Lymphedema – Not even a mom can love it. … fight it, yes – with
all that is in her – and dads fight too.
Lymphedema is alive and well in Kitsap County. I have it, many
folks have it and many of us know nothing about it other than it is
progressive and painful.
Retired Dr. Halligan of Doctors Clinic, Silverdale
knows about Lymphedema and how to treat it.
Compression stockings are a key to making lymphedema manageable and
the rightful passing of the upcoming bill will allow those who
cannot afford the cost of it thereby saving taxpayers related costs
of this dreaded disease.
Harrison Wound Care Center is packed with folks
with wounds – some of them lymphedema…a few stories on that to
follow soon.
To be sure of the wording, I’ve copied the following small portion directly from the Lymphedema website.
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“About The Bill
For the most current information about the bill, scroll to the
bottom of this page.
Congressman Reichert, our lead bill sponsor, and
advocates from his state of Washington
Why This Legislation Is Needed
Currently, Medicare, and consequently many other policies, does not
cover one of the critical components of lymphedema treatment, the
medically necessary compression supplies used daily in lymphedema
treatment. As a result, many patients suffer from recurrent
infections, progressive degradation in their condition and eventual
disability because they cannot afford the compression supplies
required to maintain their condition.
Although this legislation relates specifically to a change in
Medicare law, it would set a precedent for Medicaid and private
insurers to follow. States have already recognized that coverage
for comprehensive treatment is essential and cost saving, and are
beginning to require that private and state plans provide this
coverage. Lymphedema treatment mandates have been in effect in
North Carolina since 2010 and in Virginia since 2004, and several
other states have similar legislation pending.
Medicare’s failure to cover compression treatment supplies stems
from the fact that these items cannot be classified under any
existing benefit category in Medicare statute (law). The Center for
Medicare Services (CMS) does not have the authority to add or
redefine benefit categories, only Congress does, hence the need for
this legislation. This is explained in more detail in a written
exchange between our bill sponsor, Congressman Reichert, and former
Health and Human Services Secretary, Kathleen Sebelius. Click here
to read their correspondence.
What This Legislation Would Do
The Lymphedema Treatment Act (LTA) will improve coverage for the treatment of lymphedema from any cause by amending Medicare statute to allow for coverage of compression supplies.
Specific goals of the LTA are as follows:
to provide comprehensive lymphedema treatment coverage,
according to current
medical treatment standards;
to enable patient self-treatment plan adherence by providing
necessary medical supplies
for use at home, as prescribed for each patient (including gradient
compression
garments, bandages, and other compression devices);
to reduce the total healthcare costs associated with this disease
by decreasing the incidence of
complications, co-morbidities and disabilities resulting from this
medical condition.
The HHS Secretary has confirmed that a change in statute is necessary to allow for coverage of compression supplies. (See section above for details.) The Lymphedema Treatment Act will amend Sec. 1861 [42 U.S.C. 1395x] of the Social Security Act to enable coverage of these items under Durable Medical Equipment.
Details surrounding coverage, such as allowable quantities, etc., are not something that is written into statute. Matters of this nature are determined by policy decisions made after the legislation is passed. This allows flexibility to adjust policy as needed in the future, without having to pass new legislation.
Additional Information about the Lymphedema Treatment Act
Our current bill sponsors are: Representative Dave Reichert, WA-8 (lead sponsor); Representative Leonard Lance, NJ-7 (co-lead); Representative Earl Blumenauer, OR-3 (co-lead); and Representative Bruce Braley, IA-1 (co-lead). To read press releases from these offices about their introduction of the bill click here.
A complete list of current cosponsors can be seen here.
A PDF of the actual bill can be viewed and downloaded here.
A “scoring” report for the Lymphedema Treatment Act can be read here. A “score” estimates the federal costs that would be incurred by implementing a piece of legislation. A document explaining this report, as well as related FAQ’s, is available here.
Resources for Sharing Information about the Lymphedema Treatment Act
To download an information packet appropriate for sharing ONLY with members of Congress and their staff, click here. (Please ensure that you thoroughly read and understand this document yourself before sharing it with congressional offices. If you have any questions, don’t hesitate to Contact Us. Remember that our Advocacy Handbook is full of helpful tips, such as talking points and FAQ’s. )
To download a facts sheet appropriate for sharing with the general public, click here. Additional ways in which you can help spread awareness are outlined on our Increasing Awareness page.
How you can help
#1 PRIORITY – Contact Your Members of Congress!
Six Easy Ways To Increase Awareness
Join Your State’s Grassroots Advocacy Team
Lymphedema Lobby Days in Washington, DC
Use Our Advocacy Handbook
Tell Your Lymphedema Story
Visit Our Cafe Press Store
Donate Financial Support
Our Newsletter
Sign up to receive updates on the progress of the bill and how you
can help each step of the way. To view past issues click here.
Current Status
Check the status of the Lymphedema Treatment Act in Congress and
view the list of cosponsors.”
fhttp://lymphedematreatmentact.org/about-the-bill/
Thanks for listening – thanks for helping… Sharon O’Hara
