S. 688 would require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations.
Detailed Summary
Breast Cancer Patient Protect Act of 2009 - Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require a group health plan that provides medical and surgical benefits to ensure that inpatient (and in the case of a lumpectomy, outpatient) coverage and radiation therapy are provided for breast cancer treatment. Prohibits such a plan from: (1) restricting benefits for any hospital length of stay to less than 48 hours in connection with a mastectomy or breast conserving surgery or 24 hours in connection with a lymph node dissection, insofar as the attending physician, in consultation with the patient, determines such stay to be medically necessary; or (2) requiring that a provider obtain authorization from the plan or issuer for prescribing any such length of stay.
Requires such a plan or issuer to: (1) provide notice to each participant and beneficiary regarding the coverage required under this Act; and (2) ensure that coverage is provided for secondary consultations.
Prohibits a group health plan from taking specified actions to avoid the requirements of this Act.
Applies such requirements to health insurance issuers offering coverage in the individual market.
Allows a health insurance issuer that provides individual health insurance coverage to nonrenew or discontinue an individual's coverage based on the intentional concealment of material facts regarding a health condition related to the condition for which coverage is being claimed.
Status of the Legislation
Latest Major Action: 3/24/2009: Referred to Senate committee. Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Points in Favor
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Points Against
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Visitor Comments
Lisa Hummel
May 12, 2009, 3:17pm (report abuse)As a 7 year breast cancer survivor who had a lumpectomy,mastectomy & reconstructive surgeries, I support this bill.
June Shaw
June 9, 2009, 11:03pm (report abuse)I intent to do everything I can to support this bill and to encourage my representatives in Congress to support it.
I have a personal interest in this matter. A friend of mine had a mastectomy and I brought her home from the hospital with a drain in her chest. Her college-age son cared for her, changed her dressings and comforted her. Would our legislators and health insurance executives like to see their wives and daughters treated like this? I think not.
This legislation has been submitted for passage year after year since 1997. Last year it finally passed the House of Reps, but the Senate FAILED to vote on it before the session ended. This is SHAMEFUL!
I hope Americans everywhere will let their voices be heard on this issue. When health insurance companies are not willing to act on their own in the best interest of patients, they must be required to do so by law.
Connie Dinner
October 1, 2009, 9:42pm (report abuse)October is Breast Cancer Awareness Month; we cannot allow another one to pass by with this bill languishing in committee.
I am a Physical Therapist who sees breast cancer and post-mastectomy patients for education and treatment of complications. I urge everyone to write to your Senators to impress upon them the need for physicians, not insurance companies, to decide on the length of stay after surgery. They pay more attention to letters than e-mails. Also, write to the Committee on Health, Education, Labor, and Pensions to get the bill out of committee! And write to tell Senate Majority Leader Harry Reid to urge the U.S. Senate to pass the Breast Cancer Protection Act of 2009!
If you are not a letter writer, be bold enough to telephone them. If you get through, tell them personally! If you get a busy signal, try again, and pray that it means that persons like you are overloading the lines! I will!