/hetic brea/s4  7#i7       
,curr5tly1 ! ,m$ic>e program provides   
cov]age & reimbursem5t = cu/om fabricat$

 pro/heses = any body "p1 ) ! exception 
( brea/s1 t has be5 lo/4  7#aj7 ,foll[+ 
passage ( ! ,wom5's ,heal? & ,canc]     
,rights ,act ( #aiih 7,public ,law      
#aje-bgg2 #db ,u4,s4,c4 #bja note71 _m  
private insur]s & gr\p heal? plans began
 to provide cov]age = cu/om fabricat$   
brea/ pro/heses z an alt]native to      
surgical brea/ recon/ruction4  7#aa7    
,:ile ! ,m$ic>e program recognizes cu/om
 fabricat$ brea/ pro/heses z a discrete 
device & valid treatm5t option1 hav+    
assign$ a bill+ code = su* option "u !  
,heal?c>e ,common ,proc$ure ,cod+ ,sy/em
 7,,hcpcs7 & sett+ a maximum all[able   
fee1 ,m$ic>e does n provide reimbursem5t
 & d5ies claims z #8n m$ically          
necess>y'4 ,m$ic>e does provide         
reimbursem5t1 h[ev]1 = m co/ly surgical 
brea/ recon/ruction4  7#ab7 ,due to !   
fact t ! ,m$ic>e program does n provide 
reimbursem5t = cu/om fabricat$ brea/    
pro/heses1 _m private insurance         
companies h also begun to limit _!      
reimbursem5t = !m4  7#ac7 ,! ,dep>tm5t (

 ,vet]ans ,affairs does provide ! option
 ( a cu/om fabricat$ pro/hetic brea/ =  
wom5 po/-ma/ectomy4  7#ad7 ,provid+     
cov]age = cu/om fabricat$ pro/hetic     
brea/ devices & compon5ts w n increase !
 incid5ce ( brea/ ma/ectomies4  #b4     
,cov]age  7a7 ,9 g5]al ,section         
#ahfa7s77#h7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciex7s77#h77 is am5d$--
  7#a7 by add+ & aft] ! semicolon at !  
end2  7#b7 by ins]t+ 7,a7 aft] 7#h72 &  
7#c7 by ins]t+ aft] subp>agraph 7,a7 !  
foll[+ new subp>agraph3  7,b7 cu/om     
fabricat$ brea/ pro/heses foll[+        
surgical removal ( ! brea/1 includ+     
replacem5t ( su* pro/heses2  4  7b7     
,con=m+ am5dm5t ,section #ahfb7;a77#g7 (
 su* ,act 7#db ,u4,s4,c4 #aciey7a77#g77 
is am5d$ by /rik+ #ahfa7s77#h7 & ins]t+ 
#ahfa7s77#h77;,a74  7c7 ,effective date 
,! am5dm5ts made by ?is section %all    
apply to items & s]vices furni%$ on or  
aft] ! date ( enactm5t ( ?is ,act4