Jennifer Looby 0

Lymphedema Treatment

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Lymphedema is a chronic condition involving the abnormal accumulation of fluid in a body part. Lymphedema may be primary or secondary (surgery, cancer or trauma.)

Currently, Medicare, and consequently many other policies, do not cover one of the critical components of lymphedema treatment, the medically necessary compression supplies used daily in lymphedema treatment. As a result, many patients suffer from recurrent infections, progressive degradation in their condition and eventual disability because they cannot afford the compression supplies required to maintain their condition.

Although this legislation relates specifically to a change in Medicare law,it would set a precedent for Medicaid and private insurers to follow.States have already recognized that coverage for comprehensive treatment is essential and cost saving, and are beginning to require that private and state plans provide this coverage. Lymphedema treatment mandates have been in effect inNorth Carolinasince 2010 and inVirginiasince 2004, and several other states have similar legislation pending.

Medicare’s failure to cover compression treatment supplies stems from the fact that these items cannot be classified under any existing benefit category in Medicare statute (law). The Center for Medicare Services (CMS) does not have the authority to add or redefine benefit categories, only Congress does, hence the need for this legislation.

The Lymphedema Treatment Act will improve coverage for the treatment of lymphedema by amending Medicare statute to allow for coverage of compression supplies used in the treatment of lymphedema.

Specific goals of the Act are as follows:

to provide comprehensive lymphedema treatment coverage, according to current
medical treatment standards;to enable patient self-treatment plan adherence by providing necessary medical supplies
for use at home,as prescribed for each patient (including gradient compression
garments,bandages, and other compression devices);to reduce the total healthcare costs associated with this disease by decreasing the incidence of
complications, co-morbiditiesand disabilities resulting from this medical condition.
By signing below, I fully support the National Lymphedema Treatment Act and also the New York StateBILL NO A04082A

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