Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
34428517
label
Breast Cancer Legislation: US House of Representatives
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
34428517
sourceUrl
contentType
document
title
Breast Cancer Legislation: US House of Representatives
citationUrl
collections
Records of the First Lady's Office (Clinton Administration)
Jennifer Klein's Files
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
34428517
levelOfDescription
fileUnit
otherTitles
42-t-7422560-20140536S-007-001-2016
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
d94fc36cfe926cec
ocrText
Hotted States
Elmase of
CLINTON LIBRARY PHOTOCOPY
Dan T. Boston
Press Secretary
1222 Longworth Building
Washington, DC 20515
Office of
(202) 225-5441
Congresswoman Sue Kelly
Fax: (202) 225-3289
19th District, New York
E-Mail: [email protected]
Congressional Record
United States
of America
PROCEEDINGS AND DEBATES OF THE
105th
CONGRESS, FIRST SESSION
House of Representatives
WEDNESDAY, FEBRUARY 5, 1997
Mrs. KELLY. Mr. Speaker, I rise today to introduce the Women's Health and Cancer Rights Act
of 1997, comprehensive legislation that guarantees coverage for inpatient hospital care following
a mastectomy, lumpectomy, or lymph node dissection--based on a doctor's judgment, requires
coverage for breast reconstructive procedure, including symmetrical reconstruction, ensures a
second opinion for any cancer diagnosis, and offers significant physical protections from
inducement or retribution.
I want to first thank my colleagues in both the House and Senate that have worked so
diligently on this legislation. Senators D'Amato, Snowe, and Feinstein, as well as
Representatives Susan Molinari and Frank LoBiondo, are all part of this effort to restore the
ability of doctors to practice sound medicine and to restore compassion and dignity to the
treatment of breast cancer patients.
So why introduce this bill? I'll tell you why. Tragically, some women who must undergo
mastectomies, lumpectomies or lymph node dissections for the treatment of breast cancer are
rushed through their recovery from these procedures on an outpatient basis at the insistence of
their health plan or insurance company in order to cut cost. Other insurance companies cut cost
by denying coverage for reconstructive surgery because they have deemed such procedures
cosmetic. Ironically, they do not deny reconstructive surgery for an ear lost to cancer. We must
understand that self-image is at stake at a time when optimism and inner strength can be the
difference between life and death.
Furthermore, this bill requires coverage of second opinions when any cancer tests come back
either negative or positive, giving all patients the benefit of a second opinion. This important
provision will not only help ensure that false negatives are detected, but also give men and
women greater peace of mind.
Now, to be clear, all insurance companies are not so insensitive as to not provide these
benefits and, therefore, all will not be affected by this legislation, but we have a responsibility to
protect the doctor-patient relationship, ensuring that the medical needs of patients are fully
addressed.
Page 2
Everyone has heard that one in nine women will be diagnosed with breast cancer at some
point in their lifetime. Well, one of those women is my sister. So I know a little something about
the horror that accompanies this disease and the personal anxiety of living with the disease.
My sister and her experiences have made me realize that we should have no greater priority
than empowering those with breast cancer the right and ability to play an active role in the
management of their treatment. It is our obligation as leaders to ensure them that their medical
treatment is in the hands of physicians, not insurance companies. It is a profound injustice when
health care forgets about the patient, yet with regard to mastectomy recovery and breast
reconstruction following a mastectomy, that is just what has been done.
Let's put the reality of this disease in perspective. When a woman is told that she has breast
cancer, the feeling that immediately follows the initial denial is lack of control. Our bill is a
patient's bill aimed at providing patients, in consultation with their physicians, a greater degree of
autonomy when deciding appropriate medical care and, therefore, taking back control of their
lives.
More than 2 1/2 million women in America today are living with breast cancer. These women
are our sisters, mothers, daughters, wives, and friends. This dreadful disease now strikes over
180,000 women per year and that figure does not even include the additional 20 percent a year
who have preinvasive cancers. Devastatingly to the families involved, it is estimated that more
than 44,000 women will die of breast cancer this year.
But all the news is not grim. Overall breast cancer mortality declined 5 percent between 1989
and 1993 due to increased mammography screening and improved treatments such as
mastectomies, lumpectomies, and lymph node dissections.
There is no doubt that we have the medical know-how to fight breast cancer. The question is
do we have the commitment it takes. As long as we send a woman home 12 hours after losing a
part of herself with no compassion and no support, then the answer is no. As long as breast
reconstruction is deemed cosmetic, then the answer is no.
As long as false negatives are acceptable and we, therefore, abandon a patient unknowingly in
need, then the answer is no. As long as we fail to come to the defense of doctors who are
persecuted for practicing sound medicine, then the answer is no.
Passage of the Women's Health and Cancer Rights Act would demonstrate what we are
lacking--the commitment to fight breast cancer and stand up for those who are suffering.
In closing, I am pleased that President Clinton emphasized the importance of this legislation
in his State of the Union Address last night. It is nice to have the administration behind this
critical legislation.
Congressional Record
United States
of America
PROCEEDINGS AND DEBATES OF THE 105th CONGRESS, FIRST SESSION
House of Representatives
April 29, 1997
Mrs. KELLY. First, Mr. Speaker, I want to recognize the gentlewoman from Connecticut, Nancy
Johnson, and the gentlewoman from the District of Columbia, Eleanor Norton, for creating a true
bipartisan group concerned and focused on women's health.
Mr. Speaker, I want to take a few moments to discuss the Women's Health and Cancer Rights Act,
H.R. 616. This legislation, which I introduced in February, along with my colleagues, the gentlewoman
from New York, Ms. Molinari, and the gentleman from New Jersey, Frank LoBiondo, is a
comprehensive measure that focuses on women and breast cancer; those who fear it, those who live
with it, and in memory of those who have died as a result of it.
As we all have heard, through new reports or personal experience, some women who must undergo
mastectomies, lumpectomies or lymph node dissections for the treatment of breast cancer are rushed
through their recovery from these procedures on an outpatient basis at the insistence of their health
plan or insurance company in order to cut costs. Other insurance companies cut costs by denying
coverage for reconstructive surgery because they have deemed such procedures as cosmetic. Ironically,
they do not deny reconstructive surgery for an ear lost to cancer.
The Women's Health and Cancer Rights Act guarantees coverage for inpatient hospital care following
a mastectomy, lumpectomy or lymph node dissection based on a doctor's judgment, and requires
coverage for breast reconstructive procedures, including symmetrical reconstruction.
In addition, this bill requires coverage of second opinions when any cancer tests come back either
negative or positive, giving patients the benefit of a second opinion. This important provision will not
only help ensure that false negatives are detected but also give men and women greater peace of mind.
Several key organizations have endorsed this legislation, organizations that agree we have a
responsibility to protect the doctor-patient relationship, ensuring that the medical needs of patients are
fully addressed. In fact, I would like to thank the American Cancer Society, the American Medical
Association, the National Breast Cancer Coalition, the Center for Patient Advocacy, the Susan G.
Komen Foundation, and many, many others for their support of this bill.
Some critics claim this measure is nothing more than a mandate leading to overnment-controlled health
care. Usually those critics believe that all health care should be individually based and should utilize
medical savings accounts and other initiatives that maximize individual control over cost. I agree with
these ideas, but they are not in place.
There is also a misconception that this legislation requires 48 hours of inpatient care. It does not. The
length of stay under this bill is simply determined by the physician and the patient, as it should be.
Developing a system of health care which maximizes an individual's control over the health care
available is the goal that I in particular strongly support, and so do these organizations. Such a system
uses free market principles to ensure that the health care we receive is of the highest quality.
However, I realize that while this is a goal we strive for, we are not there yet. Most Americans do not
have access to multiple health care plans from which to choose. Until they have this choice, it is going
to be necessary for Congress to enact targeted reforms, such as the Women's Health and Cancer Rights
Act, reforms that safeguard quality care while at the same time avoiding overly broad regulations and
mandates.
I am for market-based health care, but I am not willing to stand by idly while approximately 44,000
women die of breast cancer every year. They will this year, they did last year. This is a figure which is
comparable to the number of men and women who died in all of the Vietnam war.
Mr. Speaker, the Women's Health and Cancer Rights Act aims to give women with breast cancer a
fighting chance and the dignity to endure the fight.
News from
Congresswoman Sue Kelly
FOR IMMEDIATE RELEASE
CONTACT:
Dan Boston
Wednesday, January 29, 1997
(202) 225-5441
Rep. Kelly Announces Introduction of Legislation
to End Practice of "Drive-Through" Mastectomies
* Area Rep. Joined by Bipartisan Group of Senators to Fight this Cause
*
Washington, D.C. -- This morning Congresswoman Sue Kelly (R-Katonah, NY), joined by
Senator Al D'Amato (R-NY), Senator Diane Feinstein (D-CA) and Senator Olympia Snowe (R-ME),
announced the formal introduction of the Women's Health & Cancer Rights Act of 1997. This legislation
ensures coverage of inpatient care for mastectomies, addressing the problem of "drive-through"
mastectomies. This measure would also address this same problem with respect to lymph node dissections
and lumpectomies. Additionally, the Women's Health & Cancer Rights Act would require insurance
coverage for reconstruction procedures, as well as ensure insurance coverage of second opinions for any
cancer diagnosis.
"The decision on length of hospital stay for a breast cancer patient must be left to the patient's
doctor -- not an insurance company," said Congresswoman Kelly. "Our legislation is about preserving the
doctor-patient relationship and ensuring the highest quality of medical care and peace of mind for all victims
of this deadly disease (cancer)."
Similarly, Senator D'Amato added, "The trauma that a woman suffers when she learns that she has
been diagnosed with breast cancer is tremendous." "The additional physical and psychological trauma of a
mastectomy compounds this pain. And we cannot allow, in good conscience, women to be rushed through
medical procedures that will affect them for the rest of their lives."
If enacted, the Women's Health & Cancer Rights Act would require a health plan that provides
medical and surgical benefits for the treatment of breast cancer to allow a woman's physician, not her
insurance company, to determine the duration of her stay, following a mastectomy, lumpectomy or lymph
node dissection in the treatment of breast cancer.
The Women's Health & Cancer Rights Act also includes language for coverage of second opinions
by specialists. The bill would require insurers to pay for secondary consultations when a cancer diagnosis is
returned either positive or negative, giving all patients the benefit of a second opinion. This important
provision will not only help ensure that false negatives are detected, but also give women around the country
greater peace of mind.
If you would like additional information on this legislation or further comment from
Congresswoman Kelly, please call Dan Boston at (202) 225-5441.
