Cantwell Introduces Bill to Improve Medicare Coverage for People Living with Lymphedema

Bill improves care, lowers hospitalization rate for Lymphedema patients

WASHINGTON, D.C. Today, U.S. Senator Maria Cantwell (D-WA), joined by Senators Chuck Grassley (R-IA), Mark Kirk (R-IL), and Chuck Schumer (D-NY), introduced bipartisan legislation to improve Medicare coverage for lymphedema patients. The bill would provide for Medicare coverage of physician-prescribed compression therapy equipment used to treat lymphedema, part of the clinically-recognized standard of care for the condition.   

“With more than 6,300 Medicare beneficiaries in Washington and millions of Americans suffering from Lymphedema, we must update Medicare to reflect necessary and effective treatments for this condition. This legislation is a common sense measure that improves care for Medicare beneficiaries living with lymphedema and reduces costly hospitalizations,” said Senator Cantwell.

“Medicare ought to reflect the modern practice of medicine,” Senator Grassley said.  “The equipment to treat lymphedema is something doctors recommend and that patients need.  Lymphedema is more common than people might realize.  It can affect breast cancer surgery survivors, for example.” 

“More than 11,700 Medicare patients in Illinois are living with lymphedema and they shouldn’t be denied access to medically-necessary compression treatment,” Senator Kirk said. “This bill will help patients with lymphedema effectively manage their condition and reduce the likelihood that they suffer from serious and often costly complications.”

“This important bill will finally make sure that those living with Lymphedema have access to the healthcare treatment they need to lead healthy, productive lives while also lowering the hospitalization rates for these patients. As a co-sponsor of the Lymphedema Treatment Act, I pledge to work with my colleagues in Congress to continue to improve Medicare coverage on behalf of Lymphedema patients,” said Senator Schumer.

The Lymphedema Treatment Act would clarify within the existing Medicare coverage guidelines compression therapy items as a reasonable and necessary treatment. Under current law, compression therapy equipment is not covered because it does not fall under the definition of durable medical equipment. This restriction creates a gap in coverage for people with lymphedema. A preventive treatment, compression therapy equipment can reduce the need for costly hospital admissions among Medicare beneficiaries with lymphedema. 

Lymphedema is an incurable but treatable condition affecting between 3 and 5 million Americans, many of whom are Medicare beneficiaries. It is a chronic condition caused by injury, trauma or congenital defects in the lymphatic system.  If left untreated or inadequately treated it can lead to complications including loss of function, disability, and in some cases even death.

The Lymphedema Treatment Act has broad, bipartisan support. Companion legislation in the House (H.R. 1608) has 166 cosponsors. The bill is also supported by a wide range of advocacy groups including the American Cancer Society, American Physical Therapy Association, and Susan G. Komen for the Cure.