Legislation Search

H.R. 4543: Medicaid Breast Cancer Access to Treatment Act

This bill, titled the Medicaid Breast Cancer Access to Treatment Act, aims to amend the Social Security Act to enhance Medicaid coverage for individuals with breast or cervical cancer. Here are the key provisions of the bill:

Expansion of Medicaid Coverage

The bill seeks to revise the Medicaid program to include:

Individuals diagnosed with certain types of breast or cervical cancer.
Breast reconstruction services following a medically necessary mastectomy.

Specific Amendments

The bill proposes several amendments to the existing regulations about Medicaid coverage:

Inclusion Criteria: It adds a new category for individuals with specified diagnoses of breast or cervical cancer under the eligibility criteria for Medicaid.
Breast Reconstruction: It explicitly includes coverage for breast reconstruction as part of medical assistance following mastectomy procedures.

Changes to Definitions and References

The bill modifies sections of the Social Security Act relating to definitions of covered services. This includes:

Striking certain existing clauses that limited coverage and replacing or modifying them to enhance access for cancer patients.
Redesignating existing clauses to accommodate the new provisions.

Cost Sharing Adjustments

Furthermore, it addresses cost-sharing arrangements for the services rendered to individuals diagnosed with breast or cervical cancer:

Adjustments to existing cost-sharing frameworks to prevent undue financial burden on patients receiving treatment.
Provision for alternative cost-sharing structures, making treatments more accessible to individuals who qualify under the revised criteria.

Implementation Timeline

The amendments proposed in this bill would go into effect one year following its enactment, allowing time for necessary adjustments in the Medicaid program.