SUSAN G. KOMEN® DALLAS COUNTY ADVOCATES TO REMOVE COST BARRIERS IN TEXAS

Dallas, Texas August 30, 2019 – Susan G. Komen ® Dallas County has worked for over 26 years to ensure that Dallas County women have access to life-saving breast cancer screening, diagnostics, and treatments services, through fundraising, grants and educational services.  Unfortunately, the need is always greater than the funding.  Knowing they had to do more to meet the needs of the community, Komen Dallas County along with its national office, Susan G. Komen®, and other Texas based Komen Affiliates looked to advocacy to help meet the growing need. 

Komen Dallas County works closely with health care providers and those impacted by breast cancer in the Dallas County community to identify barriers to screening and treatment, and the potential policy solutions to address the complex issues associated with care. 

Having identified several issues to target, Susan G. Komen and its Affiliate network  worked directly with Representative Diego Bernal (TX-123)  to determine how best to address the needs of women throughout Texas through policy.  

During the 2019 Texas Legislative Session, Susan G. Komen and local Affiliates like Komen Dallas County partnered with Representative Bernal to sponsor HB 170, which eliminates the patient’s out-of-pocket costs for diagnostic mammograms. 

Realizing that while traditional screening mammography is typically covered at no cost to patients, after a lump or other signs or symptoms of disease have been found, the diagnostic imaging required for Texas patients with private insurance varied from $336 to $836, depending on their insurance company.  HB 170 eliminates this disparity by requiring plans to fully cover diagnostic mammography with no cost sharing to the patient.  Governor Greg Abbot signed the bill into law on June 15, 2019.

“Screening mammograms are now fully covered through Medicare, Medicaid, and most private insurance plans. However, for diagnostic mammography patients were generally required to pay co-pays, co-insurance, and other types of cost sharing. The enactment of HB 170 will allow more people in Texas to receive the diagnostic imaging required to identify whether or not they have breast cancer, leading to saved lives through earlier detection and more timely treatment.” states Natasha Mmeje, Director of Mission Impact and Outreach, Susan G. Komen® Dallas County.

Komen and its Affiliates also supported HB 1584 by Representative Senfronia Thompson (TX-141), which eliminated step therapy protocols for metastatic, stage four cancer patients.  Step therapy, also referred to as “fail first”, is a utilization management tool that requires a patient to first try a preferred (often generic alternative) drug prior to receiving coverage for the originally prescribed drug.  HB 1584 eliminates step therapy for cancer treatments and associated conditions for metastatic, advanced stage-four cancer patients.  Texas became one of only a handful of states to enact this legislation.  Mmeje stated, “Patients and their doctors should be able to choose the best treatments and therapies without the burden of overly restrictive cost containment policies”.  Both laws will become effective on September 1, 2019.

With the passage of these two bills, women and men facing breast cancer will have access to the diagnostic services, therapies, and treatments they need to fight this terrible disease.” Mmeje stated.

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About Susan G. Komen® Dallas County

Komen Dallas County is committed to Dallas’ fight against breast cancer. Since its inception, Komen Dallas County has invested over $27.5 million in local breast health programs providing education, screening, diagnostic services, treatment, patient navigation and transportation services. Komen Dallas County has also invested nearly $8.5 million in national, cutting edge research to find the cures so that future generations will not have to face this devastating disease.