Male breast cancer patients denied Medicaid coverage

By Dr. Ananya Mandal, MDAug 9 2011

Many men with breast cancer are being denied Medicaid coverage for breast cancer treatment because of their gender.

The American Cancer society's pages on breast cancer in men lay out the facts.  About 2,000 men are diagnosed with breast cancer each year, which makes it rare: about 100 times more women get the disease. It is known that men, like women, are more likely to develop cancer if they have certain mutations of the BRCA1 and BRCA2 genes. Family history and age contribute to a man's likelihood of developing the disease as well.  Heavy drinking and exposure to radiation are believed to be risk factors, as is obesity. A recent breast cancer cluster among men who had been exposed to contaminated drinking water at North Carolina's Camp Lejeune had patients wondering if there was also a link between chemical exposure and the disease.

The director of the state's Department of Health and Human Services agreed that Medicaid should not discriminate. “We believe that the federal position on this issue is discriminatory, and we are again urging federal Medicaid officials to reconsider,” Tony Keck said in a written statement. “This is a very clear example of how overly rigid federal regulations don't serve the interests of the people we're supposed to be helping.”

The eligibility requirements say that in order to get coverage for breast cancer treatment, patients new to Medicaid must have been diagnosed through “early detection” programs funded by the CDC. But a spokesman for the Centers for Medicare & Medicaid Services - which administers the Medicaid program said that an unintended “glitch” in the law that governs the CDC programs had left men without coverage for breast cancer. “We are working with the CDC and South Carolina to see what options may exist to address this situation,” CMS spokesman Brian T. Cook, said. “We are committed to ensuring that all individuals who should be eligible for this program have coverage.”