Medicare now must tell cancer patients about free reconstruction surgery.
H.R. 4545 — Medicare Breast Reconstruction Access and Information Act · Filed by Maxine Waters (D-CA) · 29 cosponsors · Introduced Jul 17, 2025 · Referred to committee
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What it does
This bill requires Medicare to ensure that patients undergoing mastectomy are informed—before the procedure—that breast reconstruction surgery is covered by Medicare under an existing national coverage rule. Suppliers must document this notification in the patient's medical record. The requirement takes effect one year after enactment.
Why we flagged it
The bill's sole operative mechanism is a disclosure requirement—suppliers must inform mastectomy patients of an existing Medicare benefit and document it. This is a transparency/informed-consent measure, not a coverage expansion (reconstruction is already covered under NCD 140.2) or a payment change.
What the text implies
- Patients may discover reconstruction coverage for the first time at the pre-mastectomy consultation, potentially shifting surgical planning or timing decisions.
- Documentation requirement creates an audit trail; Medicare can verify compliance and identify non-compliant suppliers.
The full analysis lists 3 implications of this text.
Who it affects
Cancer patients undergoing mastectomy gain advance, documented notice of a covered reconstruction benefit, reducing information asymmetry and enabling informed decision-making about their post-surgical care. The requirement imposes a minimal administrative burden on providers (disclosure + documentation) with no cost to patients.