- 30 -
News from
Congresswoman Sue Kelly
FOR IMMEDIATE RELEASE
CONTACT:
Dan Boston
Wednesday, January 29, 1997
(202) 225-5441
Rep. Kelly Announces Introduction of Legislation
to End Practice of "Drive-Through" Mastectomies
* Area Rep. Joined by Bipartisan Group of Senators to Fight this Cause
*
Washington, D.C. -- This morning Congresswoman Sue Kelly (R-Katonah, NY), joined by
Senator Al D'Amato (R-NY), Senator Diane Feinstein (D-CA) and Senator Olympia Snowe (R-ME),
announced the formal introduction of the Women's Health & Cancer Rights Act of 1997. This legislation
ensures coverage of inpatient care for mastectomies, addressing the problem of "drive-through"
mastectomies. This measure would also address this same problem with respect to lymph node dissections
and lumpectomies. Additionally, the Women's Health & Cancer Rights Act would require insurance
coverage for reconstruction procedures, as well as ensure insurance coverage of second opinions for any
cancer diagnosis.
"The decision on length of hospital stay for a breast cancer patient must be left to the patient's
doctor -- not an insurance company," said Congresswoman Kelly. "Our legislation is about preserving the
doctor-patient relationship and ensuring the highest quality of medical care and peace of mind for all victims
of this deadly disease (cancer)."
Similarly, Senator D'Amato added, "The trauma that a woman suffers when she learns that she has
been diagnosed with breast cancer is tremendous." "The additional physical and psychological trauma of a
mastectomy compounds this pain. And we cannot allow, in good conscience, women to be rushed through
medical procedures that will affect them for the rest of their lives."
If enacted, the Women's Health & Cancer Rights Act would require a health plan that provides
medical and surgical benefits for the treatment of breast cancer to allow a woman's physician, not her
insurance company, to determine the duration of her stay, following a mastectomy, lumpectomy or lymph
node dissection in the treatment of breast cancer.
The Women's Health & Cancer Rights Act also includes language for coverage of second opinions
by specialists. The bill would require insurers to pay for secondary consultations when a cancer diagnosis is
returned either positive or negative, giving all patients the benefit of a second opinion. This important
provision will not only help ensure that false negatives are detected, but also give women around the country
greater peace of mind.
If you would like additional information on this legislation or further comment from
Congresswoman Kelly, please call Dan Boston at (202) 225-5441.
- 30 -
THE WOMEN'S HEALTH & CANCER RIGHTS ACT OF 1997
BACKGROUND
In the United States today, there are at least 2.6 million women living with breast cancer -- more than
180,000 women were diagnosed with the disease in 1996 alone. One in nine women will be diagnosed
with breast cancer at some point in their lifetime. Women facing the personal anxiety of living with
breast cancer should feel confident that their medical treatment is in the hands of physicians -- not
insurance companies. Unfortunately, some victims of breast cancer experience dangerous health
conditions that result from premature hospital dismissals following a mastectomy, lumpectomy or lymph
node dissection for the treatment of this threatening disease.
SUMMARY
The Women's Health & Cancer Rights Act of 1997 ensures coverage of inpatient hospital care for
mastectomies, lumpectomies and lymph node dissections (based on a doctor's judgement), requires
coverage for reconstructive procedures, and guarantees a second opinion for any cancer diagnosis.
PROVISIONS
Guaranteed Coverage Provision
Ensures coverage of inpatient hospital care for mastectomies, lumpectomies and lymph
node dissection for the treatment of breast cancer for a period as is determined by the
attending physician and patient to be medically appropriate.
Places the decision on length of stay with the physician and patient, not the insurance
company.
NOTE: Procedure can be done on an outpatient basis if deemed medically appropriate by
physician and patient following surgery.
Protections for Doctors
Guarantees that physicians will not be penalized for recommending longer stays.
Reconstructive Surgery
Provides reconstructive surgery coverage for all stages of reconstruction, including
symmetrical reconstruction.
NOTE: Studies have documented that the fear of losing a breast is a leading reason why
women do not participate in early breast cancer detection programs. With breast
reconstruction available as a viable option, more women would participate in detection
programs.
Second Opinions Provision
Requires insurance companies to pay full coverage for secondary consultations whenever
any cancer has been diagnosed by the patient's primary physician.
Requires health plans to cover second opinions even when the specialist finds that the
patient does not have cancer.
Allows the doctor to go outside an HMO for consultation by a specialist.
I
105TH CONGRESS
1ST SESSION
H.R.616
To require that health plans provide coverage for a minimum hospital stay
for mastectomies and lymph node dissection for the treatment of breast
cancer, coverage for reconstructive surgery following mastectomies, and
coverage for secondary consultations.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 5, 1997
Mr. MOLINARI (for herself, Mrs. KELLY, Mr. LOBIONDO, Mr. FLAKE, Mr.
ACKERMAN, Mr. KING, Mrs. MORELLA, Mr. DEAL of Georgia, Mr.
SAXTON, Mr. LAZIO of New York, Mr. SMITH of New Jersey. Mr. Fox
of Pennsylvania, Mr. ANDREWS, Mr. PALLONE, Mr. WALSH, Mr. FROST,
Mr. ENGLISH of Pennsylvania, Mr. WOLF, Mr. MCNULTY, Mrs. Rou-
KEMA, Mr. FORBES, Mr. SMITH of Washington, Mrs. MCCARTHY of New
York, Ms. SLAUGHTER, Mr. PAPPAS, Mr. FILNER, Mr. HORN, Mr. DAVIS
of Virginia, Mr. MARTINEZ, Mr. WELLER, Mr. GUTIERREZ, Ms. DUNN,
Mr. GILMAN, Mr. SANDERS, Mr. FOLEY, Mr. SHAW, Ms. GRANGER, Mr.
GIBBONS, Ms. CHRISTIAN-GREEN, Mr. OLVER, Ms. STABENOW, Mr. LA-
FALCE, and Mr. BILBRAY) introduced the following bill; which was re-
ferred to the Committee on Commerce, and in addition to the Committees
on Ways and Means, and Education and the Workforce, for a period to
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned
A BILL
To require that health plans provide coverage for a minimum
hospital stay-for mastectomies and lymph node dissection
for the treatment of breast cancer, coverage for recon-
structive surgery following mastectomies, and coverage
for secondary consultations.
2
1
Be it enacted by the Senate and House of Representa-
2 tives of the United States of America in Congress assembled,
3 SECTION 1. SHORT TITLE.
4
This Act may be cited as the "Women's Health and
5 Cancer Rights Act of 1997".
6 SEC. 2. FINDINGS.
7
Congress finds that—
8
(1) the offering and operation of health plans
9
affect commerce among the States;
10
(2) health care providers located in a State
11
serve patients who reside in the State and patients
12
who reside in other States; and
13
(3) in order to provide for uniform treatment of
14
health care providers and patients among the States,
15
it is necessary to cover health plans operating in 1
16
State as well as health plans operating among the
17
several States.
18 SEC. 3. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN-
19
COME SECURITY ACT OF 1974.
20
(a) IN GENERAL.Subpart B of part 7 of subtitle
21 B of title I of the Employee Retirement Income Security
22 Act of 1974 (as added by section 603(a) of the Newborns'
23 and Mothers' Health Protection Act of 1996 and amended
24 by section 702(a) of the Mental Health Parity Act of
3
1 1996) is amended by adding at the end the following new
2 section:
3 "SEC. 713. REQUIRED COVERAGE FOR MINIMUM HOSPITAL
4
STAY FOR MASTECTOMIES AND LYMPH NODE
5
DISSECTIONS FOR THE TREATMENT OF
6
BREAST CANCER, COVERAGE FOR RECON-
7
STRUCTIVE
SURGERY
FOLLOWING
8
MASTECTOMIES, AND COVERAGE FOR SEC-
9
ONDARY CONSULTATIONS.
10
"(a) INPATIENT CARE.-
11
"(1) IN GENERAL.-A group health plan, and a
12
health insurance issuer providing health insurance
13
coverage in connection with a group health plan,
14
that provides medical and surgical benefits shall en-
15
sure that inpatient coverage with respect to the
16
treatment of breast cancer is provided for a period
17
of time as is determined by the attending physician,
18
in consultation with the patient, to be medically ap-
19
propriate following-
20
"(A) a mastectomy;
21
"(B) a lumpectomy; or
22
"(C) a lymph node dissection for the treat-
23.
ment of breast cancer.
24
"(2) EXCEPTION.-Nothing in this section shall
25
be construed as requiring the provision of inpatient
.1111 "
4
1
coverage if the attending physician and patient de-
2
termine that a shorter period of hospital stay is
3
medically appropriate.
4
"(b) RECONSTRUCTIVE SURGERY.-A group health
5 plan, and a health insurance issuer providing health insur-
6 ance coverage in connection with a group health plan, that
7 provides medical and surgical benefits with respect to a
8 mastectomy shall ensure that, in a case in which a mastec-
9 tomy patient elects breast reconstruction, coverage is pro-
10 vided for-
11
"(1) all stages of reconstruction of the breast
12
on which the mastectomy has been performed; and
13
"(2) surgery and reconstruction of the other
14
breast to produce a symmetrical appearance;
15 in the manner determined by the attending physician and
16 the patient to be appropriate, and consistent with any fee
17 schedule contained in the plan.
18
"(c) PROHIBITION ON CERTAIN MODIFICATIONS.-In
19 implementing the requirements of this section, a group
20 health plan, and a health insurance issuer providing health
21 insurance coverage in connection with a group health plan,
22 may not modify the terms and conditions of coverage
23 based on the determination by a participant or beneficiary
24 to request less than the minimum coverage required under
25 subsection (a) or (b).
5
1
"(d) NOTICE.-A group health plan, and a health in-
2 surance issuer providing health insurance coverage in con-
3 nection with a group health plan shall provide notice to
4 each participant and beneficiary under such plan regard-
5 ing the coverage required by this section in accordance
6 with regulations promulgated by the Secretary. Such no-
7 tice shall be in writing and prominently positioned in any
8 literature or correspondence made available or distributed
9 by the plan or issuer and shall be transmitted—
10
"(1) in the next mailing made by the plan or
11
issuer to the participant or beneficiary;
12
"(2) as part of any yearly informational packet
13
sent to the participant or beneficiary; or
14
"(3) not later than January 1, 1998;
15 whichever is earlier.
16
"(e) SECONDARY CONSULTATIONS.-
17
"(1) IN GENERAL.-A group health plan, and a
18
health insurance issuer providing health insurance
19
coverage in connection with a group health plan,
20
that provides coverage with respect to medical and
21
surgical services provided in relation to the diagnosis
22
and treatment of cancer shall ensure that full cov-
23
erage is provided for secondary consultations by spe-
24
cialists in the appropriate medical fields (including
HR 616 IH
6
1
pathology, radiology, and oncology) to confirm or re-
2
fute such diagnosis. Such plan or issuer shall ensure
3
that full coverage is provided for such secondary
4
consultation whether such consultation is based on a
5
positive or negative initial diagnosis. In any case in
6
which the attending physician certifies in writing
7
that services necessary for such a secondary con-
8
sultation are not sufficiently available from special-
9
ists operating under the plan with respect to whose
10
services coverage is otherwise provided under such
11
plan or by such issuer, such plan or issuer shall en-
12
sure that coverage is provided with respect to the
13
services necessary for the secondary consultation
14
with any other specialist selected by the attending
15
physician for such purpose at no additional cost to
16
the individual beyond that which the individual
17
would have paid if the specialist was participating in
18
the network of the plan.
