[Congressional Record Volume 166, Number 175 (Friday, October 9, 2020)]
[Extensions of Remarks]
[Pages E939-E940]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          THE COMPREHENSIVE BREAST RECONSTRUCTION ACT OF 2020

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                         HON. ALCEE L. HASTINGS

                               of florida

                    in the house of representatives

                        Friday, October 9, 2020

  Mr. HASTINGS. Madam Speaker, I rise today to introduce the 
Comprehensive Breast Reconstruction Act of 2020. This bill would 
provide breast cancer patients the option to have comprehensive 
reconstruction, including nipple-areola complex tattooing.
  Approximately 275,000 new cases of breast cancer will be diagnosed in 
the United States this year. As surgical options have improved in

[[Page E940]]

recent decades, the number of women pursuing breast reconstruction has 
continued to increase. In 2019 alone, 107,238 breast reconstructive 
procedures were performed in the United States--a 36 percent increase 
since 2000 when 78,832 procedures were performed. Post-mastectomy 
breast reconstruction is now universally recognized as a gold standard 
component of comprehensive breast cancer treatment. Breast 
reconstruction has been proven to significantly improve a woman's 
psychological and physical well-being, providing self-assurance, and 
affording women a new beginning.
  The final stage of breast reconstruction surgery is to the nipple-
areolar complex. This results in fully restoring the breast to a 
natural, symmetric appearance. This is achieved by a combination of 
tattooing with or without the addition of a surgical procedure to 
create a nipple. At times, tattooing is the only option for nipple-
areolar reconstruction in patients that may have damaged tissue due to 
radiation therapy or simply want to avoid an additional surgical 
procedure. Most commonly, nipple-areolar tattooing is performed in a 
surgeon's office if a woman selects to have tattooing performed, which 
is not always the case. However, plastic and reconstructive surgeons 
are increasingly recognizing that professional tattoo artists can 
achieve superior results, including an impressively realistic 3-D 
nipple-areola complex tattoo. The price of tattooing can start at 
approximately $400 for a single breast and reach as high as $1,000 for 
both breasts.
  Greater standardization of insurance coverage for nipple-areolar 
reconstruction across insurance carriers is needed. In order to achieve 
this consistency, we need to amend the Women's Health and Cancer Rights 
Act of 1998 (WHCRA), within the Employee Retirement Income Security Act 
of 1974. Further, we need to enhance the requirements for Medicare and 
Medicaid through the Social Security Act to protect a woman's right to 
comprehensive breast reconstruction, including nipple-areola complex 
tattooing.
  My bill will:
  Amend the Women's Health and Cancer Rights Act of 1998 (WHCRA) to 
state that nipple-areola complex tattooing is medical necessary and is 
a part of breast reconstruction;
  Amend the Social Security Act to require Medicare to follow the 
Women's Health and Cancer Rights Act of 1998;
  Amend the Social Security Act to add licensed tattoo artists to the 
list of Medicare providers; and
  Amend the Social Security Act to require Medicaid to add nipple-
areola complex tattooing (as medically necessary) to the list of 
required services each State must offer relating to breast cancer 
reconstruction.
  Madam Speaker, as you know, breast cancer can affect not only a 
woman's physical well-being, but also her psychological well-being. 
Considering the significant role psychological factors can play in 
patients' overall well-being, it is essential that comprehensive breast 
reconstruction, including nipple-areola complex tattooing be required 
coverage by group health insurance companies, Medicare, and Medicaid.
  I urge my colleagues to assist women in their fight against breast 
cancer by supporting this important legislation.

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