Women’s Health and Cancer Rights Modernization Act of 2025

HR 5813, the Women’s Health and Cancer Rights Modernization Act of 2025, requires health insurance plans to cover all medically necessary breast or chest wall reconstruction services following breast cancer treatment, including mastectomy or breast-conserving surgery. It mandates coverage for every reconstruction method (like implants, tissue flaps, or future recognized techniques), symmetrical surgery for the other breast, custom prostheses, and treatment of complications like lymphedema. Health plans must ensure at least one in-network provider for each reconstruction type, provide annual written notices to patients about this coverage, and cannot deny coverage or penalize providers for following these requirements. This applies to group and individual health insurance plans, with no effect on stricter state laws requiring broader coverage.