I 
118TH CONGRESS 
1ST SESSION H. R. 4779 
To amend title XVIII of the Social Security Act to provide coverage for 
custom fabricated breast prostheses following a mastectomy. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 20, 2023 
Ms. CHU (for herself and Mrs. MILLER-MEEKS) 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 subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
coverage for custom fabricated breast prostheses fol-
lowing a mastectomy. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; FINDINGS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Breast Cancer Patient Equity Act’’. 
(b) FINDINGS.—Congress finds the following: 
(1) There are currently more than 4,000,000 
women with a history of breast cancer in the United 
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States, many of whom experience unreconstructed 
breast loss. 
(2) In 2023, an estimated 297,790 women will 
be diagnosed with invasive breast cancer that re-
quired surgery, with many having to undergo sur-
gical breast removal. 
(3) In 2023, an estimated 43,100 women in the 
United States are expected to die from breast can-
cer. 
(4) Annually, there are more than 100,000 
women 
in 
the 
United 
States 
who 
undergo 
mastectomies, a surgical removal of the breast. 
(5) The number of breast mastectomies in the 
United States has increased among younger women, 
ages 18 to 34 years old, at a rate of 30 percent and 
at a rate of 15 percent for women ages 35 to 44 
years old. 
(6) The results of breast reconstruction surgery 
can vary and, as with any surgical procedure, there 
are inherent risks associated with such surgery. Ad-
ditionally, reconstruction of the breast using im-
plants requires lifelong follow up to ensure the 
health of the patient. 
(7) While the number of women choosing to un-
dergo surgical breast reconstruction continues to in-
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crease, many women continue to lack the viable op-
tion of custom fabricated prosthetic breasts to re-
store the lost breast. 
(8) Both older women and minority women are 
less likely to be offered or undergo surgical breast 
reconstruction and are disproportionately disadvan-
taged by a lack of access to the option of custom 
fabricated prosthetic breasts. 
(9) Currently, the Medicare program provides 
coverage and reimbursement for custom fabricated 
prostheses for any body part, with the exception of 
breasts, that has been lost. 
(10) Following passage of the Women’s Health 
and Cancer Rights Act of 1998 (Public Law 105– 
277; 42 U.S.C. 201 note), many private insurers 
and group health plans began to provide coverage 
for custom fabricated breast prostheses as an alter-
native to surgical breast reconstruction. 
(11) While the Medicare program recognizes 
custom fabricated breast prostheses as a discrete de-
vice and valid treatment option, having assigned a 
billing code for such option under the Healthcare 
Common Procedure Coding System (‘‘HCPCS’’) and 
setting a maximum allowable fee, Medicare does not 
provide reimbursement and denies claims as ‘not 
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