July 17, 2025
Ms. Waters (for herself, Ms. Garcia of Texas, Ms. Norton, Ms. Velázquez, Ms. Wasserman Schultz, Mrs. Dingell, Ms. Clarke of New York, Mr. Fields, Mr. Johnson of Georgia, Ms. Tlaib, Mr. Thompson of Mississippi, Ms. Sewell, Mr. Gottheimer, Mrs. Watson Coleman, Mr. Thanedar, Ms. Lee of Pennsylvania, Mr. Latimer, Ms. Wilson of Florida, Mr. Veasey, Mr. Cohen, Mr. Lynch, Mrs. McIver, Mr. García of Illinois, Mrs. Cherfilus-McCormick, Ms. Salinas, and Mr. Olszewski) introduced the following bill; which was 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
To amend title XVIII of the Social Security Act to require the provision of certain information with respect to breast reconstruction surgery under the Medicare program.
Section 1. Short title
This Act may be cited as the Medicare Breast Reconstruction Access and Information Act
.
Sec. 2. Requiring the provision of certain information with respect to breast reconstruction surgery
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:
(aa) Requirement To provide certain information with respect to breast reconstruction surgery
Notwithstanding any other provision of this part, no payment may be made under this part for a mastectomy furnished to an individual on or after the date that is 1 year after the date of the enactment of this subsection unless the supplier furnishing such mastectomy, prior to the furnishing of such mastectomy—
(1)
informs such individual that breast reconstruction surgery following a medically necessary mastectomy is covered under this part pursuant to national coverage determination 140.2; and
(2)
documents the provision of such information in the medical record of such individual.