Bill lobbies for compression garments

Wednesday, March 10, 2010

WASHINGTON - A bill that would require Medicare to cover compression garments and other items used to treat lymphedema began making the rounds in February, but some industry stakeholders say it needs some clarification.

Introduced Feb. 23 by Rep. Larry Kissell, D-N.C., the Lymphedema Diagnosis and Treatment Cost Saving Act of 2010, would improve the diagnosis and treatment of lymphedema under the Medicare program. Among other things, the bill, H. R. 4662, seeks to establish Medicare coverage for compression bandage systems, compression garments and compression devices.

"The garments are used every day (by patients) and they are the backbone of the treatment," said Robert Weiss, a volunteer advocate with grassroots organization National Lymphedema Network, who helped get the bill introduced.

The bill also seeks to define who can provide the garments. The list includes nurses; physicians and physician assistants; chiropractors; licensed massage therapists; licensed home health practitioners; and licensed prosthetists and orthotists. Also on the list: someone certified by the manufacturer of an item to provide that particular item.

That's where the bill gets a little gray.

"The bill in many ways limits the provision of services to those particular disciplines," said Rhonda Turner, executive director of the American Association of Breast Care Professionals. "It does have some language saying 'anyone else deemed appropriate by the DHHS secretary.' We want to see if they could have a little bit more definition of that provider list."

The bill may simply need some tweaks, she said.

Ultimately, Weiss said, the bill "attacks" a number of large problems that prevent patients from getting proper care, and proper care would save the government money.

"If you treat the lymphedema, you are avoiding very expensive and hard-to-treat cellulitis, which can require hospitalization," he said.

At the end of the day, the bill is a step in the right direction, said stakeholders.

"While H.R. 4662 leaves many unanswered questions and concerns, we are encouraged that the bill will serve to raise awareness to the issue of lymphedema and the need for services/items to be covered without exception by commercial insurances and Medicare/Medicaid," said Turner.