SCLD Update
January 1998

Breast Cancer Detection
Cancer-General
Gynecologic Cancers-General
Tobacco-Use Reduction
Enacted Legislation and Adopted Resolutions
Addendum

Breast Cancer Detection
Third-Party Reimbursement

In Pennsylvania, effective February 3, 1998, S.B. 176 requires health maintenance organizations (HMOs), the state medical assistance program, and other specified insurers that cover mastectomies to provide coverage for prosthetic devices and reconstructive surgery following a mastectomy. The coverage must include surgery on both breasts to provide a symmetrical appearance, and is subject to the same deductible and co-insurance provisions applied to the mastectomy. Coverage for the prosthetic devices may be limited to six years following the mastectomy. See the additional summary of this legislation in the Breast Cancer Detection/Inpatient Care section.

Inpatient Care

Effective February 3, 1998, Pennsylvania's S.B. 176 requires HMOs, the state medical assistance program, and other specified insurers to provide coverage for inpatient care following a mastectomy, with the period of coverage to be determined by the treating physician. This coverage is subject to copayment, co-insurance, and deductible provisions. See the additional summary of this legislation in the Breast Cancer Detection/Third-Party Reimbursement section.

Awareness

Pennsylvania passed S.R. 80, a resolution declaring October as Breast Cancer Awareness Month in the state and recognizing the work of the state Breast Cancer Coalition.