ASPS efforts yield victory

Breast Cancer Patient Education Act becomes law

When the Women’s Health and Cancer Rights Act (WHCRA) was enacted into law in 1998, it was considered a watershed moment for breast cancer reconstruction. The legislation introduced and established a federal mandate that requires all payers that provide coverage for breast cancer treatment to also cover reconstruction and prostheses. At the time, the plastic surgery community saw this as a solution to breast cancer patient-access problems related to reconstructive services.

Unfortunately, this mandate alone has not sufficiently increased access to reconstructive services – and women continue to live without reconstruction simply because they’re not aware that it’s a covered benefit. In response, ASPS worked with Congress to introduce the Breast Cancer Patient Education Act (BCPEA), which takes direct aim at this lack of information.

On December 18, 2015, the journey that began with the passage of the WHCRA came one sizeable step closer to completion when the BCPEA was signed into law by President Obama.

‘A huge victory’

“This is a huge victory for ASPS,” says ASPS President David Song, MD, MBA. “Most importantly, it’s a victory for breast cancer survivors. It’s shameful that women don’t undergo breast reconstruction – a crucial part of the healing process that they have a federal right to – simply because they weren’t given adequate information.’

Under the new law, the HHS secretary is required to plan and implement an education campaign that informs breast cancer patients about the availability and coverage of breast reconstruction and other post-mastectomy alternatives. Educational materials created by the secretary will inform women of their right to breast reconstruction under federal law, and provide women with information about when breast reconstruction or prostheses may be appropriate within their recovery plan.

This campaign will support existing material on breast-cancer awareness already created by the Office of Women’s Health and the Office of Minority Health – therefore, it will not result in any new federal spending.

ASPS Legislative Advocacy Committee Federal Chair Gregory Greco, DO, says the newly signed BCPEA “will address a problem that’s more severe than I think most people realize. The American Cancer Society projects more than 230,000 new cases of invasive breast cancer in 2015.

“Sadly, though, less than half of all women requiring a mastectomy are even offered reconstruction,” he adds. “Coverage is mandated, yet less than half of these women ever get to have this conversation. We have to do better.”

Better coverage, better education

In this important instance, doing better means not just patient education, but also education of other health-care providers. Through the BCPEA, ASPS hopes to foster a broader understanding of breast cancer treatment, according to ASPS President-elect Debra Johnson, MD.

“Women are quite frightened by the breast cancer diagnosis, and they want the cancer removed as quickly as possible,” Dr. Johnson says. “The haste to extirpate the disease can mean that women aren’t offered the chance to meet with a plastic surgeon. But we know how disturbing the body-image change of mastectomy can be to a woman. Plastic surgeons and breast reconstruction must be an integral part of the breast-cancer treatment team.”

ASPS has worked to spread greater awareness among health-care providers through the Breast Cancer Patient Education Act Coalition and its annual Breast Reconstruction Awareness Day. With passage of the BCPEA, patients and their providers will have increased awareness of treatment options.

ASPS has worked tirelessly to advance the BCPEA since its 2012 introduction. The Society has organized multiple, grassroots campaigns that helped ASPS members connect with their representatives in Congress, to ask that they cosponsor the legislation; made the BCPEA a primary focus of its federal ASPS Legislative Advocacy Fly-In events, where over the years ASPS members conducted hundreds of face-to-face meetings on the Hill in support of the bill; worked with the bill’s congressional sponsors to organize letters in which they directly requested the support of their colleagues, as well as briefings where they joined physicians and patient advocates to educate congressional staff about breast reconstruction; and developed a far-reaching coalition of medical society and patient advocacy stakeholder groups.

Redoubled efforts

This year saw an escalation of these efforts, as ASPS redoubled its grassroots efforts and expanded on them with a new “sign-on” e-mail approach that resulted in the highest total to date of ASPS member contacts with members of Congress. To supplement this grassroots work, ASPS has increased its efforts to grow the ASPS-led BCPEA Coalition, which has resulted in a record-high 40 members.

Among the new additions to this group are major national supporters, including the AMA, the American Cancer Society’s Cancer Action Network, the ACS’s Commission on Cancer, and the Susan G. Komen Foundation.

ASPS has also devised and executed a massive, targeted direct-outreach strategy that resulted in 85 meetings with members of the House and Senate committees with jurisdiction over the bill; members of the Congressional Doctor’s Caucus; and members of Congress who were previously visited during an ASPS Fly-In event. When the latter events are taken into account, ASPS and Hart Health Strategies, its federal lobbying partners, conducted 161 meetings on the BCPEA in 2015, directly leading to 22 of the 25 first-time congressional sponsors added this year.

Forming a critical mass

While none of these efforts alone were enough to move the needle in Congress, in combination they were an undertaking that ASPS Board Vice President, Health Policy & Advocacy Anne Taylor, MD, describes as being so substantial that “they ultimately became a testament to the commitment of our members, to the commitment and competence of our professional staff and, more than anything else, to the fact that even a small group of people can make major change if they are willing to put in the work.

“If you’ve attended an ASPS Fly-In event during the last four years, contributed to PlastyPAC, written a letter to your member of Congress or picked up the phone and called, then this victory is your victory,” Dr. Taylor adds. “This was accomplished because our members believed it was the right thing to do, and our team in Arlington Heights and Washington, D.C., channeled that belief into action. This is a proud day.”

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