19
"(2) EXCEPTION.-Nothing in paragraph (1)
20
shall be construed as requiring the provision of sec-
21
ondary consultations where the patient determines
22
not to seek such a consultation.
7
1
"(f) PROHIBITION ON PENALTIES OR INCENTIVES.-
2 A group health plan, and a health insurance issuer provid-
3 ing health insurance coverage in connection with a group
4 health plan, may not-
5
"(1) penalize or otherwise reduce or limit the
6
reimbursement of a provider or specialist because
7
the provider or specialist provided care to a partici-
8
pant or beneficiary in accordance with this section;
9
"(2) provide financial or other incentives to a
10
physician or specialist to induce the physician or
11
specialist to keep the length of inpatient stays of pa-
12
tients following a mastectomy, lumpectomy, or a
13
lymph node dissection for the treatment of breast
14
cancer below certain limits or to limit referrals for
15
secondary consultations; or
16
"(3) provide financial or other incentives to a
17
physician or specialist to induce the physician or
18
specialist to refrain from referring a participant or
19
beneficiary for a secondary consultation that would
20
otherwise be covered by the plan or coverage in-
21
volved under subsection (e).".
22
(b) CLERICAL AMENDMENT.-The table of contents
23 in section 1 of such Act, as amended by section 603 of
24 the Newborns' and Mothers' Health Protection Act of
25 1996 and section 702 of the Mental Health Parity Act
8
1 of 1996, is amended by inserting after the item relating
2 to section 712 the following new item:
"Sec. 713. Required coverage for minimum hospital stay for mastectomies and
lymph node dissections for the treatment of breast cancer, cov-
erage for reconstructive surgery following mastectomies, and
coverage for secondary consultations.".
3
(c) EFFECTIVE DATES.-
4
(1) IN GENERAL.-The amendments made by
5
this section shall apply with respect to plan years be-
6
ginning on or after the date of enactment of this
7
Act.
8
(2) SPECIAL RULE FOR COLLECTIVE BARGAIN-
9
ING AGREEMENTS.-In the case of a group health
10
plan maintained pursuant to 1 or more collective
11
bargaining agreements between employee representa-
12
tives and 1 or more employers ratified before the
13
date of enactment of this Act, the amendments made
14
by this section shall not apply to plan years begin-
15
ning before the later of-
16
(A) the date on which the last collective
17
bargaining agreements relating to the plan ter-
18
minates (determined without regard to any ex-
19
tension thereof agreed to after the date of en-
20
actment of this Act), or
21
(B) January 1, 1998.
22
For purposes of subparagraph (A), any plan amend-
9
1
agreement relating to the plan which amends the
2
plan solely to conform to any requirement added by
3
this section shall not be treated as a termination of
4
such collective bargaining agreement.
5 SEC. 4. AMENDMENTS TO THE PUBLIC HEALTH SERVICE
6
ACT RELATING TO THE GROUP MARKET.
7
(a) IN GENERAL.Subpart 2 of part A of title
8 XXVII of the Public Health Service Act (as added by sec-
9 tion 604(a) of the Newborns' and Mothers' Health Protec-
10 tion Act of 1996 and amended by section 703(a) of the
11 Mental Health Parity Act of 1996) is amended by adding
12 at the end the following new section:
13 "SEC. 2706. REQUIRED COVERAGE FOR MINIMUM HOSPITAL
14
STAY FOR MASTECTOMIES AND LYMPH NODE
15
DISSECTIONS FOR THE TREATMENT OF
16
BREAST CANCER, COVERAGE FOR RECON-
17
STRUCTION
SURGERY
FOLLOWING
18
MASTECTOMIES, AND COVERAGE FOR SEC-
19
ONDARY CONSULTATIONS.
20
"(a) INPATIENT CARE.-
21
"(1) IN GENERAL.-A group health plan, and a
22
health insurance issuer providing health insurance
23
coverage in connection with a group health plan,
24
that provides medical and surgical benefits shall en-
25
sure that inpatient coverage with respect to the
HR 616 IH
10
1
treatment of breast cancer is provided for a period
2
of time as is determined by the attending physician,
3
in consultation with the patient, to be medically ap-
4
propriate following-
5
"(A) a mastectomy;
6
"(B) a lumpectomy; or
7
"(C) a lymph node dissection for the treat-
8
ment of breast cancer.
9
"(2) EXCEPTION.-Nothing in this section shall
10
be construed as requiring the provision of inpatient
11
coverage if the attending physician and patient de-
12
termine that a shorter period of hospital stay is
13
medically appropriate.
14
"(b) RECONSTRUCTIVE SURGERY.-A group health
15 plan, and a health insurance issuer providing health insur-
16 ance coverage in connection with a group health plan, that
17 provides medical and surgical benefits with respect to a
18 mastectomy shall ensure that, in a case in which a mastec-
19 tomy patient elects breast reconstruction, coverage is pro-
20 vided for-
21
"(1) all stages of reconstruction of the breast
22
on which the mastectomy has been performed; and
23
"(2) surgery and reconstruction of the other
24
breast to produce a symmetrical appearance;
11
1 in the manner determined by the attending physician and
2 the patient to be appropriate, and consistent with any fee
3 schedule contained in the plan.
4
"(c) PROHIBITION ON CERTAIN MODIFICATIONS.-In
5 implementing the requirements of this section, a group
6 health plan, and a health insurance issuer providing health
7 insurance coverage in connection with a group health plan,
8 may not modify the terms and conditions of coverage
9 based on the determination by a participant or beneficiary
10 to request less than the minimum coverage required under
11 subsection (a) or (b).
12
"(d) NOTICE.-A group health plan, and a health in-
13 surance issuer providing health insurance coverage in con-
14 nection with a group health plan shall provide notice to
15 each participant and beneficiary under such plan regard-
16 ing the coverage required by this section in accordance
17 with regulations promulgated by the Secretary. Such no-
18 tice shall be in writing and prominently positioned in any
19 literature or correspondence made available or distributed
20 by the plan or issuer and shall be transmitted-
21
"(1) in the next mailing made by the plan or
22
issuer to the participant or beneficiary;
23
"(2) as part of any yearly informational packet
24
sent to the participant or beneficiary; or
25
"(3) not later than January 1, 1998;
HR 616 IH
12
1 whichever is earlier.
2
"(e) SECONDARY CONSULTATIONS.-
3
"(1) IN GENERAL.-A group health plan, and a
4
health insurance issuer providing health insurance
5
coverage in connection with a group health plan that
6
provides coverage with respect to medical and sur-
7
gical services provided in relation to the diagnosis
8
and treatment of cancer shall ensure that full cov-
9
erage is provided for secondary consultations by spe-
10
cialists in the appropriate medical fields (including
11
pathology, radiology, and oncology) to confirm or re-
12
fute such diagnosis. Such plan or issuer shall ensure
13
that full coverage is provided for such secondary
14
consultation whether such consultation is based on a
15
positive or negative initial diagnosis. In any case in
16
which the attending physician certifies in writing
17
that services necessary for such a secondary con-
18
sultation are not sufficiently available from special-
19
ists operating under the plan with respect to whose
20
services coverage is otherwise provided under such
21
plan or by such issuer, such plan or issuer shall en-
22
sure that coverage is provided with respect to the
23
services necessary for the secondary consultation
24
with any other specialist selected by the attending
25
physician for such purpose at no additional cost to
13
1
the individual beyond that which the individual
2
would have paid if the specialist was participating in
3
the network of the plan.
4
"(2) EXCEPTION.-Nothing in paragraph (1)
5
shall be construed as requiring the provision of sec-
6
ondary consultations where the patient determines
7
not to seek such a consultation.
8
"(f) PROHIBITION ON PENALTIES OR INCENTIVES.-
9 A group health plan, and a health insurance issuer provid-
10 ing health insurance coverage in connection with a group
11 health plan, may not-
12
"(1) penalize or otherwise reduce or limit the
13
reimbursement of a provider or specialist because
14
the provider or specialist provided care to a partici-
15
pant or beneficiary in accordance with this section;
16
"(2) provide financial or other incentives to a
17
physician or specialist to induce the physician or
18
specialist to keep the length of inpatient stays of pa-
19
tients following a mastectomy, lumpectomy, or a
20
lymph node dissection for the treatment of breast
21
cancer below certain limits or to limit referrals for
22
secondary consultations; or
23
"(3) provide financial or other incentives to a
24
physician or specialist to induce the physician or
25
specialist to refrain from referring a participant or
HR 616 IH
14
1
beneficiary for a secondary consultation that would
2
otherwise be covered by the plan or coverage in-
3
volved under subsection (e).'
4
(b) EFFECTIVE DATES.-
5
(1) IN GENERAL.-The amendments made by
6
this section shall apply to group health plans for
7
plan years beginning on or after the date of enact-
8
ment of this Act.
9
(2) SPECIAL RULE FOR COLLECTIVE BARGAIN-
10
ING AGREEMENTS.-In the case of a group health
11
plan maintained pursuant to 1 or more collective
12
bargaining agreements between employee representa-
13
tives and 1 or more employers ratified before the
14
date of enactment of this Act, the amendments made
15
by this section shall not apply to plan years begin-
16
ning before the later of-
17
(A) the date on which the last collective
18
bargaining agreements relating to the plan ter-
19
minates (determined without regard to any ex-
20
tension thereof agreed to after the date of en-
21
actment of this Act), or
22
(B) January 1, 1998.
23
For purposes of subparagraph (A), any plan amend-
24
ment made pursuant to a collective bargaining
25
agreement relating to the plan which amends the
15
1
plan solely to conform to any requirement added by
2
this section shall not be treated as a termination of
3
such collective bargaining agreement.
4 SEC. 5. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT
5
RELATING TO THE INDIVIDUAL MARKET.
6
(a) IN GENERAL.-Subpart 3 of part B of title
7 XXVII of the Public Health Service Act (as added by sec-
8 tion 605(a) of the Newborn's and Mother's Health Protec-
9 tion Act of 1996) is amended by adding at the end the
10 following new section:
11 "SEC. 2752. REQUIRED COVERAGE FOR MINIMUM HOSPITAL
12
STAY FOR MASTECTOMIES AND LYMPH NODE
13
DISSECTIONS FOR THE TREATMENT OF
14
BREAST CANCER AND SECONDARY CON-
15
SULTATIONS.
