Advocates Hopeful That Lawmakers Will Approve Hospital Stay Coverage Mandates For Breast Cancer Patients

Main Category: Breast Cancer
Also Included In: Public Health;  Health Insurance / Medical Insurance
Article Date: 13 Mar 2008 - 5:00 PDT

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Congress has been "slow to act" on legislation (HR 758, S 459) that would require health insurers to cover hospital stays after a mastectomy, lumpectomy or lymph node dissection, but advocates "are hoping that with Democrats controlling Congress, the measure might finally be approved," the Chicago Tribune reports. The legislation would mandate that health plans cover hospital stays up to 48 hours after a mastectomy or lumpectomy and up to 24 hours after a lymph node dissection. The bill would not require a minimum stay time, but it would require insurers to inform policyholders of the benefit. According to the American College of Surgeons, the industry standard for hospital stays after a patient undergoes a mastectomy is a minimum of one night.

The House bill has 217 co-sponsors, and the Senate version has 18. Representatives from the office of Rep. Rosa DeLauro (D-Conn.), who introduced the House measure, said the lawmaker is "cautiously optimistic" about the bill's chances this year. Twenty states have laws that limit outpatient mastectomies. Where the state law is stricter than the proposed federal law, the state law would apply, according to legislation.

Christine Laronga, chief of the Comprehensive Breast Program at H. Lee Moffitt Cancer Center & Research Institute, said she would consider allowing a patient to have an outpatient mastectomy only if the person has had the procedure before. She added that most people who have a mastectomy stay one night, while a woman who has a mastectomy with reconstructive breast surgery stays at the hospital for two to five days on average.

Mohit Ghose of America's Health Insurance Plans said research has found that outpatient mastectomies are successful in treating breast cancer. "If we can get people out of hospitals quicker, that's going to be a better thing," Ghose said, adding that because some diseases can spread in hospitals, it could be better for people to recover at home (Wyckoff, Chicago Tribune, 3/9).

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