Understanding the Lymphedema Treatment Act
The Lymphedema Treatment Act (LTA) is a federal bill that aims to improve insurance coverage for the medically necessary, doctor-prescribed compression supplies that are the cornerstone of lymphedema treatment.
Lymphedema is chronic swelling caused by a build-up of fluid that occurs when the lymphatic system is either faulty or damaged. While there is no known cure for lymphedema, it can be effectively treated with compression therapy.
According to the National Cancer Institute, “The goal of lymphedema treatment centers on controlling limb swelling and minimizing complications.”1 Under current Medicare policy, lymphedema patients have coverage for Manual Lymphatic Drainage (MLD) and when certain conditions are satisfied, a pneumatic compression pump.
The function of compression is to maintain the affected body part in its reduced state and prevent it from swelling further. Without the use of compression garments outlined in the Lymphedema Treatment Act, MLD and lymphedema pumps provide no lasting benefit and do not allow the patient to sustain their condition.
Lymphedema pumps are typically used for an hour a day. While in use, a person is recumbent, and therefore cannot carry on with their usual tasks throughout the day. In order to prevent fluid accumulation, it’s vital for compression garments and other compression supplies to be worn continuously throughout the day.
Therefore, the Lymphedema Treatment Act intends to close this gap in coverage that prevents Medicare beneficiaries from accessing these medically necessary compression supplies that are crucial in the standard care for lymphedema.
Lymphedema is a life-long illness and compression is a cornerstone in maintaining any reduction achieved for longevity management. Without this therapy, no other component of treatment will provide any lasting benefit.
So, what will this legislation ultimately do for lymphedema patients?
- Provide for Medicare coverage of doctor-prescribed medical compression supplies under the Durable Medical Equipment (DME) category.
- Enable lymphedema patients to maintain their overall health, activities of daily living and quality of life.
- Reduce the total healthcare costs associated with this disease by decreasing the incidence of complications, comorbidities, disabilities and hospitalizations.
- Align Medicare coverage with existing Federal precedent established by TriCare, Veterans Affairs and Federal.2
What can you do to help?
Contact your members of Congress and ask them to support this bill. Visit LymphedemaTreatmentAct.org to check out the advocacy tools available and make your voice heard!
- 1 http://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-hp-pdq#section/all