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New Law Mandates Coverage

BREASTRECON3D.GIF (1792 bytes)

After two years of congressional lobbying and a handful of stalled bills, on October 21, 1998 President Clinton signed into law a bill that includes a provision protecting breast cancer victims from arbitrary coverage denials for breast reconstruction.  The breast reconstruction protection was included as a part of the omnibus budget bill negotiated over the past few weeks among Congressional leaders.  The massive $ 520 billion spending bill includes language requiring insurance companies to cover the cost of reconstructive breast surgery for women who have undergone a mastectomy.

This is a proud and historical moment for plastic surgery, as this is believed to be only the second instance of Congress requiring that a certain medical procedure be covered by health policies, the first being the 1996 law assuring a minimum hospital maternity stay.

The federal Women's Health and Cancer Rights Act of 1998 requires certain benefits are available to you the patient.  Under this act, benefits must be provided for:
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Reconstruction of a surgically removed breast;

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Surgery and reconstruction of the other breast to produce a symmetrical appearance;

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Prostheses and treatment for physical complications from all stages of mastectomy, including lymhedemas.

 


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Erel Laufer, MD, FACS l Jay H. Ross, MD, FACS l Jennifer Buck, MD, FACS
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