16
"The provisions of section 2706 shall apply to health
17 insurance coverage offered by a health insurance issuer
18 in the individual market in the same manner as they apply
19 to health insurance coverage offered by a health insurance
20 issuer in connection with a group health plan in the small
21 or large group market."
22
(b) EFFECTIVE DATE.-The amendment made by
23 this section shall apply with respect to health insurance
HR 616 IH
16
1 coverage offered, sold, issued, renewed, in effect, or oper-
2 ated in the individual market on or after the date of enact-
3 ment of this Act.
4 SEC. 6. AMENDMENTS TO THE INTERNAL REVENUE CODE
5
OF 1986.
6
(a) IN GENERAL.-Chapter 100 of the Internal Reve-
7 nue Code of 1986 (relating to group health plan port-
8 ability, access, and renewability requirements) is amended
9 by redesignating sections 9804, 9805, and 9806 as sec-
10 tions 9805, 9806, and 9807, respectively, and by inserting
11 after section 9803 the following new section:
12 "SEC. 9804. REQUIRED COVERAGE FOR MINIMUM HOSPITAL
13
STAY FOR MASTECTOMIES AND LYMPH NODE
14
DISSECTIONS FOR THE TREATMENT OF
15
BREAST CANCER, COVERAGE FOR RECON-
16
STRUCTIVE
SURGERY
FOLLOWING
17
MASTECTOMIES, AND COVERAGE FOR SEC-
18
ONDARY CONSULTATIONS
19
"(a) INPATIENT CARE.-
20
"(1) IN GENERAL.-A group health plan that
21
provides medical and surgical benefits shall ensure
22
that inpatient coverage with respect to the treatment
23
of breast cancer is provided for a period of time as
17
1
is determined by the attending physician, in con-
2
sultation with the patient, to be medically appro-
3
priate following-
4
"(A) a mastectomy;
5
"(B) a lumpectomy; or
6
"(C) a lymph node dissection for the treat-
7
ment of breast cancer.
8
"(2) EXCEPTION.-Nothing in this section shall
9
be construed as requiring the provision of inpatient
10
coverage if the attending physician and patient de-
11
termine that a shorter period of hospital stay is
12
medically appropriate.
13
"(b) RECONSTRUCTIVE SURGERY.-A group health
14 plan that provides medical and surgical benefits with re-
15 spect to a mastectomy shall ensure that, in a case in which
16 a mastectomy patient elects breast reconstruction, cov-
17 erage is provided for-
18
"(1) all stages of reconstruction of the breast
19
on which the mastectomy has been performed; and
20
"(2) surgery and reconstruction of the other
21
breast to produce a symmetrical appearance;
22 in the manner determined by the attending physician and
23 the patient to be appropriate, and consistent with any fee
24 schedule contained in the plan.
18
1
"(c) PROHIBITION ON CERTAIN MODIFICATIONS.-In
2 implementing the requirements of this section, a group
3 health plan may not modify the terms and conditions of
4 coverage based on the determination by a participant or
5 beneficiary to request less than the minimum coverage re-
6 quired under subsection (a) or (b).
7
"(d) NOTICE.-A group health plan shall provide no-
8 tice to each participant and beneficiary under such plan
9 regarding the coverage required by this section in accord-
10 ance with regulations promulgated by the Secretary. Such
11 notice shall be in writing and prominently positioned in
12 any literature or correspondence made available or distrib-
13 uted by the plan and shall be transmitted—
14
"(1) in the next mailing made by the plan to
15
the participant or beneficiary;
16
"(2) as part of any yearly informational packet
17
sent to the participant or beneficiary; or
18
"(3) not later than January 1, 1998;
19 whichever is earlier.
20
"(e) SECONDARY CONSULTATIONS.-
21
"(1) IN GENERAL.-A group health plan that
22
provides coverage with respect to medical and sur-
23
gical services provided in relation to the diagnosis
19
1
and treatment of cancer shall ensure that full cov-
2
erage is provided for secondary consultations by spe-
3
cialists in the appropriate medical fields (including
4
pathology, radiology, and oncology) to confirm or re-
5
fute such diagnosis. Such plan or issuer shall ensure
6
that full coverage is provided for such secondary
7
consultation whether such consultation is based on a
8
positive or negative initial diagnosis. In any case in
9
which the attending physician certifies in writing
10
that services necessary for such a secondary con-
11
sultation are not sufficiently available from special-
12
ists operating under the plan with respect to whose
13
services coverage is otherwise provided under such
14
plan or by such issuer, such plan or issuer shall en-
15
sure that coverage is provided with respect to the
16
services necessary for the secondary consultation
17
with any other specialist selected by the attending
18
physician for such purpose at no additional cost to
19
the individual beyond that which the individual
20
would have paid if the specialist was participating in
21
the network of the plan.
22
"(2) EXCEPTION.-Nothing in paragraph (1)
23
shall be construed as requiring the provision of sec-
24
ondary consultations where the patient determines
25
not to seek such a consultation.
20
1
"(f) PROHIBITION ON PENALTIES.-A group health
2 plan may not-
3
"(1) penalize or otherwise reduce or limit the
4
reimbursement of a provider or specialist because
5
the provider or specialist provided care to a partici-
6
pant or beneficiary in accordance with this section;
7
"(2) provide financial or other incentives to a
8
physician or specialist to induce the physician or
9
specialist to keep the length of inpatient stays of pa-
10
tients following a mastectomy, lumpectomy, or a
11
lymph node dissection for the treatment of breast
12
cancer below certain limits or to limit referrals for
13
secondary consultations; or
14
"(3) provide financial or other incentives to a
15
physician or specialist to induce the physician or
16
specialist to refrain from referring a participant or
17
beneficiary for a secondary consultation that would
18
otherwise be covered by the plan involved under sub-
19
section (e).".
20
(b) CONFORMING AMENDMENTS.-
21
(1) Sections 9801(c)(1), 9805(b) (as redesig-
22
nated by subsection (a)), 9805(c) (as so redesig-
23
nated), 4980D(e)(3)(B)(i)(I), 4980D(d)(3), and
24
4980D(f)(1) of such Code are each amended by
21
1
striking "9805" each place it appears and inserting
2
"9806".
3
(2) The heading for subtitle K of such Code is
4
amended to read as follows:
5 "Subtitle K-Group Health Plan
6
Portability, Access, Renewabil-
7
ity, and Other Requirements".
8
(3) The heading for chapter 100 of such Code
9
is amended to read as follows:
10 "CHAPTER 100-GROUP HEALTH PLAN PORT-
11
ABILITY, ACCESS, RENEWABILITY, AND
12
OTHER REQUIREMENTS".
13
(4) Section 4980D(a) of such Code is amended
14
by striking "and renewability" and inserting "renew-
15
ability, and other".
16
(c) CLERICAL AMENDMENTS.-
17
(1) The table of contents for chapter 100 of
18
such Code is amended by redesignating the items re-
19
lating to sections 9804, 9805, and 9806 as items re-
20
lating to sections 9805, 9806, and 9807, and by in-
21
serting after the item relating to section 9803 the
22
following new item:
"Sec. 9804. Required coverage for minimum hospital stay for mastectomies and
lymph node dissections for the treatment of breast cancer, cov-
erage for reconstructive surgery following mastectomies, and
coverage for secondary consultations."
22
1
(2) The item relating to subtitle K in the table
2
of subtitles for such Code is amended by striking
3
"and renewability" and inserting "renewability, and
4
other".
5
(3) The item relating to chapter 100 in the
6
table of chapters for subtitle K of such Code is
7
amended by striking "and renewability" and insert-
8
ing "renewability, and other".
9
(d) EFFECTIVE DATES.-
10
(1) IN GENERAL.-The amendments made by
11
this section shall apply with respect to plan years be-
12
ginning on or after the date of enactment of this
13
Act.
14
(2) SPECIAL RULE FOR COLLECTIVE BARGAIN-
15
ING AGREEMENTS.-In the case of a group health
16
plan maintained pursuant to 1 or more collective
17
bargaining agreements between employee representa-
18
tives and 1 or more employers ratified before the
19
date of enactment of this Act, the amendments made
20
by this section shall not apply to plan years begin-
21
ning before the later of-
23
1
(A) the date on which the last collective
2
bargaining agreements relating to the plan ter-
3
minates (determined without regard to any ex-
4
tension thereof agreed to after the date of en-
5
actment of this Act), or
6
(B) January 1, 1998.
7
For purposes of subparagraph (A), any plan amend-
8
ment made pursuant to a collective bargaining
9
agreement relating to the plan which amends the
10
plan solely to conform to any requirement added by
11
this section shall not be treated as a termination of
12
such collective bargaining agreement.
O
News from
Congresswoman Sue Kelly
The Women's Health & Cancer Rights Act of 1997
Endorsees/Supporters
To date, the following organizations have endorsed or are supporting the Women's
Health & Cancer Rights Act of 1997:
The American Cancer Society
The American Medical Association
The Adelphi N.Y. Statewide Breast Cancer Hotline & Support Program
The Albany Plastic & Reconstructive Surgery Center
The Alliance with the Medical Society of the State of New York
The American Association of Nurse Anesthetists
The American College of Obstetricians & Gynecologists
The American Physical Therapy Association
The Center for Patient Advocacy
The Susan G. Komen Breast Cancer Foundation
The Greater New York Hospital Association
The Memorial Sloan-Kettering Cancer Center (NY)
The National Association of Breast Cancer Organizations
The National Federation of Republican Women
The National Breast Cancer Coalition
The National Coalition for Cancer Research
The National Federation of Republican Women of Puerto Rico
The New Jersey Federation of Republican Women
The New York State Chapter of the American Cancer Society
The New York State Chapter of the American College of Obstetricians & Gynecologists
The New York State Medical Society
The Northern Metropolitan Hospital Association (NY)
The Oklahoma Federation of Republican Women
"1 in 9" -- The Long Island (NY) Breast Cancer Action Coalition
The Strang-Cornell Prevention Center (NY)
As of C.O.B. 4/15/97
News from
Congresswoman Sue Kelly
The Women's Health & Cancer Rights Act of 1997..
