Background Information

 

Why This Legislation Is Needed

Currently, Medicare, and consequently many other policies, do not cover one of the critical components of lymphedema treatment, the medically necessary doctor-prescribed 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. 

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. This is explained in more detail in a written exchange between our bill sponsor, Congressman Reichert, and former Health and Human Services Secretary, Kathleen Sebelius. Click here to read their correspondence.  

States have already recognized that coverage for comprehensive lymphedema treatment is essential, and are beginning to require that private plans include this coverage.  California and Louisiana have state laws that improve coverage for compression supplies, and full lymphedema treatment mandates have been in effect in North Carolina since 2010 and in Virginia since 2004. Several other states have similar legislation pending.

The Lymphedema Treatment Act was was first introduced into Congress in 2010 by Representative Larry Kissell. Each consecutive Congress our bill has garnered more support. You can learn more about our current bill here.

Advocates with Congressman Kissell (From left to right - seated are Jenny Sterner and Heather Ferguson, and standing is Jennifer Hovatter, Patti Graybeal, Robin Miller, Bob Weiss, Congressman Kissell, Michael Cannon, Jane Gregerson and Carol Johnson.)

Patient advocates surrounding our original House bill sponsor, Larry Kissell