Below is the compiled list of all questions submitted thus far. If you have a question that you do not see on this list, please send it to us by the end of the week by responding to this email.
Due to the large number of inquiries, we are still working on the Frequently Asked Questions document and will share it with you as soon as it is completed. Keep in mind that some of these questions are not fully answerable at this time, but everything on this list (plus any additional submitted questions) will be addressed to the extent possible.
As previously stated, over this next year, we will be working with CMS (Centers for Medicare and Medicaid Services) as they write the rules to implement the coverage. It is very important that we stay engaged throughout that process, because it will include the establishment of many of the important details you have asked about.
Please do let us know if you have a question that is not already included on the list. Thank you so much and we hope your year is off to a good start!
Heather Ferguson
Founder & Executive Director
Lymphedema Advocacy Group
LymphedemaTreatmentAct.org
DRAFT LIST OF QUESTION (in no particular order):
- Can I read a copy of the bill/law?
- What does the bill do, and why is it only about compression supplies?
- Will this cover patients with primary lymphedema and non-cancer related lymphedema?
- When will coverage begin?
- What about patients not on Medicare?
- Will this cover patients with Lipedema?
- Will this cover patients with Venous Insufficiency?
- Will this cover both standard-fit and custom-fit compression garments?
- Will other compression items such as bandaging supplies, low stretch (velcro) garments, nighttime garments, etc. also be covered?
- What about coverage for other items currently not covered, such as surgery, custom shoes, etc?
- Will this affect coverage for MLD (manual lymphatic drainage) / lymphedema therapy?
- Will this affect coverage for lymphedema pumps?
- Will this affect the coverage I am receiving due to the Women’s Health and Cancer Rights Act of 1998?
- Will this affect coverage for compression supplies used in wound care?
- Will I need a prescription, and who will determine the compression level?
- Will I have to see a CLT (Certified Lymphedema Therapist) before I can order my compression garments?
- Will there be criteria that must be met in order to receive custom-fit versus standard-fit garments?
- How many compression garments will I be able to get at one time and how often will I be able to replace them?
- What will my out of pocket costs be?
- Where will I be able to get my compression garments?
- What will the reimbursement rates be? In other words, what will the suppliers who sell compression garments be paid by Medicare for providing these items?
- Under the home health care rules of participation, a home care agency is responsible for covering patients’ supplies while they are receiving home health services. Will the same be true for compression garments while patients are receiving home health services, and if so, will the home care agency be reimbursed the same as any other supplier?
- What if I need to replace my garments sooner than what is allowed, or want to get more at one time than what is allowed?
- What if Medicare is unwilling to cover everything that I need, or all types of compression products currently on the market?
- What if new compression products are developed that are different from the choices available today – will they be covered?
- What can be done if a non-Medicare insurance plan still fails to cover compression garments and supplies after the Medicare coverage has gone into effect?