Sponsors & Co-Sponsors
To date, here is a complete listing of both the Senate and House sponsors and co-sponsors of the
Women's Health & Cancer Rights Act of 1997, H.R. 616:
U.S. Senate -
Original Sponsors:
Sen. D'Amato (R-NY)
Sen. Feinstein (D-CA)
Sen. Hollings (D-SC)
Sen. Snowe (R-ME)
Co-Sponsors (15):
Sen. Biden (D-DE)
Sen. Hatch (R-UT)
Sen Cochran (R-MS)
Sen. Inouye (D-HI)
Sen. Dodd (D-CT)
Sen. Kerrey (D-NE)
Sen. Domenici (R-NM)
Sen. Moseley-Braun (D-IL)
Sen. Faircloth (R-NC)
Sen. Moynihan (D-NY)
Sen. Ford (D-KY)
Sen. Murkowski (R-AK)
Sen. Gregg (R-NH)
Sen. Smith (R-NH)
Sen Wellstone (D-MN)
U.S. House of Representatives -
Original Sponsors:
Rep. Kelly (R, NY-19)
Rep. LoBiondo (R, NJ-2)
Rep. Molinari (R, NY-13)
Co-Sponsors (80):
Rep. Ackerman (D, NY-5)
Rep. King (R, NY-3)
Rep. Andrews (D, NJ-1)
Rep. Kleczka (D, WI-4)
Rep. Bachus (R, Al-6)
Rep. LaFalce (D, NY-29)
Rep. Baldacci (D, ME-2)
Rep. Lampson (D, TX-9)
Rep. Barrett (D, WI-5)
Rep. Lazio (R, NY-2)
Rep. Bilbray (R, CA-49)
Rep. Lofgren (D, CA-16)
Rep. Bishop (D, GA-2)
Rep. Martinez (D, CA-31)
Rep. Brown (D, FL-3)
Rep. McCarthy (D, NY-4)
Rep. Julia Carson (D, IN-10)
Rep. McIntyre (D, NC-7)
Rep. Christian-Green (D, VI-At Large)
Rep. McNulty (D, NY-21)
Rep. Condit (D, CA-18)
Rep. Meek (D, FL-17)
Rep. Cooksey (R, LA-5)
Rep. Morella (R, MD-8)
Rep. Crapo (R, ID-2)
Rep. Myrick (R, NC-9)
Rep. Danner (D, MO-6)
Rep. Ney (R, OH-18)
Rep. Davis (D, IL-7)
Rep. Olver (D, MA-1)
Rep. Davis (R, VA-11)
Rep. Pallone (D, NJ-6)
Rep. Deal (R, GA-9)
Rep. Pappas (R, NJ-12)
Rep. Dellums (D, CA-9)
Rep. Pascrell, Jr. (D, NJ-8)
Rep. Dunn (R, WA-8)
Rep. Price (D, NC-4)
Rep. English (R, PA-21)
Rep. Quinn (R, NY-30)
Del. Faleomavaega (D, AS-At Large)
Rep. Rahall (D, WV-3)
Rep. Filner (D, CA-50)
Rep. Rangel (D, NY-15)
Rep. Flake (R, NY-6)
Rep. Riggs (R, CA-1)
Rep. Forbes (R-NY-1)
Rep. Rivers (D, MI-13)
Rep. Foley (R, FL-16)
Del. Romero-Barcelo (D, PR-At Large)
Rep. Ford (D, TN-9)
Rep. Roukema (R, NJ-5)
Rep. Fox (R, PA-13)
Rep. Sanders (I, VT-At Large)
Rep. Frost (D, TX-24)
Rep. Saxton (R, NJ-3)
Rep. Ganske (R, IA-4)
Rep. Shaw (R, FL-22)
Rep. Gibbons (R, NV-2)
Rep. Slaughter (D, NY-28)
Rep. Gilman (R, NY-20)
Rep. Smith (R, NJ-4)
Rep. Gordon (D, TN-06)
Rep. Smith (D, WA-9)
Rep. Granger (R, TX-12)
Rep. Stabenow (D, MI-08)
Rep. Green (D, TX-29)
Rep. Sununu (R, NH-01)
Rep. Gutierrez (D, IL-4)
Rep. Traficant (D, OH-17)
Rep. Hinchey (D, NY-26)
Rep. Walsh (R, NY-25)
Rep. Holden (D, PA-6)
Rep. Watt (D, NC-12)
Rep. Horn (R, CA-38)
Rep. Weller (R, IL-11)
Rep. Jackson-Lee (D, TX-18)
Rep. Wolf (R, VA-10)
Rep. Kildee (D, MI-9)
Rep. Yates (D, IL-9)
As of c.o.b. 5/6/97
Oklahoma Federation of Republican Women
March 11, 1997
PRESIDENT
The Honorable Sue W. Kelly
Nancy L. Stirman
United States House of Representatives
1222 Longworth Building
Washington, DC. 20515
FIRST VICE
PRESIDENT
My dear Ms. Kelly,
Patty Bryant
2631 S. Florence Drive
There probably isn't one family in America that hasn't been affected
Tulsa, OK 74114
in some way, at one time or another, by the dreaded disease of
SECOND VICE
breast cancer.
PRESIDENT
Margaret Jolley
The passage of the Women's Health and Cancer Rights Act of 1997 is
2312 Mansfield
a bipartisan and moral obligation of each elected Congressional
Del City, OK 73115
delegate in Washington DC.
THIRD VICE
Members of the Oklahoma Federation of Republican Women join me in
PRESIDENT
support and endorsement of H.R. 616. We strongly believe in
Myrna Nelson
individual rights and the control of ones own life. The preserva-
Rt. 2. Box 249
tion of doctor and patient decisions made to ensure high quality
McLoud, OK 74851
medical care is an individuals right.
SECRETARY
Pat Tautfest
I am hand delivering this letter today to your office with signa-
800 N. Markwell
tures of members of the Oklahoma Federation of Republican Women that
Moore, OK 73160
wish to expedite their support for this legislation and request
Oklahoma Congressional support of H.R.616.
TREASURER
Cathy Stephens
Sincerely,
1809 Woodland Road
Edmond, OK 73013
PAST PRESIDENT
Irma Losey
Nancy K. Stirman
State President
CLUB PRESIDENTS
AT LARGE
Pat Braswell
Helen Helen S. 8.7ay Fay
Esther Rose
Jan Collins
Wanda Herring
felleen Palmer
Colleen Palmer
DISTRICT DIRECTORS
Jean Eyler
Doris Selvidge
Vicki Ryker
Jeannine Marjorie Long Cook Cook
Vicki Ryker
Elaine Garland
Colleen Palmer
Grace Hickman
Jane Jones Jan Jones
Patty Schimmer
Marguerite Elliott
Doris Selvidge
Pat Braswell Pat Braswell
Doris Selvidge
CC: Oklahoma Congressmen: Don Nickles, Jim Inhofe, Steve Largent,
Tom Coburn, Wes Watkins, J.C. Watts, Ernest Istook, Frank Lucas
1203 Pecan Street
Perry, Oklahoma
(405) 336-2392
336-5020
73077
AMERICAN
CANCER
SOCIETY®
April 7, 1997
Representative Sue Kelly
U.S. House of Representatives
Washington, D.C. 20515
Dear Representative Kelly:
On behalf of the American Cancer Society, I applaud your leadership in introducing the
"Women's Health and Cancer Rights Act of 1997." This bill, which expands hospital coverage
for women undergoing treatment for breast cancer, and provides coverage for breast
reconstruction and second opinions, is an important step in improving the quality of care for
patients with cancer.
Breast cancer will affect more than 180,000 women this year alone. Taking into account the
medical situation and the patient's preferences, treatment may involve full or partial removal of
the breast, radiation therapy, chemotherapy, hormone therapy, or some combination of several
therapies. It is the American Cancer Society's position that all decisions regarding treatment
should be made by the woman and her physician based on what is medically appropriate. Like
you, we strongly oppose arbitrary limits on available services, including limits on hospital stays
and breast reconstruction, that are put in place by some health plans.
As you move forward on this bill, we hope you and your colleagues will also take this opportunity
to address some of the larger quality of care problems that are becoming more prevalent as our
nation moves to a managed care based health delivery system. Providing patients with full
disclosure of plan policies on treatment, eliminating gag clauses, strengthening utilization review
standards, and providing comprehensive grievance procedures are just some of the remedies that
are needed. We urge you to push for Congressional hearings at the earliest possible date to
address these and other concerns with managed care.
Sincerely,
Linda Hay Crawford
National Vice-President
for Federal and State Government Relations
316 PENNSYLVANIA AVE., S.E., SUITE 200, WASHINGTON, DC 20003-1146
202-546-4011
FAX 202-546-1682
of
COLLEGE
OBSTETRICIANS
AND
AMERICAN
1951
THE
HEALTH CARE PHYSICIANS
March 25, 1997
The Honorable Sue Kelly
1037 Longworth House Office Building
Washington, DC 20515
Dear Representative Kelly:
On behalf of the American College of Obstetricians and Gynecologists (ACOG), an
organization representing more than 37,000 physicians dedicated to improving women's
health, I am writing to express appreciation for the leadership role you are playing in the
105th Congress in addressing the needs of women suffering from breast cancer.
Introduction of HR 616, the "Women's Health and Cancer Rights Act of 1997," is a
major step toward assuring that women and families, who are fighting breast cancer,
don't also have to fight their insurer to obtain the care recommended by their physician.
ACOG strongly supports the three major components of this legislation: 1) assuring that
women have insurance coverage for hospital stays following mastectomies. as
recommended by their physicians. 2) guaranteeing coverage of reconstructive surgery for
mastectomy patients, and 3) providing insurance coverage for second opinions from
appropriate specialists for either positive or negative cancer diagnosis. As the only
physicians group that serves women exclusively. ACOG is committed to protecting the
unique concerns and health care needs of women. Your bill does just that We look
forward to an opportunity to work with you to protect women's health.
Sincerely,
Executive Director
THE AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS
WOMEN'S HEALTH CARE PHYSICIANS
409 12TH STREET SW WASHINGTON DC 20024-2188
MAILING ADDRESS: PO BOX 96920 WASHINGTON DC 20090-6920
202/638-5577
70/20'd
STATE
HOMEN
The Susan G. Komen
Breast Cancer Foundation
FOUNDATION
National I leadquarters
February 21, 1997
The Honorable Sue W. Kelly
United States House of Representatives
Washington, DC 20515
Dear Representative Kelly:
The Susan G. Komen Breast Cancer Foundation applauds the initiative you and your
colleagues have demonstrated in introducing the "Women's Health and Cancer Rights
Act of 1997." The Komen Foundation comprises volunteers in 38 states, numbering
approximately 14,000. We have polled our volunteer leadership, which wholeheartedly
supports and applauds this legislation. Women and their health care providers are those
best able to make decisions about their treatments, including timing required for
procedures and recovery. This decision process should not be limited arbitrarily by
economic factors. Mastectomy and lymph node removal are major procedures with
abundant potential side effects. Ensuring adequate length of hospital stay will help
diminish side effects, providing substantive medical benefits for women undergoing
mastectomy and lymph node removal for the treatment of breast cancer.
Further, ensuring that reconstruction is covered by third-party payors is critical. It is
important that women who choose reconstruction have that coverage within their health
insurance benefits, and that this coverage not be limited to reconstruction procedures that
are performed at the time of the mastectomy.
