More good news! In addition to the Lymphedema Treatment Act being placed on the House Consensus Calendar last week (click here to read that news if you missed it) our group recently met with the Center for Medicare and Medicaid Services (CMS).
Earlier this month, I, along with our Board Chair, Sarah Bramblette, and our lobbyist from Prime Policy, met with staff from CMS. The meeting included the Director of Policy for the DMEPOS Group and the head of Technology Coding and Pricing Group, along with several members of their support staff.
The purpose of the meeting was to discuss the importance of coverage of lymphedema compression garments and supplies. In the past, the Lymphedema Advocacy Group has met with CMS staff under each administration and asked if they could find a way to cover compression under their current authority. Their answer has always been “no”, because the items do not fit in a Medicare benefit category, and only Congress has the authority to redefine or add new categories — hence the need for the Lymphedema Treatment Act!
We presented them our recent cost savings analysis from Avalere, and the real-world data from Virginia that showed a reduction in hospitalizations. In addition to the cost-savings that coverage of compression would provide, we explained how the lack of coverage for compression garments hinders patients’ access to current lymphedema treatments that are covered by CMS, and that if compression was covered, treatment overall would be more effective and efficient.
The CMS staff were sincere in their interest to want to know and understand more about how they might help. They requested additional information, which we will provide with a follow-up. After the call, our lobbyist stated it was one of the best meetings he has ever had with CMS.
These conversations are important because, after the LTA is passed, CMS will be the agency we will need to work with to ensure that the coverage is implemented correctly, including reimbursement. A good relationship with CMS will also be important for future coverage of any new treatments for lymphedema.
Heather Ferguson
Founder & Executive Director
Lymphedema Advocacy Group
LymphedemaTreatmentAct.org
Contributions or gifts to the Lymphedema Advocacy Group are not tax-deductible.
As a 501c(4) nonprofit organization, the Lymphedema Advocacy Group engages in lobbying activity, in keeping with its mission, for passage of the Lymphedema Treatment Act. |
