Understanding reconstruction rights following a mastectomy

By November 30, 2018 Uncategorized No Comments

For 20 years, the U.S. Women’s Health and Cancer Rights Act has required that providers insure breast reconstruction for women who have undergone a mastectomy.

Signed into law in October of 1998, the act represented a paradigm switch in the availability of breast reconstruction for cancer survivors.

The law requires that group and individual health plans must provide insurance coverage after mastectomy, regardless of diagnosis. It also assures that surgery is covered for all stages of cancer. And it covers patients who need surgery on the unaffected breast to produce a symmetrical appearance.

Because of the law, reconstruction has become part of the standard care that most breast cancer patients undergo today. More than 109,000 reconstruction procedures were done in 2017 , according to the American Society of Plastic Surgeons.

Even so, researchers show that it is apparent that many women were not aware that they qualified for reconstruction coverage after a mastectomy. To fill that gap, Congress passed the Breast Cancer Patient Education Act in December of 2015.

The Act requires that the Secretary of Health and Human Services reach women through education campaigns to let them know all of the care options available to them.

Despite that legal requirement, published studies have shown that women eligible for breast reconstruction following breast cancer are often not informed about what is available to them. Only about a quarter of women understand all their reconstruction options, research shows.

Fortunately, that number is increasing, althoughplastic surgeons are finding other hurdles to overcome, such as poor reimbursement for the healthcare they provide and the increased use of radiation as a secondary treatment.