WASHINGTON, D.C. – This week, the Centers for Medicare and Medicaid Services (CMS) implemented a rule to allow Medicare Part B coverage of doctor-prescribed compression garments, the clinically recognized treatment for lymphedema. This rule was made possible by the passage of the Lymphedema Treatment Act, authored by U.S. Representatives Earl L. "Buddy" Carter (R-GA) and Jan Schakowsky (D-IL), which finally amended the Medicare statute to allow for coverage of compression supplies.
“Help has arrived for lymphedema patients, some of whom live through one of the worst diagnoses imaginable – cancer – only to come out the other side with an equally debilitating condition and a fraction of the resources and support. As co-chair of the Cancer Survivors Caucus and a pharmacist, I am excited that Congress is providing relief to patients who have been denied Medicare coverage for far too long. For lymphedema patients, compression garments are a need, not a luxury, and this need is finally being met. I remain committed to ensuring that all patients can access the treatment and care they need," said Congressman Buddy Carter.
“Starting this week, nearly three million lymphedema patients on Medicare will see needed relief thanks to the passage of the Lymphedema Treatment Act, a bill I proudly championed alongside Rep. Buddy Carter. Our bill finally expands access to medical compression garments that lymphedema patients rely on to treat their painful, incurable swelling,” said Congresswoman Jan Schakowsky.“For years, I heard from friends and constituents suffering from lymphedema about the high-out of pocket costs for compression garment, the only remedy for this debilitating condition. Cost should never be a barrier to care. I am glad to see that Medicare Part B will now cover these compression garments and related accessories for patients diagnosed with lymphedema. This would not have been possible without the tireless work of advocates who helped push this bill over the finish line. We must continue our efforts to ensure that every person has access to quality, affordable health care.”
Specifically, thanks to the passage of the Lymphedema Treatment Act, Medicare Part B will pay for standard and custom-fitted lymphedema compression treatment items for each affected body part, including:
- Compression garments, including those for daytime and nighttime, which offer different levels of compression
- Compression bandaging systems and supplies provided during the initial decongestion phase and maintenance phases of treatment
- Gradient compression wraps with adjustable straps
- Necessary accessories for gradient compression garments and wraps, including:
- Aids for putting on and taking off (donning and doffing) items for different body parts, like lower limb butlers or foot slippers that help patients put on compression stockings
- Fillers
- Lining
- Padding
- Zippers
“Thanks to the leadership of Representatives Schakowsky and Carter, plus support from hundreds of members on both sides of the aisle, patients like my teenage son, who was born with a rare congenital form of lymphedema, will now be able to access the treatment supplies they need to lead healthier and more productive lives,” said Heather Ferguson, Founder and Executive Director of the Lymphedema Advocacy Group. “Other insurance plans typically follow the coverage standards set by Medicare, so we are hopeful that soon every American suffering from this chronic and potentially debilitating disease will have better access to care.”
“After years of advocacy from our community and many others, the recent implementation of the Lymphedema Treatment Act takes a monumental step forward in making care for lymphedema more accessible to breast cancer patients and survivors,” said Molly Guthrie, Vice President of Policy and Advocacy for Susan G. Komen. “While there is still work to be done to ensure everyone, regardless of insurance type, has access to high-quality, affordable lymphedema care, we are grateful to Congresswoman Schakowsky and Congressman Carter for this victory on behalf of patients everywhere.”
Lymphedema is a chronic, progressive group of conditions characterized by swelling and discomfort in various parts of the body due to malfunctions in the lymphatic system. Patients undergoing treatment for cancer are particularly susceptible to lymphedema. When left untreated or undertreated, lymphedema can lead to complications, infections, comorbidities, loss of function, and disability—often necessitating costly emergency department or hospital visits.
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