Vermont State Representative Charen Fegard has just introduced an historic bill requiring insurance coverage for revision surgery!
Charen Fegard VT State Representative has just introduced a bill that will require healthcare stakeholders to decide on a clear coding and billing protocol for revision surgery for women who have chosen flat closure after mastectomy. Working across the aisle with Rep. Lynn Batchelder (R), herself a medical coding specialist, the good Rep. Fegard has 77 cosigners (of 150 house members) for the bill. Rep. Fegard explains:
“I have submitted one bill that affects a very small percentage of the population but I hope can make a difference for them and be used as a model in other states. When a woman undergoes mastectomy surgery, she may choose to have breast mound reconstruction or have chest wall reconstruction (also known as flat closure). Each of the two choices has advantages and drawbacks and the decision is a very personal one. Regardless, sometimes the initial surgery needs a follow up revision surgery to make corrections. The coding is pretty clear for women who need revision for breast mound reconstruction, but is less clear for those who have chest wall reconstruction. My bill requires state healthcare stakeholders to decide on clear coding and billing protocol so that no woman recovering from the devastation of mastectomy surgery must deal with incorrect coding and denial of revision surgery. Representative Lynn Batchelder (R), who has long worked as an insurance coder, was a strong ally, reaching across the aisle to help me gather 77 co-sponsors for the bill, which hopefully prompts the bill off the wall in committee.
Introducing a bill or signing on as a co-sponsor is a bit of a gamble and is not a guarantee to vote for it in the end. One reason for this is that bills are often modified in some way before passing out of their committee of jurisdiction and then the Senate committee of jurisdiction makes changes, too. While the topics of a bill generally hold, it can have a very different affect after it gets through two committees. “– Charen Fegard VT State Representative (Facebook post, January 09, 2020)
This is an historic moment for the flat community. Women have had to fight their insurance companies to get revision surgery covered for far too long. It’s way past time to #putflatonthemenu.
A heartfelt thank you to Rep. Fegard and to all of the good Vermont Representatives who have co-signed to this historic bill to protect the interests of women who choose flat closure. This bill will serve as a template for other states to pass similar legislation, and eventually this momentum will carry over to amending our federal target legislation, the WHCRA.