We appreciate your concern for American women with breast cancer. The Komen
Foundation does not believe that legislation of specific healthcare benefits is the first or
best course of action to be pursued. In this instance, however, the coverage policies of
many third-party payors have been detrimental to the health and well-being of women
with breast cancer, the most prevalent cancer among women in this country.
Thank you again for your support.
Sincerely,
Diana Rawden
President/CEO Susan G. Braun
Diana Rowden
Chairman of the Board
5005 LBJ Freeway Suite 370 Dallas, Texas 75244 972.385.5000 fax 972.385.5005
TOTAL P.02
AMERICAN
CANCER
SOCIETY
KERRIE B WILSON
National vice President
Government Relations
January 30, 1997
Senator Alfonse 'Amato
United States Senate
Washington, D.C. 20510
Dear Senator D'Amato.
On behalf of the American Cancer Society, I applaud your leadership in introducing the
"Women's Health and Cancer Rights Act of 1997." This bill, which expands hospital coverage
for women undergoing treatment for breast cancer, provides coverage for breast reconstruction,
and ensures coverage for second opinions, is an important step in improving the quality of care for
patients with cancer.
Breast cancer will affect more than 180,000 women this year alone. Taking into account the
medical situation and the patient's preferences, treatment may involve full or partial removal of
the breast, radiation therapy, chemotherapy, hormone therapy, or some combination of several
therapies. It is the American Cancer Society's position that all decisions regarding treatment,
including length of hospital stay, should be made by the woman and her physician based on what
is medically appropriate. Like you we strongly oppose arbitrary limits on available treatments,
including limits on hospital stays and breast reconstruction, that are put in place by some health
plans.
As you move forward on your bill, we hope you and your colleagues will also take this
opportunity to address some of the larger quality of care problems that are becoming more
prevalent as our nation moves towards a managed care based health delivery system. Providing
patients with full disclosure of plan policies on treatment, eliminating gag clauses, strengthening
utilization review standards, and providing comprehensive grievance procedures are just some of
the remedies that are needed. We urge you to push for Congressional hearings at the earliest
possible date to address these concerns as well as those related to outpatient mastectomies.
Again, thank you for your efforts on behalf of patients with cancer.
Sincerely,
Kerrie Wilson
Kerrie Wilson
NSYLVANIA AVE., S.E., SUITE 200. WASHINGTON, DC 20003-1146
202-546-4011
FAX 202-546
AMERICAN
CANCER
SOCIETY
NEW YORK STATE PUBLIC AFFAIRS OFFICE
January 15, 1997
VIA FAX
The Hon. Alfonse D'Amato
Room 520, Hart Senate Office Building
Washington, DC 20510
Dear Senator D'Amato:
On behalf of the American Cancer Society, I applaud your recently announced legislation to expand
patient's access to cancer detection and treatment. As you know, the diagnosis of cancer can be
devastating - not only must patients confront an array of medical decisions, they must deal with the
financial and emotional burdens as well.
We support the immediate focus of your proposal: eliminating outpatient mastectomy, ensuring that
second opinions are available to patients facing a diagnosis of breast, prostate, or colon cancer and
requiring coverage for reconstructive surgery following a mastectomy. Further, it is the American
Cancer Society's position that all decisions regarding treatment, including length of hospital stay,
should be made by a patient and his/her physician. Like you, we strongly oppose the arbitrary
limitation of available treatments for patients with cancer, including limits on hospital services that
are put into some health plans.
Again, we thank you for taking leadership on issues that are critical to cancer patients. The
American Cancer Society has over 200,000 volunteers throughout the state of New York who work
in partnership with staff to further our mission We look forward to working with you and your staff
to see that this legislation in enacted.
Sincerely,
Martha McNeil
Director of Public Affairs
1450 Western Ave., Albany, New York 12203-3539 (518) 438-9327 FAX: (518) 438-9608
REPRESENTING THE NEW YORK STATE. LONG ISLAND, NEW YORK CITY. QUEENS AND WESTCHESTER DIVISIONS
FOR INFORMATION ABOUT CANCER 1-800-ACS-2345
FEB 14 '97 56PM AMERICAN MEDICAL ASSOCIATION WDC
American Medical Association
MEDICAL
Physicians dedicated 10 the health of America
P. John Seward, MD
515 North State Street.
312 464-5000
Executive Vice President
Chicago, Illinois 60610
312 464-4134 Fax
February 14, 1997
The Honorable Alfonse D'Amato
United States Senate
520 Hart Senate Office Bldg.
Washington, DC 20510
Dear Senator D'Amato:
On behalf of the American Medical Association (AMA), I am writing to express our
appreciation and support for your bill, the "Women's Health and Cancer Rights Act of
1997," (S.249/H.R.616). The AMA is gratified that this legislation endorses the
fundamental concept that medical decisions should be made by patients and their
physicians rather than by insurers or legislators. The AMA will be working throughout
the 105th Congress to advance additional, comprehensive patient protections.
We applaud your bi-partisan efforts aimed at providing coverage for reasonable cancer
treatment. Decisions about hospital lengths of stay and other medical matters must reside
with patients and physicians. Similarly, decisions must be influenced by the facts and
circumstances affecting individual patients. In this regard, we agree that the interests of
patients must come before the interests of insurance companies.
The AMA will work to ensure that appropriate decision-making is left in the hands of
patients and physicians. We look forward to working with you on a swift and positive
outcome for this legislation.
Sincerely,
P. John Seward, MD
150
Years of Caring for the Country
1847 . 1997
New Jersey Federation of Republican Women, Inc.
Affiliated With National Federation of Republican Women
est. 1929
PRESIDENT
Theresa E. Nagel
(908) 671-3538
JOHNEY REPUBLICAN JERSEY
April 10, 1997
IMMEDIATE
PAST PRESIDENT
Grace Scaduto
The Honorable Sue Kelly
FIRST VICE
PRESIDENT
1222 Longworth House Office Bldg.
Barbara Woodhull
Washington, D.C. 20515
REGIONAL VICE
PRESIDENTS
Dear Congresswoman Kelly:
Region 1
Nancy Knapp
Region 2
On behalf of the New Jersey Federation of Republican
Madeline
Carambio Women we are pleased to express our support for your
legislation, entitled the Women's Health and Cancer Rights
Region 3
Act of 1997. This legislation is especially important to our
Joan Roman
membership which is 100 percent female, with members who have
Region 4
personally been through these procedures.
Nancy Steele
We applaud your bi-partisan efforts aimed at providing coverage
Region 5
for reasonable cancer treatment. Decisions about hospital
Linda Pagliughi
lengths of stay and other medical matters must reside with
RECORDING
patients and physicians. Similarly, decisions must be
SECRETARY
influenced by the facts and circumstances affecting individual
Jeri Zayak
patients. In this regard, we agree that the interests of
patients must come before the interests of insurance
ASSISTANT
RECORDING
companies.
SECRETARY
Anne Richards
We congratulate you on your efforts, and look forward to
working with you to help secure passage of this important
CORRESPONDING legislation.
SECRETARY
Bea Cerkez
Sincerely,
TREASURER
Jo Joel
Theresa &. nagel
ASSISTANT
TREASURER
Ime
Theresa E. Nagel
Helen Macri
President
TEN/emo
"Politics Make it Possible, Women Make it Work."
173 Hamiltonian Drive
Red Bank, New Jersey 07701
Phone/Fax: (908) 706-1513
Carol Tarpey Executive Secretary
1896
1996
ADELPHI
UNIVERSITY
SCHOOL OF SOCIAL WORK
BREAST CANCER HOTLINE AND
SUPPORT PROGRAM
March 10, 1997
The Honorable Sue W. Kelly
U.S. House of Representatives
1222 Longworth House of Office Building
Washington, DC 20515
Dear Congresswoman Kelly:
On behalf of the Adelphi N.Y. Statewide Breast Cancer Hotline and Support Program, I am
writing to express our support for the "Women's Health and Cancer Rights Act of 1997.* We
are pleased that the bill supports a woman's right to make decisions in conjunction with her
physician regarding her treatment for breast cancer.
We believe that decisions regarding hospital lengths of stay following surgery be determined by
the patient and doctor, not the insurance companies. We also support a woman's right to have
the option of reconstructive surgery following a mastectomy and have it covered by her
insurance company. In addition, the requirement for insurer's to provide coverage for a second
opinion is both reasonable and essential.
The Adelphi N.Y. Statewide Breast Cancer Hotline and Support Program and the thousands of
men and women we service and represent applaud you for your efforts to introduce legislation
which focuses on ensuring appropriate and quality medical care for those dealing with breast
cancer.
Sincerely,
Hillary Rutter
Hillary Rutter, ACSW
Director, Adelphi N.Y. Statewide Breast Cancer
Hotline and Support Program
N.Y. STATEWIDE BREAST CANCER HOTLINE
ADELPHI UNIVERSITY
GARDEN CITY. NEW YORK 11530
HOTLINE: 800/877-8077
OFFICE: 516/877-4320
FAX: 516/877-4336
News From MSSNY
KORIMMEDIATR RELEASE
Contact:
Marc L. Kaplan
Phone:
(518) 465-8085
January 16, 1997
STATEMENT OF STANLEY L grossman, M.D.
PRESIDENT, MEDICAL SOCIETY OF THE STATE OF NEW YORK
"On behalf of the 30,000 physician members of the Medical Society d the State of New York
and on behalf also of our patients to whom we are all committed, I would like to commend
Senstor Alfonse M. 'Amato for the introduction of the crucial "Women's Health and Cancer
Rights Act of 1997." We would also like to thank Senate Majority Leader Joseph L. Bruno and
Assembly Speaker Sheldon Silver for their work toward this goal in New York State. We will
continue to work with our representatives in Washington and Albany to pass this legislation. We
believe that all health care decisions must be made by the patient and his or her physician. Along
with Senator Amato, Senstor Bruno, Speaker Silver and, of course, Governor Pataki who
specifically addressed this issue in his State of the State Message last week, we are committed to
maintaining a health care system which assures, to the greatest extent possible thet all of our
citizens will have access to the highest quality care."
- 30 -
Medical Society of the State of New York
One Commerce Plaza, Suite 2005
Albany, NY 12210
National Federation of Republican Women of Puerto Ríco
Miriam J Ramirez de Ferrer MD, President
Box 3225
email. [email protected]
Mayaguez P.R. 00681
Tel: (787) 834-0726
March 10,1997
Hon. Sue Kelly
US House Of Representatives
Washington DC
I received your letter dated February 27, regarding the Women's Health & Cancer Rights Act of
1997.
We praise your efforts regarding these important Women's health issues, and more so since I am a
physician and gynecologist.
