The Lowdown on the Lymphedema Treatment Act
Lymphedema is a chronic disease caused by excessive lymph fluid in one area of the body. This condition can be caused by a number of things, but most commonly results from the treatment for cancer when lymph nodes or vessels are adversely affected or taken out. The Lymphedema Treatment Act is a crucial piece of legislation that will, if approved by Congress, means drastic improvements for the quality of life of lymphedema sufferers nationwide. It will also reduce the risk of the common problem of recurrent infections. A few states, such as Virginia and North Carolina, have already come to the conclusion that paying for broad treatment is necessary and cost preventing, but this bill is federal and as such would help a much broader base of the population. Here is some key information on this bill proposal.
According to the lead sponsor of the bill, Representative Dave Reichert, lymphedema is a condition that approximately 1.5 to 3 million people receiving Medicare are currently facing. Their coverage pays for a portion of their treatment, such as compression pumps and therapy, but does not cover compression supplies that are an additional necessity prescribed by physicians. Due to this deficiency in funds available, many sufferers who can’t afford to pay out of pocket for these products deal with recurrent infections, a physical decline and ensuing permanent impairment. This bill would change that by altering Medicare guidelines to grant reimbursement for compression supplies. Even though it would initially only affect Medicare law, it will set an important precedent for Medicaid as well as private insurance.
The specific intentions are:
- To lower the overall healthcare expenses incurred by lymphedema by reducing the frequency of complications, co-morbidities and impairments associated with it
- To support patients as they comply with the upkeep of their treatment by providing for their physician-prescribed necessities
- To allow for coverage for compression, a vital part of the treatment for lymphedema (e.g. gradient compression apparel, bandages and accessories)
The reason that Medicare does not offer remuneration for these supplies at the moment is due to the fact that they cannot be grouped in any already-provided-for benefit division. The Center for Medicare Services can’t alter benefit categories, this is the responsibility of Congress, therefore this bill is required. The condition of lymphedema is progressive and gets worse if left inadequately treated, as such patients and the overall health care system is stressed. Complete Decongestive Therapy is the established treatment, proven to generate results, but it has multiple components that are shown to work only when used in conjunction with each other. These issues and expenses can be avoided with the appropriate, regular care provided for with this proposed bill.