Protect Access to Breast Reconstruction
The Centers for Medicare and Medicaid Services (CMS) announced that it will retain procedure codes for breast cancer reconstruction, after hearing feedback from The Breasties and other patient advocates, patients, and health care professionals.
The Breasties rallied over 13,000 community members and asked CMS to retain the S codes for breast reconstruction, so that people in need of breast reconstruction have access to DIEP flap procedures. DIEP flap is an important reconstruction option for those who choose reconstruction with their own tissue, rather than breast implants.
The plan to eliminate certain breast reconstruction codes was creating barriers to care for individuals seeking access to medically appropriate breast reconstruction after a cancer diagnosis or with a family history of cancer.
The Breasties actively advocated for this change and partnered with other patient advocacy organizations and Dr. Elisabeth Potter, to share with CMS the access challenges that were resulting from the plan to eliminate the codes.
In February 2023, The Breasties launched a social media campaign educating the community about the medical coding change and the sunsetting of the S codes followed by a series of Instagram lives.
In the spring, The Breasties drafted a letter to CMS, which was signed by 34 patient advocacy organizations, 12 medical professional societies, and 231 health care professionals, including hospitals, practices, and individual health care providers. We also shared with CMS a petition with more than 4,600 signatures.
On May 18th, The Breasties leadership team met with the Oversight Committee to detail our concerns about access to care.
On June 1, CMS hosted a public meeting, in which they sought input on its decision to sunset the S code. Patient advocacy organizations and Breasties urged CMS to retain the codes.
On August 21, CMS announced CMS Announces It Will Retain Breast Reconstruction Codes, A Reversal That Protects Patient Access to DIEP Flap Surgery.
On October 2nd, The Breasties appeared on CBS Morning along with Dr. Potter to celebrate this historic advocacy win.
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PBS NewsHour
Health insurance companies are changing the way they reimburse doctors who perform a complex type of breast reconstruction surgery.
CBS Mornings
On CBS Morning News, Dr. Potter discusses new policy change that can have an impact on breast cancer survivors
Advocacy commitment
The Breasties are committed to counteracting the gaps that exist in cancer care, support, research, and representation.