Please be assured that you can rely on our full support for you initiative. We will contact our
Representative, the Honorable Carlos Romero Barcelo, in Congress and request him to co-sponsor
said legislation. We will make sure that he is aware of our support. Please contact Mr. Luis Baco in
his office for further assistance.
Yours Truly.
Miriam J. Ramirez MD
If I, or my group, can be of any additional help, please do not hesitate to contact me at:
Miriam J.Ramirez MD
Tel. & Fax : (787) 834-0726
PO Box 3225
email: [email protected]
Mayaguez, P.R. 00681
AANA
American Association of Nurse Anesthetists
January 16, 1997
Federal Government Affairs Office
The Capitol Hill Office Building
412 First Street, S.E., Suite 12
Washington, DC 20003
Phone:
(202) 484-8400
Fax:
(202) 484-8408
Honorable Sue Kelly
1222 Longworth HOB
Washington, D.C. 20515
Dear Congresswoman Kelly:
On behalf of the American Association of Nurse Anesthetists (AANA), we are pleased to
support your legislation, the Women's Health and Cancer Rights Act of 1997.
This legislation will go far to ensure that women with mastectomies will have a minimum
of 48 hours in the hospital to recover. In addition, the provisions which require insurers to
provide coverage for second opinions for breast, colon & prostate cancer diagnoses is a
reasonable requirement and will go far to enhance patients' rights.
We look forward to working with you as this legislation moves through Congress. Please
let us know how we may be helpful in your efforts.
Sincerely,
Drive E. Hls
David E. Hebert
Director of Federal Government Affairs
AMERICAN ASSOCIATION OF NURSE ANESTHETISTS . FEDERAL GOVERNMENT AFFAIRS OFFICE
The Capitol HIII Office Building, 412 1st Street, S.E., Suite 12, Washington, D.C. 20003
Telephone: (202) 484-8400 - Facsimile: (202) 484-8406
Northern Metropolitan
Hospital Association
400 Stony Brook Court
Newburgh. New York 12550-5162
(914) 562-7520
Dutchers County
FAX (914) 562-0187
Northern Dutchess Hospital
Rhunebeck
St. Francis Hospital
Poughkeepsic
Vassar Brothers Hospital
Poughkorpuie
Venerans Administration Medical Center
February 21, 1997
Castle Parat
Orange County
Andee Hill Hospital
Goshen
The Correal Hospital
Cornwall
Hortos Memorial Hospital
Honorable Sue W. Kelly
Middletons
Ketier Artn Community Hospital
U.S. House of Representatives
West Poax
Mercy Community Hospital
Room 1222 LOB
Port lens
St. Anthom Community Hospital
Washington DC 20515
Warwice
SL Luke's Hospital
Newburg:
Putners Commy
Ju. 1 L. Butterfield Memorial Hospital
Dear Congresswoman Kelly:
Cold Spring
Pucnam Hospital Center
Carme:
Rockland Commy
On behalf of the hospitals in the 19th Congressional District of New York,
Good Samaritan Hospital
Suffero
we are pleased to express our support for your legislation, entitled the
He.co Haves Hospital
West Haverstraw
Women's Health and Cancer Rights Act of 1997.
Nyack Hospital
Novack
Sullivan County
Community General Hospital
Harris
This bill will help assure that the important treatment decisions, including
Unster County
Benedictine Hospital
the length of hospitalization, will be determined based on decisions made
Kingston
Elserville Community Hospital
between a patient and the physician, rather than by insurance companies or
Ellenville
The Kingsteen Hospital
by legislative determination.
Kingsioe
Westchester County
Bivthedale Children's Hospital
Valballa
Burke Rehabilitation Center
We believe your bill will also enhance patient rights by requiring that the
White Plans
Community Hospital at Dobbs Ferry
insurer provide coverage for any reconstructive surgery which may be
Doobs Fem
FDR Veterans Administration Hospital
required, eliminating a barrier that has often discouraged women from
Montrose
Human Valey Hospital Center
seeking care early. Hopefully, this "patient first" approach will be instilled
Peckskill
Lawrence Hospital
in all aspects of public policy dealing with patient care.
Broaxvalk
The Mours Verson Hospital
Mount Verson
New Rochelie Hospital Medical Center
New Rechelle
We congratulate you on your efforts, and look forward to working with you
The New York Hospital-Cornell Medical
Center. Westchester Division
to help secure passage of this important legislation.
White Plans
Northern Westchester Hospital Center
Mt. Kinc:
Photos Memorial Hospital Center
Sincerely,
North Tarrytown
St. Agencs Hospital
White Plans
St. John's Riverside Hospital
Yonkers
St. Joseph's Medical Center
ActiEllitian
Yorkers
St. Vincent's Hospital & Medical Center
Arthur E. Weintraub
Westcheser Branch
Harrison
United Hospital Medical Center
President
Port Chester
" estcheam County Medical Center
Valhella
Whole Plans Hospital Center
White Plans
Yorkers General Hospital
AEW/lf
Yonkers
Artist E. Weistranb
President
NABCO
NATIONAL ALLIANCE
OF BREAST CAN( ER
ORGANIZATIONS
bounders
Pran. Plan MAA
February 21, 1997
Name banker
...
Barb spear
Medical Advisors Board
via facsimile: (202) 225-5441
Andrew Do: TD
Bernand Fisher MD
Ldwer Finile MD
The Honorable Sue W. Kelly
Ruth crobstein MD
U.S. House of Representatives
to Harris, MP
Samuel Hellman MD
1037 LHOB
Craig Henderson MD
Washington, DC 20515
Maureen M Henderson, M.D
limmie Holland MD
Craig Jordan Ph D pise
Dear Congresswoman Kelly:
Marc F. Lippman, MD
susan MD
Kenns Sheets MD
This letter is to clarify that the National Alliance of Breast Cancer Organizations is
Michael Osborne MD
pleased to support "The Women's Health & Cancer Rights Act of 1997". Please
William ? Peters MO Pup
Peter Pressman MP
feel free to list NABCO among your list of endorsing organizations. We have
Alan issued MP
previously submitted comments to your office regarding the exact provisions of the
Irma MD
lettres seniom MD
bill in our letter dated February 11th, and look forward to working with you and
Helene's Sands PHI
your staff on the proposal as it develops.
$17.1\ MD
Required Ziegler PICD
NABCO encourages legislative resolution to the problems of coverage denials for
Honorary Board
Felonades
hospitalization following breast cancer surgery, breast reconstruction and second
Penda
opinions. With your leadership, women with breast cancer and their supporters can
Beiened we
be hopeful about meaningful insurance reforms to assure them the type of insurance
cid
coverage they need and deserve.
'mon
Thank you again for your dedication to the breast cancer cause.
Hagher
lean
Sincerely,
Most.
From 3, Rose:
Sens P.....:
and selve
Lunkerly Calde
Board of Directors
Kimberly Calder, MPS
Valerie Salembier President
Associate Executive Director
Lou-Ellen Barkan
Robin Bell-Stevens
Betsy Carter
tudith R Haberson
Levine
N Harmon Mever-
Norton MD
Staniey Portinger
Ruth Spear
And Rubenstein Fisch
Revals Wurtzburge
Executive Director
Amv $ Langer
Associate Executive Director
Kimberly } Calde:
Founding Executive Director
Editor, NABC () News
Rush Spear
370 Street 10th Floor
New Yers New York 10010
212-889 Under The
212-7 719.01 :- Services
aup nabcolote
apTa
Physical there
Associate
1111 North Carrias Street
Mexandria 11 22314-1488
January 30, 1997
Marilyn Mottar P1 PhD EAPTA
PREMIDENT
The Honorable Sue Kelly
Colleen M Kigin " MPA PI
1222 Longworth House Office Building
in PRESENT
Washington, DC 20515
Ben F Masses PI
SECRETARY
Dear Congresswoman Kelly:
David W Perry. MS. PT
TREASURER
On behalf of the American Physical Therapy Association (APTA), we are pleased to
Andrew Guecione PhD PI
support the legislation, the Women's Health and Cancer Rights Act of 1997. This
NUMBER How
legislation is especially important to a membership such as ours which is
Pamela Duth PT
approximately 70% female. APTA is the national professional association representing
Val
more than 72,000 physical therapists, physical therapist assistants, and students of
physical therapy.
James Ball MA P!
This legislation will go far to eliminate "drive-by" mastectomies and ensure that
women with mastectomies will have a minimum of 48 hours in the hospital to recover.
Samuel " Brown. PT
In addition, the provisions which require insurers to provide coverage for second
Paincia No Adim PI MEd
opinions for breast, colon and prostate cancer diagnoses is a reasonable requirement
Rodney \ Mivasaki. MA PT
and will go far to enhance patients' rights
junk Richardson Pi PhD ocs
We look forward to working with you as this legislation moves through Congress.
Randy Roesch PI MBA
Please let us know how we may be helpful in your efforts.
Javan Snyder MA PT
Sincerely,
I I Scott Stephens MS PT
Francis J. Welk. PT MEd
Nancy Garland
Francis Mallon E-4
Director, Government Affairs
PT
NG/lcw
, ou- COMBINED HONS
MEETING
Datas
PHYSIC THERAPY -
SCIENTIFR METING
& EXPOSITION
Mas Vi-June 100.
un Diego Cultornia
Neil Kahanovitz. MD.
Terre McFillen Hall
President and Founder
Executive Director
CENTER FOR
PATIENT ADVOCACY
January 28, 1997
The Honorable Sue Kelly
1222 Longworth House Office Bldg.
Washington, DC 20515
Dear Congresswoman Kelly:
We are writing to express our support for the "Women's Health & Cancer Rights Act
of 1997." This legislation is urgently needed to guarantee protections for millions of
American women afflicted with breast cancer.
First, the bill removes a barrier that has discouraged many women from participating
in vital early breast cancer detection programs by requiring insurers to cover reconstructive
procedures. The bill also helps to assure high quality patient care by guaranteeing that
patients have access to a second opinion from the provider of their choice. Finally, and most
important, the bill empowers patients and their doctors, not insurance company officials, with
the decisions affecting their health care.
While the Center supports the efforts of all Members of Congress who have introduced
similar mastectomy stay legislation, we strongly believe that unified support behind your
legislation is necessary to realize the common goal of ensuring quality health care for
American women.
We applaud your efforts to protect the health of American women and look forward to
working with you to secure passage of the Women's Health & Cancer Rights Act of 1997.
Sincerely,
Filky
All
Neil Kahanovitz, M.D.
