II 

112TH CONGRESS 

2D SESSION S. 3628 

To amend the Public Health Service Act to raise awareness of, and to 

educate breast cancer patients anticipating surgery regarding, the availability and coverage of breast reconstruction, prostheses, and other options. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 14, 2012 

Mr. BLUNT (for himself, Mr. BROWN of Ohio, and Mr. VITTER) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to raise awareness 

of, and to educate breast cancer patients anticipating 

surgery regarding, the availability and coverage of breast 

reconstruction, prostheses, and other options. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Breast Cancer Patient 

5 Education Act of 2012’’. 

6 SEC. 2. FINDINGS. 

7 The Congress makes the following findings: 


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1 (1) Annually, about 207,090 new cases of 

2 breast cancer are diagnosed, according to the Amer3 ican Cancer Society. 

4 (2) Breast cancer has a disproportionate and 

5 detrimental impact on African-American women and 

6 is the most common cancer among Hispanic/Latina 

7 women. 

8 (3) African-American women under the age of 

9 40 have a greater incidence of breast cancer than 

10 Caucasian women of the same age. 

11 (4) Individuals undergoing surgery for breast 

12 cancer should give due consideration to the option of 

13 breast reconstructive surgery, either at the same 

14 time as the breast cancer surgery or at a later date. 

15 (5) According to the American Cancer Society, 

16 immediate breast reconstruction offers the advan17 tage of combining the breast cancer surgery with the 

18 reconstructive surgery and is cost effective. 

19 (6) According to the American Cancer Society, 

20 delayed breast reconstruction may be advantageous 

21 in women who require post-surgical radiation or 

22 other treatments. 

23 (7) A woman suffering from the loss of her 

24 breast may not be a candidate for surgical breast reVerDate Mar 15 2010 23:54 Nov 14, 2012 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3628.IS S3628

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1 construction or may choose not to undergo addi2 tional surgery and instead choose breast prostheses. 

3 (8) The Women’s Health and Cancer Rights 

4 Act of 1998 (WHCRA; Public Law 105–277) re5 quires health plans that offer breast cancer coverage 

6 to also provide for breast reconstruction. 

7 (9) Required coverage for breast reconstruction 

8 includes all the necessary stages of reconstruction. 

9 Surgery of the opposite breast for symmetry may be 

10 required. Breast prostheses may be necessary. Other 

11 sequelae of breast cancer treatment, such as 

12 lymphedema, must be covered. 

13 (10) Up to 70 percent of women eligible for 

14 breast reconstruction are not informed of their re15 constructive options. 

16 (11) Several states have enacted laws to require 

17 that women receive information on their breast can18 cer treatment and reconstruction options. 

19 (12) A 2009 study by Amy Alderman, M.D. at 

20 the University of Michigan and Caprice Greenberg 

21 of the Dana Farber Institute determined the two 

22 dominant reasons why women did not undergo 

23 breast reconstruction: (1) the woman was not in24 formed of her options, and (2) the woman was not 

25 referred to a breast reconstruction surgeon. 


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1 (13) According to a 2008 report by Greenberg, 

2 most women undergo breast reconstruction because 

3 the option was offered and discussed by the breast 

4 cancer surgeon. This critical discussion is often lack5 ing. 

6 (14) Greenberg reports that women with Medi7 care undergo breast reconstruction at a rate of 11 

8 percent. Women with managed care or indemnity in9 surance undergo reconstruction at a rate of approxi10 mately 54 percent. Nationally, only 33 percent of eli11 gible women with breast cancer undergo breast re12 construction. 

13 SEC. 3. BREAST RECONSTRUCTION EDUCATION. 

14 Part V of title III of the Public Health Service Act 

15 (42 U.S.C. 280; programs relating to breast health and 

16 cancer) is amended by adding at the end the following: 

17 ‘‘SEC. 399NN–1. BREAST RECONSTRUCTION EDUCATION. 

18 ‘‘(a) IN GENERAL.—The Secretary shall provide for 

19 the planning and implementation of an education cam20 paign to inform breast cancer patients anticipating sur21 gery regarding the availability and coverage of breast re22 construction, prostheses, and other options. 

23 ‘‘(b) INFORMATION TO BE DISSEMINATED.— 


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1 ‘‘(1) SPECIFIC INFORMATION.—Such campaign 

2 shall include dissemination of the following informa3 tion: 

4 ‘‘(A) Breast reconstruction is possible at 

5 the time of breast cancer surgery, or in a de6 layed fashion. 

7 ‘‘(B) Prostheses or breast forms may be 

8 available. 

9 ‘‘(C) Federal law mandates both public 

10 and private health plans to include coverage of 

11 breast reconstruction and prostheses. 

12 ‘‘(D) The patient has a right to choose 

13 their provider of reconstructive care, including 

14 the potential transfer of care to a surgeon that 

15 provides breast reconstructive care. 

16 ‘‘(E) The patient may opt to undergo 

17 breast reconstruction in a delayed fashion for 

18 personal reasons, or after completion of all 

19 other breast cancer treatments. 

20 ‘‘(2) OTHER INFORMATION.—In addition to the 

21 information described in paragraph (1), such cam22 paign may include dissemination of such other infor23 mation (whether developed by the Secretary or by 

24 other entities) as the Secretary determines relevant. 


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1 ‘‘(3) RESTRICTION.—Such campaign shall not 

2 specify, or be designed to serve as a tool to limit, the 

3 health care providers available to patients. 

4 ‘‘(c) CONSULTATION.—In developing the information 

5 to be disseminated under this section, the Secretary shall 

6 consult with appropriate medical societies and patient ad7 vocates related to breast cancer, breast reconstructive sur8 gery, and breast prostheses and breast forms.’’. 

Æ 


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