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Kelly-led Lymphedema Treatment Act passes House of Representatives

Government and Politics

November 17, 2022


Kelly-led Lymphedema Treatment Act passes House of Representatives

WASHINGTON, D.C. -- Today, the U.S. House of Representatives passed landmark legislation, H.R. 3630, the Lymphedema Treatment Act, which is co-led by U.S. Rep. Mike Kelly (R-PA). The bill will ensure Medicare Part B coverage of doctor-prescribed compression garments, the clinically recognized treatment for lymphedema. The bill, which was reintroduced in May 2021, is led by Reps. Jan Schakowsky (D-IL) and Buddy Carter (R-GA) and co-led by Representatives Kelly and Earl Blumenauer (D-OR). The bill passed by a vote of 402-13.

"Today my bill, the Lymphedema Treatment Act, passed the House with overwhelmingly bipartisan support," Rep. Mike Kelly (R-PA). "This bill will ensure Lymphedema patients on Medicare get the treatment they deserve. Too often these patients cannot get their basic care covered by Medicare. Not anymore.”

“We are one step closer to providing relief for lymphedema patients, many of whom live through one of the worst diagnoses imaginable – cancer – only to come out the other side with an equally debilitating condition and a fraction of the resources and support. As co-chair of the Cancer Survivors Caucus and a pharmacist, I am excited to see Congress provide relief to patients who have been denied Medicare coverage for far too long,” said Congressman Buddy Carter (R-GA).

"Today, the House of Representatives took one giant step closer to finally providing needed relief to over three million Lymphedema patients on Medicare,” said Congresswoman Jan Schakowsky (D-IL). “My bill, the Lymphedema Treatment Act, which I was proud to introduce with my colleague, Rep. Buddy Carter (GA-01), will expand access to medical compression garments that Lymphedema patients rely on to treat their painful, incurable swelling. The bill passed the House with overwhelming bipartisan support thanks to the tireless work of advocates like Heather Ferguson, Founder and Executive Director of the Lymphedema Advocacy Group, and her teenage sons. With tremendous bipartisan support in the Senate, we can get this bill to President Biden’s desk before the end of the year. Millions of Lymphedema patients are counting on us."

“Komen applauds the passage of the Lymphedema Treatment Act as an important step in relieving the financial burden felt by many breast cancer patients and survivors who experience lymphedema, particularly Black and Hispanic women, and calls for swift passage in the Senate," said Molly Guthrie, Vice President of Policy and Advocacy for Susan G. Komen. “The use of prescribed medical compression garments significantly improves health and quality of life for patients through reduced incidence of infections, hospitalizations, and other costly, yet preventable, complications. However, the out-of-pocket costs for these garments prevent people from accessing them."

“The Oncology Nursing Society applauds the bipartisan leadership of U.S. Representatives Jan Schakowsky and Buddy Carter for championing the necessary patient-centered Lymphedema Treatment Act (LTA). Nurses help patients with cancer and survivors navigate symptom management, and LTA will have a direct impact on how patients and their families cope with the many burdens of lymphedema. Thank you for your support in passing this legislation!” said Jeannine Brant, PhD, APRN-CNS, AOCN®, FAAN, ONS President.

BACKGROUND

Lymphedema is a chronic, progressive group of conditions characterized by swelling and discomfort in various parts of the body due to malfunctions in the lymphatic system. Between 1.5 and 3 million Medicare beneficiaries currently suffer from lymphedema. Patients undergoing treatment for cancer are particularly susceptible to lymphedema.

When left untreated or undertreated, lymphedema can lead to complications, infections, comorbidities, loss of function, and disability—often necessitating costly emergency department or hospital visits. Commercial insurance and state Medicaid programs currently cover compression therapy.

Under current law, Medicare Part B does not cover most Lymphedema treatments. The means Medicare beneficiaries with the disease must either pay out of pocket or go without treatment, which can lead to more significant medical complications over time. In recent years, Congress has repeatedly encouraged CMS to begin covering Lymphedema treatments in the same way they cover other preventative treatments for Medicare beneficiaries, but CMS has failed to act.