Lymphedema Treatment Act - Amends title XVIII (Medicare) of the Social Security Act (SSA) to cover certain lymphedema compression treatment items as durable medical equipment.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3877 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 3877
To amend title XVIII of the Social Security Act to provide for Medicare
coverage of certain lymphedema compression treatment items as items of
durable medical equipment.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 15, 2014
Mr. Reichert (for himself, Mr. Blumenauer, Mr. Lance, and Mr. Braley of
Iowa) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for Medicare
coverage of certain lymphedema compression treatment items as items of
durable medical equipment.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Lymphedema Treatment Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Lymphedema is a chronic disease that results in an
accumulation of protein-rich lymph fluid in parts of the body
where lymph nodes or lymphatic vessels are damaged or
inadequate.
(2) Lymphedema afflicts millions of Americans, including
men, women, and children who can be born with a primary form of
lymphedema. The majority of cases, however, are secondary forms
of lymphedema most often caused by cancer treatments that
damage the body's lymph transport and immune functions.
(3) A 2010 peer-reviewed study in the American Cancer
Society's Cancer journal stated ``lymphedema is a common post-
treatment condition [and] has been described as one of the most
significant survivorship issues''. The study reported an
overall cancer-related lymphedema incidence rate of 15.5
percent, with specific rates as follows: sarcoma 30 percent,
breast 20 percent, gynecological 20 percent, melanoma 16
percent, genital-urinary 10 percent, and head and neck 4
percent. Risk increased 22 percent after pelvic lymph node
removal and 31 percent after radiation therapy.
(4) Lymphedema is progressive when left untreated or under-
treated and can put patients at greater risk for serious
infections or other costly complications.
(5) Congress acknowledged the importance of comprehensive
lymphedema treatment coverage with passage of the Women's
Health and Cancer Rights Act of 1998, which requires group
health plans, insurance companies, and health maintenance
organizations to cover breast cancer-related lymphedema
treatment post mastectomy and reconstruction.
(6) Medicare beneficiaries with lymphedema currently lack
coverage for compression therapy, an essential component of
care they must use to manage their chronic disease. As a
result, many patients cannot maintain their condition and
experience an unnecessary loss of health and of function in the
activities of daily living.
(7) This Medicare coverage gap should be closed to help
provide improved health care for lymphedema patients and in
turn decrease the incidence of costly complications, co-
morbidities and related disabilities.
SEC. 3. MEDICARE COVERAGE OF CERTAIN LYMPHEDEMA COMPRESSION TREATMENT
ITEMS AS ITEMS OF DURABLE MEDICAL EQUIPMENT.
(a) In General.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (n), in the first sentence, by inserting
before the semicolon the following: ``and includes lymphedema
compression treatment items (as defined in subsection (iii))'';
and
(2) by adding at the end the following new subsection:
``(iii) Lymphedema Compression Treatment Items.--The term
`lymphedema compression treatment items'--
``(1) means, with respect to an individual, compression
garments, devices, bandaging systems, components, and
supplies--
``(A) that are primarily and customarily used in
the medical treatment of lymphedema;
``(B) as prescribed by a physician (or a physician
assistant, nurse practitioner, or a clinical nurse
specialist (as those terms are defined in section
1861(aa)(5)) to the extent authorized under State law);
and
``(C) which would not, other than under subsection
(s)(6), be included as medical and other health
services under this title; and
``(2) includes--
``(A) multilayer compression bandaging systems;
``(B) custom or standard fit gradient compression
garments;
``(C) non-elastic and low-elastic compression
garments and compression wraps and directional flow
pads; and
``(D) any other compression garments, bandaging
systems, devices, and aids determined by the Secretary
to be effective in the prevention or treatment of
lymphedema.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to lymphedema compression treatment items furnished on or after
180 days after the date of the enactment of this Act.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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