H.R. 4545

119th CONGRESS 1st Session

To amend title XVIII of the Social Security Act to require the provision of certain information with respect to breast reconstruction surgery under the Medicare program.

IN THE HOUSE OF REPRESENTATIVES · July 17, 2025 · Sponsor: Ms. Waters

Table of contents

• H.R. 4545
  • SEC. 1. Short title
  • SEC. 2. Requiring the provision of certain information with respect to breast reconstruction surgery

SEC. 1. Short title

• This Act may be cited as the Medicare Breast Reconstruction Access and Information Act.

SEC. 2. Requiring the provision of certain information with respect to breast reconstruction surgery

• Section 1834 of the Social Security Act () is amended by adding at the end the following new subsection: 42 U.S.C. 1395m
  • (aa) Requirement To provide certain information with respect to breast reconstruction surgery
    • Notwithstanding any other provision of this part, no payment may be made under this part for a mastectomy furnished to an individual on or after the date that is 1 year after the date of the enactment of this subsection unless the supplier furnishing such mastectomy, prior to the furnishing of such mastectomy—
      • informs such individual that breast reconstruction surgery following a medically necessary mastectomy is covered under this part pursuant to national coverage determination 140.2; and
      • documents the provision of such information in the medical record of such individual.