This bill would add a rule to Medicare (title XVIII of the Social Security Act). It says that for any mastectomy given on or after 1 year after the law is enacted, the supplier who will perform the mastectomy must, before the surgery, tell the patient that breast reconstruction after a medically necessary mastectomy is covered under national coverage determination 140.2. The supplier must also put a note in the patient’s medical record showing they gave that information. The bill says Medicare payment for the mastectomy cannot be made unless the supplier does both things.
If you are a Medicare patient getting a mastectomy, your provider must inform you before the operation that breast reconstruction after a medically necessary mastectomy is a covered benefit under NCD 140.2, and that the provider must document that notice in your medical record. If you are a supplier or provider, you must give that information and document it before the mastectomy in order for Medicare payment to be allowed for that service, for surgeries on or after the date one year after enactment.
No publicly available information on cost estimates, funding, or fiscal effects is included in the bill text or provided metadata.
No publicly available information on proponents' stated reasons or intended benefits is included in the bill text or provided metadata.
No publicly available information on opponents' objections or concerns is included in the bill text or provided metadata.