Provider, lawmakers work for lymphedema coverage

Saturday, September 30, 2006

LAS VEGAS - It's back to the drawing board for one provider's quest to gain better coverage of lymphedema treatment and supplies.
Cyndi Ortiz, owner of Nevada Vascular and Lymphatic Specialty Co. and founder of the Coalition for Quality Healthcare--a political action committee--is focusing her efforts on effecting change administratively after a bill fell through earlier this year. She is currently working with Sen. John Ensign, R-Nev., and Senate Minority Leader Harry Reid, D.-Nev.
"Senator Reid's office would like to submit a letter to (Department of Health and Human Services) Secretary Leavitt asking him to make the changes we've requested," said Ortiz. "If that doesn't work, Sen. Ensign said maybe he could introduce (legislation) next year."
Ortiz wants Medicare--which currently covers only pumps--and other insurers to cover compression therapy, foot care and wound care in the treatment of lymphatic and vascular diseases.
"The current Medicare coverage for vascular disease and lymphedema is 30 years behind technology," said Ortiz. "We now have items that are much less expensive than items that are currently covered and they are not covered by Medicare."
Ortiz said she has seen far too many patients end up in hospitals--at government expense--to treat preventable complications because they couldn't afford to pay for treatment out-of-pocket.
"Patients are being denied care because Medicare can't figure out what exactly the guidelines are trying to say," said Ortiz.
Election years are the best time for providers to get involved, said Ortiz, who got a face-to-face appointment with Sen. Ensign this year after three years of trying.
"During election years, they set aside more time just for that," said Ortiz. "They need votes. They're willing to listen."
She said she is frustrated with providers who claim they don't have time to get involved. That needs to change, said Ortiz.
"Call your congressman," said Ortiz. "Providers need to get their patients and referring physicians to call, also. The more people we have contacting Congress, the more likely changes will be made."