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STATE | ASPS Rallies Breast Cancer Patient Advocacy Groups

The Utah Department of Health finalized a new regulation on Medicaid coverage for breast reconstruction limits coverage for certain aspects of reconstructive or restorative services. Furthermore, some provisions in the final rule were written ambiguously and will create confusion for patients who are trying to understand their coverage options. This uncertainty could also cause the department to be in direct conflict with federal agencies on the coverage of breast reconstruction procedures and necessary follow up care.

Following the final adoption of this proposed rule, ASPS requested that national and state physician and patient breast cancer advocacy groups support ASPS's efforts in opposing the new restrictions to coverage. Seventeen organizations cosigned the letter drafted by ASPS, including the state medical association, numerous Utah-based physician specialty groups and patient advocates. ASPS has since received a response from the executive director of the Utah Department of Health, Joe Miner, MD, indicating that the agency will review the group's concerns.

This sign-on letter is the third correspondence ASPS has had with the Utah Department of Health regarding this rule. In two previous letters, ASPS highlighted the need for the department to loosen the language, rather than allow it to restrict coverage options for breast cancer patients.

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