EVERY WOMAN CAN ADVOCACY

2023 | SB5396 Passed!

Thanks to you and your support, EWC came alongside other agencies and individuals to help pass SB5396 to prohibit patient cost sharing for medically necessary diagnostic mammograms, breast ultrasounds, and breast MRIs.

Get the details HERE.

During the 2023 legislative session, the Washington Legislature passed SB 5396 to prohibit patient cost sharing for medically necessary diagnostic mammograms, breast ultrasounds, and breast MRIs.

• The law applies to state-regulated health insurance plans with existing coverage of

  diagnostic imaging (nearly all plans offer this coverage).

• It covers imaging requested by a doctor where: 1) there is a breast abnormality de-

  tected or suspected (diagnostic) or 2) the imaging is used as screening for patients

  at high risk for breast cancer (supplemental).

• The law prohibits patient co-pays or deductible payments for procedures conducted under the above criteria.

H.R.549/S.663

We support the National Breast Cancer Coalition and the Metastatic Breast Cancer Access to Care Act. This Act calls for the passage of legislation to waive the 24-month waiting period for Medicare and the 5-month waiting period for Social Security Disability Insurance benefits for eligible individuals with metastatic breast cancer

In the works…

Metastatic Step Therapy Legislation

Metastatic Step Therapy is also referred to “fail first,” meaning insurers require a patient to first try a health plan-preferred (often generic alternative) drug and have that drug fail them before they get access to coverage for the originally prescribed drug. Cancer drugs are toxic – first fail means that they are taking additional toxic drugs.

This legislation would eliminate step therapy protocols for metastatic cancer treatments and associated conditions. Although metastatic breast cancer cannot be cured, it can be treated. Treatment is highly personalized and must be based on decisions made by the patient and their health care providers, as they are most capable in determining the appropriate treatment for patients.

Unfortunately, most step therapy protocols rely on generalized information regarding patients and their treatments and don't consider unique experiences, previous responses to treatments and any comorbidities.

Ensuring patients receive consistent and effective treatments is critical in situations when treating patients with potentially life ending diseases such as metastatic breast cancer, where any delays or deviations could be deadly.