Why This Legislation Is Needed
It is estimated that two to three million Americans suffer from lymphedema, possibly more. Due to a lack of awareness, information, and education (even within the medical community), lymphedema is often misdiagnosed or undiagnosed. Delays in diagnosis or treatment can result in rapid and unchecked progression of the disease.
Currently, Medicare, and the majority of private insurance policies, do not cover the medically necessary compression supplies and compression garments used daily in lymphedema treatment. These are doctor-prescribed supplies that are critical components of complete decongestive therapy. As a result, many patients cannot afford treatment and suffer from a progressive disease that can cause serious skin and tissue changes, as well as, recurrent infections and eventual disability.
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.