If you haven’t already done so, we encourage you to read the draft rules for the LTA this weekend. As a reminder, the LTA rules are part of a larger package of rules, so we have created this separate document with just the pages containing the LTA-related rules.
Answers to many of the questions we have received are found in the rules.We are here to help clarify as needed, but it is imperative that you read the full draft.
A recording of our webinar on Thursday, July 6th will be available soon. On Thursday July 13th at 8:00pm eastern, we will be hosting another webinar to provide talking points and guidance on submitting your comments (register here).
The Public Comment Period will be open until August 29th. As soon as our submission form is set up (which will not be until after the second webinar on July 13th) we will send you the link to begin submitting your comments.
We encourage you to review all of the materials we will be providing before submitting your comment. The Center for Medicare and Medicaid Services (CMS) will only allow one submission per person.
Highlights are as follows, however, please also read the entire draft of the LTA rules:
- Covered supplies will include standard and custom fitted gradient compression garments; gradient compression wraps with adjustable straps; compression bandaging systems; and other items determined to be lymphedema compression treatment items.
- Additional covered items will include accessories such as zippers in garments, liners worn under garments or wraps with adjustable straps, and padding or fillers that are necessary for the effective use of a gradient compression garment or wrap with adjustable straps.
- Two daytime garments per affected body part will be covered every 6 months, or sooner if the item is lost, stolen, irreparably damaged, or if needed based on a change in the beneficiary’s medical or physical condition.
- One nighttime garment per affected body part will be covered every year, or sooner if the item is lost, stolen, irreparably damaged, or if needed based on a change in the beneficiary’s medical or physical condition.
- New/additional codes will be created to facilitate reimbursement, including codes specific to non-limb areas of the body (head, neck, genitals, torso, etc.) to ensure that supplies needed to treat these areas of the body are included in coverage.
- CMS is seeking comments on specific issues where further clarification of the rules is needed, and we will outline those areas during the webinars and in our subsequent communications and materials.
Thank you for your advocacy!
Heather Ferguson
Founder & Executive Director
Lymphedema Advocacy Group
LymphedemaTreatmentAct.org
