Today marks two months since the start of Medicare coverage for lymphedema compression supplies. Considering the magnitude of this undertaking – the last time a new Medicare benefit category was created was in the 1980s – implementation has gone smoothly. But as expected, there have been a few bumps in the road, and there are still issues that need to be addressed.
We know that some Medicare beneficiaries have faced delays in getting their compression garments, and as the parent of a lymphedema patient, I understand how frustrating this can be. To clarify, Medicare has been ready and accepting orders since January 1st. Unfortunately, not enough compression suppliers were enrolled with Medicare at the start of the year. Consequently, those who were ready to begin accepting orders on January 1st have been inundated, and those who are still in the process of enrolling with Medicare are doing so as quickly as possible. In the meantime, if you are looking for a supplier who is able to place your order now, we have a partial list of suppliers on our website.
If you are not a traditional Medicare beneficiary, remember that it will take time for other insurers to adopt the new coverage. You can hasten this process by contacting your own insurance company using the template letter and instructions on our Take Action page.
That said, if you have been denied coverage for a compression garment order placed on or after January 1, 2024 – whether you have traditional Medicare or any other plan – we want to know. We are now tracking this through our Denial Reporting Form in order to identify where additional advocacy may be needed.
As you may recall, the majority of the recommendations in our group’s Public Comments were incorporated into the final rule. But one key issue – therapist reimbursement for fitting and measuring services – was not. Our group is partnering with the APTA, AOTA, and other stakeholder groups to resolve this issue. A joint letter to CMS is in the works, and we will share a copy once finalized.
Additionally, other stakeholders are helping to educate about the new coverage. There are two webinars next week jointly produced by the National Lymphedema Network and SunMED medical. They will be held on March 6th at 3:00pm easternand March 8th at 12:00pm eastern. These webinars are for answering clinician questions and are free to attend, but you must register.
As a reminder, we have a new one-pager available that is very easy to download and print. Patients can bring this to clinicians and suppliers who may not be aware of the new coverage or who need more information. And likewise, clinicians and suppliers can use this to educate patients who may not be aware of the new benefits available to them.
If you have questions, please consult our Frequently Asked Questions documentfirst, which was recently updated. If you do not find the answers you are seeking there, or elsewhere on our website, feel free to respond to this email.
As depicted in the graphic below, it’s been a long journey. We’ve come a long way and accomplished a great deal, but there is still more work to do. Donations to support our continued efforts are always deeply appreciated. Thank you so much and we hope you find this information helpful!
Heather Ferguson
Founder & Executive Director
Lymphedema Advocacy Group
LymphedemaTreatmentAct.org
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