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R.I. House passes bill mandating insurance coverage for mastectomies

Providence Journal - 6/20/2018

June 20--PROVIDENCE, R.I. -- House Majority Leader K. Joseph Shekarchi made it his personal mission to pass legislation that would spare women from getting surprise medical bills after a mastectomy.

He tried last year without success in the face of heavy opposition from the insurance industry. He tried again this year, and the House on Tuesday unanimously approved a reworked version of his bill.

The legislation headed to the Senate removes these words from current law: "Nothing in this section shall be construed to require an individual or group policy to cover the surgical procedure known as mastectomy or to prevent application of deductible or co-payment provisions contained in the policy or plan."

Shekarchi said he introduced the legislation on behalf of the breast-cancer survivors whose stories he heard, and who were stunned by the thousands of dollars in unexpected bills that followed them out of the hospital.

"This bill makes it clear that insurers must cover all of the costs of mastectomies, without copays and deductibles," Shekarchi said. "Breast cancer is a very emotional cancer, one that can leave even those who fight it very successfully with a tremendous feeling of loss. That loss should not be compounded by struggles to pay for their treatment, heal and recover their lives."

The state's Health Insurance Commissioner Marie Ganim raised a note of caution in the written testimony she provided lawmakers in April. She wrote; 'This bill could potentially pose unintended consequences for other health insurance costs, such as increased premiums across the board or increases in other patient co-sharing obligations."

Similarly, Blue Cross & Blue Shield of Rhode Island told lawmakers it "recognizes the extraordinary toll breast cancer can take on patients and their families," but said the legislation would increase the overall cost of insurance "by mandating that one condition be covered differently and more expensively than other conditions."

"The bill positions patients with this type of serious illness above patients with other significant medical conditions," the company noted.

Objections -- and statements of concern -- also streamed in from lobbyists for America's Health Insurance Plans and the Rhode Island Business Coalition, which urged the lawmakers to determine the potential cost to consumers and businesses as state law requires before hitting the insurers with any new mandates.

The Rhode Island Academy of Physicians Assistants lauded the bill, which specifically acknowledges the role that physicians' assistants play in much of the postoperative care women receive. Other supporters include the American Cancer Society'sRhode Island chapter and the Gloria Gemma Breast Cancer Resource Foundation, according to a legislative press release.

Cosponsors of the bill include Reps. Edith H. Ajello, D-Providence; Teresa Tanzi, D-South Kingstown; Kathleen A. Fogarty, South Kingstown; and Charlene M. Lima, D-Cranston.

Shekarchi said the Senate has not, at this point, committed to passing the bill, but he had a meeting scheduled with his fellow Warwick Democrat, Senate Majority Leader Michael McCaffrey, on Wednesday afternoon to make his case for the bill and others.

Asked, in the language of the State House, what he was willing to trade the Senate to pass his bill, he said: "My right arm."

According to a legislative press release, Rhode Island law has had some requirements about what insurance coverage for mastectomies must include since 2005, but the law stopped short of actually requiring that insurers cover the procedure.

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(c)2018 The Providence Journal (Providence, R.I.)

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