of uterine fibroids, including uterine artery embolization, intraoperative ultrasound guidance, and monitoring and radiofrequency ablation, commencing January 1, 2023.4


As of Jan. 1, 2023, private health insurance carriers, health maintenance organizations, nonprofit health medical service plans and nonprofit hospital service plans providing obstetric and gynecological care to women in Rhode Island must pay for specific fibroid treatments and procedures.


This legislation represents one of the few times a state has passed a law directing payers to cover the cost of specific medical procedures that might otherwise be denied. For those in Rhode Island suffering with fibroids but unable to afford therapy, this act will be life-changing.


Motivated by a desire to help women suffering from fibroids (especially low- income women of color), Rep. Camille Vella-Wilkinson, D-R.I., first introduced this bill, moving it to the floor of the Rhode Island General Assembly in early 2021. At the time, however, UFE was not included in the list of covered procedures.


In April 2021, SIR received a call from a member expressing concern that the Rhode Island fibroid treatment legislation was rapidly making its way to becoming law, without including UFE.


An initial phone conversation with Rep. Vella-Wilkinson revealed that she did not know about interventional radiology or IR procedures for fibroids. She wanted to learn more. A virtual meeting with several IRs introduced Rep. Vella-Wilkinson to IR and the many ways that interventional radiologists improve women’s health. At the conclusion of the meeting, Rep. Vella-Wilkinson promised to put a hold on her legislation and reintroduce the bill in 2022 with UFE in place.


Not only was the bill reintroduced in January 2022, but Rep. Vella-Wilkinson accelerated her pace and got the bill passed by the Rhode Island Senate and General Assembly in June. SIR representatives Theresa Caridi, MD, FSIR, and John C. Lipman, MD, FSIR, joined the governor at a bill-signing ceremony on July 22 as part of the state’s recognition of Fibroid Awareness Month.


The Rhode Island situation was an example of an extraordinary convergence of factors that rarely happens in advocacy: a passionate and persistent bill sponsor who was open to a cold call from a stranger and then willing to adjust course to ensure that interventional radiology and UFE were included.


Navigating federal legislation The federal legislative process is quite another story. By design, it is lengthy, laborious and can take many years to enact legislation.


In 2007, Rep. Stephanie Tubbs Jones, D-Ohio, introduced a bill to increase funding and awareness of fibroids. It was written with full awareness of the impact that fibroids have on women—Black women in particular. It did not pass.


Now, more than 15 years later, SIR is working closely with Rep. Yvette Clarke, D-N.Y., and Sens. Corey Booker, D-N.J., and Shelley Moore Capito, R-W.Va., to pass the Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021. H.R. 2007 would provide $150 million to the National Institutes of Health (NIH) for critical research into uterine fibroids and fund public education programs to support women suffering from fibroids.5


Elected to Congress in 2001, Rep. Clarke was forced to miss her swearing-in ceremony because she was having a partial hysterectomy to remove her fibroid tumors. Rep. Clarke has said she regrets that she was never told at that


time there were less invasive procedures available and wants to help women preserve their ability to bear children despite having fibroids.


The uterine fibroid research and education legislation has been referred to health committees in the House of Representatives and the Senate but will expire when this session of Congress ends. The bill sponsors are persistent, and SIR will continue to advocate when the fibroid research bills are reintroduced again.


With support, fast change is possible That said, Congress can still act quickly to address urgent medical situations. One example is the passage of the Dr. Lorna Breen Healthcare Provider Protection Act (HR 1667), which President Biden signed into law on Feb. 24 of last year. The bill protects physicians who receive mental health assistance without jeopardizing their medical licenses and establishes grants for employee education and mental and behavioral health treatment.6


When


Lorna Breen, MD, tragically committed suicide in April 2020, this legislation was rushed through Congress to address the growing problem of physician burnout.


Support for PAD screening With UFE legislation experiencing success and Congress passing bills such as H.R. 1667, many see this progress as an opportunity for additional legislation aimed at improving healthcare access.


For instance, The Amputation Reduction and Compassion (ARC) Act (H.R. 2631)7 was introduced to the House of Representatives in April 2021. If passed, the bill would cover screening for peripheral arterial disease (PAD) for at-risk beneficiaries through Medicare and Medicaid. PAD impacts an estimated 20 million Americans, a disproportionate number of whom are underrepresented minorities (URMs).8


Expanding


Microaggressions: Subtle snubs, slights and insults directed towards minorities, as well as to women and other historically stigmatized groups, that implicitly communicate or at least engender hostility.


For more discussion of microaggressions, follow the QR code to read “The macro effect of microaggressions.” irq.sirweb.org | 23


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