Advocacy

Dr. Potter featured on The Breasties Instagram Live discussing Letter to stakeholders

The Breasties + Dr. Potter

Stakeholder DIEP Flap Letter

SIGN THE PETITION:

Patients, click here to sign the Petition to CMS to Reinstate Breast Reconstruction Surgery Code S2068 to protect access to DIEP Flap.

SEND THE BELOW LETTER TO YOUR PHYSICIANS:

Click this link to send the letter to your physicians to CMS to protect access to DIEP Flap through insurance.

April 19th Breaking News:

CIGNA has announced that it is delaying implementation of  their reimbursement policy for DIEP flaps. If you had DIEP flap surgery planned on or after March 12th, your claims will be remedied. This is a MAJOR win for patients.

THANK YOU to everyone that has joined this fight.

April 3rd CMS Letter Update:

A huge THANK YOU to all who have sent the CMS letter to your doctors and those in your circle. Your voices are being heard!

4,600 individuals from across the country signed the petition!

The letter to CMS was signed by:

(see outline below or click here to view)

-34 patient advocacy organizations

-12 medical  professional societies

-231 health care professionals, including hospitals, practices, and individual  health care providers

 

Recent changes to insurance have affected patients’ access to modern reconstruction techniques. The good news is that the Women’s Health and Cancer Rights Act of 1998 protects breast reconstruction, so we can fix this problem. We just need to stay engaged and advocate for patients facing surgery to treat or prevent breast cancer.

Read the ARTICLE here to learn more.

“A 2022 Breastcancer.org survey of 1,437 people who live in the United States and were diagnosed with breast cancer in the past 10 years found that 47% said their breast cancer-related out-of-pocket costs were a “significant” or “catastrophic” burden.”

We encourage you to follow Living Beyond Breast Cancer. They are an incredible resource for all updates about DIEP flap access and issues that are facing the breast cancer community.

What are we working on?

Protecting access to modern breast reconstruction through insurance for all people facing surgery to treat or prevent breast cancer.

Breast reconstruction using a woman’s own tissue should be an option for all woman facing breast reconstruction; however, access to the best and most modern natural reconstruction procedure, DIEP flap reconstruction, is being threatened due to insurance companies refusing to pay for the procedure women need and deserve.

CLICK HERE for more background information.

How Can You Help?

Get Involved! Fill Out This Form To…

-Help raise awareness about changes to access and insurance coverage of breast reconstruction.

-Share your contact information and your personal experience with breast reconstruction.

-Stay informed about our latest efforts and where your help is needed most.

CBRA logo

– We’ve partnered with the non-profit CBRA: Community Breast Reconstruction Alliance to continue the efforts to protect access to modern breast reconstruction. Learn more about CBRA.

Why?

-We love our patients and the work we do.

-We have seen reconstruction transform the lives of our patients.

-We believe that all patients should have access to modern breast reconstruction.

-We believe that all patients should be informed about their reconstructive options before undergoing surgery to treat breast cancer.

-We believe that insurance coverage for modern breast reconstruction is necessary and should be protected.

Encourage your senator and local representative to fight for access to autologous reconstruction

Take these quick steps to contact your senator and local representative:

Contact Your Senator

1. Find your senator here to email the below letter to fight for access to autologous reconstruction

2. Paste this text into your subject line:
Copy Subject

3. Copy this U.S. Senate letter text into the body of your email and sign your name at the bottom:
Copy Letter

4. Send!

Contact Your Local Representative

1. Find your local representative here to email the below letter to fight for access to autologous reconstruction

2. Paste this text into your subject line:
Copy Subject

3. Copy this House of Representatives letter text into the body of your email and sign your name at the bottom:
Copy Letter

4. Send!

Click the below to view a letter to CMS from The Senate

11/29 CMS Letter Update

Click the below to view a letter to CMS from Congress

 

https://www.drpotter.com/wp-content/uploads/2022/08/Letter-to-CMS-re-Breast-Recon-SIGNED-1.pdfhttps://www.drpotter.com/wp-content/uploads/2022/08/Letter-to-CMS-re-Breast-Recon-SIGNED-1.pdf

See our momentum below!

Dr. Potter on CBS MorningsSenate LetterWe are increasing awareness

The Background:

Breast reconstruction may be performed with an implant or with a woman’s own tissue. The decision is highly personal and individualized. Each patient should discuss the full range of options with their care team and have the chance to choose what is best for them. For example, patients may choose aesthetic flat closure, implant placement, or reconstruction with tissue from another part of their own body.

Natural tissue reconstruction using tissue from a patient’s own body is less commonly performed than implant reconstruction in the United States, but it is increasing as women are informed about their options. Some women choose to use their own tissue because they want a life-long reconstruction instead of an implant, which is not a lifetime device. Some women choose to use their own tissue because they prefer a natural reconstruction over a foreign body or medical device. Some women choose to use their own tissue because they have undergone radiation and understand the increased health risks of having implants in the setting of radiation, such as capsular contracture, infection, asymmetry, and reconstruction failure.  

The Details:

All surgeries are not equal. When natural tissue reconstructions were first developed, surgical techniques were not refined, and the side effects of the surgery were severe. Importantly, early efforts to reconstruct a breast caused harm and injury to a woman’s muscles. In some cases, as in fTRAM reconstruction, an entire abdominal muscle was removed, leaving the woman with lifelong weakness and hernia. As surgeons gained knowledge and experience, they developed techniques that don’t remove muscle. The new surgery, called a DIEP reconstruction, is more difficult to perform, but the benefits to the patient are profound. A woman can have a breast reconstruction with a DIEP flap and still lead an active and productive life, without the lifelong weakness and side effects caused by removing her rectus abdominis muscle.

The Challenge:

CMS has announced that they are equating all breast flaps (like DIEP and fTRAM) and insurance companies have begun to stop paying for the more advanced DIEP procedure that women need and deserve.

We are advocating for you! If you want to get involved in these efforts, please email us at advocacy@drpotter.com