Terre McFillen Hall
President and Founder
Executive Director
"Working for Quality Healthcare in America"
1350 Beverly Road
Suite 108
McLean Virginia 22101
(703) 748-0400
Fax (703) 748-0402
800-846-7442
January 14, 1997
Representative Sue W. Kelly
U.S. House of Representatives
1222 Longworth House Office Building
Washington, D.C. 20515-3219
RESEARCH
Dear Representative Kelly:
On behalf of the National Coalition for Cancer Research
(NCCR), I would like to thank you for sending us information
about your legislation, the "Women's Health and Cancer
Albert and Mary
Lasker Foundation
Rights Act of 1997." We agree that medical decisions should
be made by doctors, not by insurance companies. We also
Amer Association
for Cancer Education
share your concern about the impact of managed care on the
quality of care for persons with cancer. You are to be
American Association
am Cancer Research
commended for your commitment to improving the care of women
with breast cancer.
American Cancer
Sixty. inc
Established in 1986, the NCCR is a nonprofit
American Society for
Trerapeutic Radiology
organization comprised of national organizations in the U.S.
and Oncology
dedicated to the eradication of cancer. Its mission is to
support public education efforts which communicate the value
American Society of
Hematology
of cancer research to progress against cancer, and to ensure
adequate funding for a balanced National Cancer Program to
American Society
Pediatric
conduct research to improve cancer prevention, detection,
Hematology-Oncology
and treatment. The NCCR focuses its efforts on educating
Association A Answern
policy makers and members of the general public about the
Cancer Institutes
vital importance of cancer research and how cancer research
Association or Pediatric
positively impacts the lives of most Americans.
Oncology Nurses
Currently, eighteen national organizations belong to
Cancer Research
Foundation of America
the NCCR representing:
Candlelighters
Tens of thousands of cancer survivors and their
Childhood Cancer
Foundation
families;
40,000 children with cancer, as well as their
Cap CURE
Association for the Cure
parents, and brothers and sisters;
of Cancer of the Prostate
45,000 cancer researchers, nurses, physicians, and
health care workers; and
FACT: Families
Agamst Cancer. Inc.
82 cancer research centers.
publicly-supported non-profit organizations which
Oniology Nursing
Society
provide patient services, research grants, and
education
Relistion Research
Swity
patient advocacy groups dedicated to fostering a
broad-based public and governmental commitment to
The Society of
Gynecologic
the well-being of persons with cancer
Oncologists
The
G Komen
Brost Cannit
Foundation
The V Foundation for
Cancer Research
42n C STREET, N.E.
WASHINGTON, DC
20002
(202) 544-1880
as 543-2565 FAX
Again, thank you for your commitment to all those affected
by breast cancer. Please feel free to call me or Marguerite
Donoghue, NCCR's Deputy Executive Director, at (202) 544-1880 if
we may be of assistance to you as the 105th Congress continues to
address important legislative issues.
Sincerely,
abbert Jd Owens
Albert H. Owens, Jr., M.D.
President
Daniel Sisto, President
Volume 29, Number 5
January 31, 1997
HANYS MEETS WITH SENATOR D'AMATO;
ENDORSES HIS CANCER LEGISLATION
HANYS President Daniel Sisto met with Senator Alfonse
D'Amato (R-NY) in Washington, D.C. on January 28 to
discuss federal issues concerning New York State's health
care providers. The Senator expressed his commitment to
addressing the needs of health care providers across the State,
particularly with regard to protecting New York from the
redistribution of Medicare and Medicaid funds to other states
and from budget cuts that unfairly affect New York State.
There also was discussion of HANYS' opposition to the
President's proposal to implement a per capita cap on
Medicaid spending.
During the meeting, HANYS endorsed legislation introduced
by Senators D'Amato, Dianne Feinstein (D-CA), and Olympia
Snowe (R-ME) which would protect women's rights to
hospital care for breast removal and associated surgery,
including breast reconstruction, and guarantee all cancer
patients the right to a second medical opinion. The legislation
is an improvement over the federal and State legislation
granting women minimum lengths of inpatient care for
childbirth in that it does not set limits on the length of stay for
breast surgery cases.
The Women's Health and Cancer Rights Act of 1997 will be
introduced in the House of Representatives early next week by
Representatives Susan Molinari (R-Staten Island), Sue Kelly
(R-Katonah), and Frank LoBiondo (R-NJ). In addition, to
date, nine other New York Representatives have signed onto
this legislation as co-sponsors including Gary Ackerman (D-
Queens), Floyd Flake (D-Queens), Michael Forbes (R-
Shirley), Peter King (R-Massapequa Park), Rick Lazio (R-
Babylon), Carolyn McCarthy (D-Mineola), Michael McNulty
(D-Green Island), Louise Slaughter (D-Rochester), and James
Walsh (R-Syracuse).
Senator D'Amato is scheduled to visit Strong Memorial
Hospital in Rochester on February 1. While at Strong, the
Senator will hold a press conference at the facility's cancer
center to discuss the HANYS-endorsed cancer treatment
legislation. HANYS also supports similar legislation that will
be introduced in the State Legislature by Assembly Speaker
Sheldon Silver (D-Manhattan) and Senate Majority Leader
Joseph Bruno (R-Brunswick).
- Steven Kroll
74 NORTH PEARL STREET
ALBANY, NEW YORK 12207
518-431-7600
Ullasbington, DC 20515
END THE PRACTICE OF "DRIVE-THROUGH" MASTECTOMIES!
Cosponsor the Women's Health & Cancer Rights Act of 1997
January 8, 1997
Dear Colleague:
We are joining together in a bipartisan effort to introduce legislation to improve services provided to women experiencing
the trauma of a breast cancer diagnosis, and every American faced with the possibility of cancer. We ask you to join us
in this important endeavor.
In the United States today, there are at least 2.6 million women living with breast cancer and more than 180,000 wives.
mothers and daughters were diagnosed with the disease this year alone. Tragically, some women who must undergo
mastectomies and lymph node dissection for the treatment of breast cancer are rushed through the procedure on an "out-
patient" basis M the insistence of their insurance companies just to cut costs. Insurance companies also cut costs by denying
coverage for reconstructive surgery as well as follow-up procedures because they are deemed "cosmetic". Ironically.
insurance companies do not deny reconstructive surgery for an our that is lost to cancer.
We write to you today to ask that you join us in cosponsoring the Women's Health & Cancer Rights Act of 1997. a
that places medical decisions where they belong - with physicians and patients. The fisasure would require that a health
plan that provides medical and surgical benefits for the treatment of breast cancer guarantee at least 48 hours of in-patient
care following a mastectomy or a lymph node dissection, and longer if the patient and physician feel it is medically
appropriate.
The bill also ensures that all mastectomy patients have reconstructive surgery paid for, including symmetrical
reconstruction. A recent survey found that 43% of the respondents had been denied coverage for follow-up reconstructive
symmetry procedures.
The Women's Health & Cancer Rights Act also includes a unique provision for coverage of second opinions by specialists.
The bill would require health care providers to pay for secondary consultations when cancer tests come back either negative
or positive, giving all cancer patients the benefit of a second opinion. This important provision will not only help ensure
that false negatives are detected, but also give men and women greater peace of mind.
Please nelp us to ensure that breast cancer victims and cancer patients get the care they deserve by avoiding the careless
outcomes of decisions based on simple economics instead of good medicine. If you would like to cosponsor this critical
legislation, please contact Kraig Siracuse with Senator D'Amato at 224-6542, Conwell Smith in Rep. Sue Kelly's office
at 5-5441, Jennifer Prazmark of Rep. Susan Molinari's staff at 5-3371, or Carl Thorsen with Rep. Frank LoBiondo's office
at 5-6572.
Eucan Molinari
afflumato
Susan Molinari
Alfonse M. D'Amato
Member of Congress
U.S. Senate
Sun Kelly See W. Kelly
Showe Auan
Olympia J.
Member of Congress
U
enate
Frank A. LoBiondo
Emest U.S. Schere Houses Holly
Member of Congress
Floyd Flake
Gery Ackerman
Member of Congress
Member of Congress
Nathan Deal
Nathan Deal
Member of Congress
Peter T. King
Member of Congress
SUE W. KELLY
19TH DISTRICT, New York
Congress of the United States
House of Representatives
Blashington, DC 20515-3219
January 22, 1997
END THE PRACTICE OF "DRIVE-THROUGH" MASTECTOMIES!
Cosponsor the Women's Health & Cancer Rights Act of 1997
Dear Colleague:
In the United States today, there are at least 2.6 million women living with breast cancer more than 180,000 women
were diagnosed with the disease in 1996 alone. Women facing the personal anxiety of living with breast cancer should
feel confident that their medical treatment is in the hands of physicians - not insurance companies.
Tragically, some women who must undergo mastectomies, lumpectomies or lymph node dissection for the treatment of
breast cancer are rushed through their recovery from these procedures on an "outpatient" basis at the insistence of their
health plan or insurance company in order to cut cost. Many insurance companies also cut costs by denying coverage
for reconstructive surgery, as well as coverage for follow-up procedures because they are deemed "cosmetic". Ironically,
they do not deny reconstructive surgery for an ear that is lost to cancer.
The Women's Health and Cancer Rights Act of 1997 places medical decisions where they belong -- with physicians and
patients. This measure guarantees coverage for inpatient hospital care following a mastectomy, lumpectomy, or lymph
node dissection (based on a doctor's judgement), requires coverage for reconstructive procedures, ensures a second
opinion for any cancer diagnosis and offers significant physician protections from inducement or retribution.
The Women's Health & Cancer Rights Act of 1997
Cosponsor List
Rep. Sue Kelly (R-NY-19)
Rep. Susan Molinari (R-NY-13)
Rep. Frank LoBiondo (R-NJ-02)
Rep. Floyd H. Flake (D-NY-06)
Rep. Gary L. Ackerman (D-NY-05)
Rep. Peter T. King (R-NY-03)
Rep. Constance Morella (R-MD-08)
Rep. Nathan Deal (R-GA-09)
Rep. Jim Saxton (R-NJ-03)
Rep. Rick A. Lazio (R-NY-02)
Rep. Chris Smith (R-NJ-04)
Rep. Jon Fox (R-PA-13)
Rep. Robert E. Andrews (D-NJ-01)
Rep. Frank Pallone (D-NJ-06)
Rep. James T. Walsh (R-NY-25)
Rep. Martin Frost (D-TX-24)
Rep. Phil English (R-PA-21)
Rep. Frank Wolf (R-VA-10)
Please help us to ensure that breast care patients get the care they deserve by avoiding the careless outcomes of decisions
based on simple economics instead of good medicine. If you would like to cosponsor this critical legislation, please
contact Conwell Smith (Rep. Sue Kelly) at 5-5441, Jennifer Prazmark (Rep. Susan Molinari) at 5-3371 or Carl Thorsen
(Rep. Frank LoBiondo) at 5-6572.
Sincerely,
Ru Kelly Member of Congress Kelly
Sunn Molinari
Th A. RoBiendo
SUE W. KELLY
SUSAN V. MOLINARI
FRANK A. LoBIONDO
Member of Congress
Member of Congress
PRINTED ON RECYCLED PAPER