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) · 30 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 one-year implementation window allows suppliers time to update consent forms and workflows.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
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.
Named in the bill
Centers for Medicare & Medicaid Services (CMS), Medicare, Social Security Act § 1834, National Coverage Determination 140.2
Where it stands
30 cosponsors: 30 Democrats.
- Jul 17, 2025 — Introduced · Congress.gov: “Introduced in House”
- Jul 17, 2025 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (984 characters) on May 19, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
As of — page rendered 2026-10-20.
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