Legislation Search

H.R. 4545: Medicare Breast Reconstruction Access and Information Act

This bill, known as the Medicare Breast Reconstruction Access and Information Act, aims to amend the Social Security Act to improve information access for patients undergoing mastectomy and breast reconstruction surgeries under Medicare. Here are the key aspects of what the bill would do:

Provision of Information

The bill introduces a requirement that healthcare providers must inform patients diagnosed with breast cancer about their options for breast reconstruction surgery following a medically necessary mastectomy. The providers are required to communicate that breast reconstruction is covered under Medicare, specifically under the national coverage determination 140.2.

Documentation Requirement

In addition to providing the necessary information, healthcare providers must document that this information has been shared with the patient. This documentation must be included in the medical record of the individual undergoing the mastectomy.

Effective Timeline

The provisions of this bill will take effect one year after its enactment. This means that after the bill becomes law, healthcare providers will have a year to comply with these new requirements.

Impact on Medicare Payments

According to the bill, Medicare will not make payments for mastectomies unless the healthcare provider has fulfilled the aforementioned requirements regarding patient information and documentation. This aligns the conditions for receiving reimbursement with the new information-sharing obligations.

Overall Intent

The overall intent of the bill is to ensure that patients are fully aware of their options regarding breast reconstruction, thereby improving access to this vital surgery for those who have undergone mastectomies.

Relevant Companies

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This is an AI-generated summary of the bill text. There may be mistakes.

Actions

2 actions

Date	Action
Jul. 17, 2025	Introduced in House
Jul. 17, 2025	Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

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