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Cancer advocates fight to get breast prostheses covered by Medicare

Politico has an interesting report today on a lobbying effort to make custom breast prostheses for mastectomy patients a Medicare benefit. Under current Medicare policy, prostheses - an alternative to reconstructive surgery for cancer survivors - are not considered medically necessary and not paid for. But breasts are the only body part for which Medicare doesn't reimburse prosthetic replacements - something U.S. Sens. Blanche Lincoln (D-Ark.) and Olympia Snowe (R-Maine) call a "significant inequity" facing women.

Lincoln and Snowe introduced legislation last spring that would mandate Medicare coverage of post-mastectomy breast prostheses - so the issue may be resolved sooner than later. But as writer Sarah Kliff points out, this isn't the last we'll hear of efforts to get insurers to pay for certain benefits:

The push to cover this benefit - a back-and-forth struggle that has gone on for two years - is likely to become an increasingly familiar plot line as health reform comes into effect.

And, Kliff says, this lobbying campaign "exemplifies many of the challenges and competing interests that regulators will face in defining what counts as medicine and what does not."

Via Kaiser Health News

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