House Passes Cantwell Legislation to Expand Medicare Coverage for People Living with Lymphedema

Bipartisan Lymphedema Treatment Act could help more than 6,300 Washingtonians, 1.5 million Americans get essential, effective care

WASHINGTON, D.C. – Today, the U.S. House of Representatives passed bipartisan legislation pushed by U.S. Senator Maria Cantwell (D-WA) and Congresswoman Jan Schakowsky (D, IL-9) to improve Medicare coverage for lymphedema patients. The Lymphedema Treatment Act would expand available care and benefits for Medicare beneficiaries with lymphedema by requiring Medicare to cover compression treatment items, which are essential in the effective treatment of the disease. The measure passed as part of a larger House bill, the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), which now moves to the Senate for consideration.

“Lymphedema affects millions of Americans, including more than 6,300 Washingtonians,” Senator Cantwell said. “Updating Medicare to cover necessary and effective treatment for this condition is a commonsense measure that will improve care for Medicare beneficiaries with lymphedema, while also reducing costly hospitalizations.”

Lymphedema is an incurable but treatable condition affecting between three and five million Americans. It is a chronic condition caused by injury, trauma, or congenital defects in the lymphatic system, which can occur after cancer treatment. If left untreated or inadequately treated, it can lead to complications including loss of function, disability, and in some cases, death.

The House-passed Lymphedema Treatment Act would close an existing coverage gap and improve care for the more than 1.5 million Medicare beneficiaries with lymphedema by ensuring that Medicare covers physician-prescribed compression therapy items. These items include multi-layer compression bandaging systems, standard fit compression garments, and other compression items that are used in the medical treatment of lymphedema. These compression therapy items, which reduce complications and disease progression by controlling swelling of the limbs, are part of the standard of care for lymphedema. State Medicaid programs and private health insurance plans currently cover compression therapy items, but Medicare Part B does not.

The Senate version of the legislation was introduced this year by Senator Cantwell and Senator Todd Young (R-IN), and is co-sponsored by 68 senators from both parties and widely supported by patient advocates and health care providers. Groups endorsing the bill include the American Cancer Society, the Lymphedema Advocacy Group, and the American Medical Association.

Senator Cantwell has a long record of working to protect and improve the Medicare program. In July 2019, Cantwell and the Senate Finance Committee passed a bipartisan bill through the Committee that would lower Medicare patients’ prescription drug costs.