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July 12th:
H.R.2499 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2011 was introduced in the 112th Congress (2011-2012) by Rep. Larry Kissel.
(H.R. 2499, 2011)
January 15th:
H.R. 3877 Lymphedema Treatment Act was introduced to the 113th Congress (2013-2014) by Rep. David G. Reichert.
(H.R. 3877, 2014)
The proposed Lymphedema Treatment Act (LTA) will help to improve coverage for the treatment of lymphedema. This will occur via amending the current Medicare statute, mentioned previously, to allow for coverage of compression supplies. This legislation was specifically proposed to a change in Medicare law, however, it would set an example for Medicaid and private insurers to follow suite
However, it can be managed with compression techniques, thus reducing these risks.
After several years of gaining sponsorship...
The Lymphedema Treatment Act was born!
(Lymphedema Treatment Act, 2011)
February 23rd:
Sponsored by Representative Larry Kissell, the first version of the LTA was introduced in the 111th Congress (2009-2010) as H.R.4662 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2010 .
The 114th Congress (2015-2016)
March 25th:
December 8th:
According to House Bill 1608 (2015),
Medicare and other policies will not cover one of the vital components of lymphedema treatment, which is....
(H.R. 4662, 2010)
Compression Treatment Supplies
(H.R. 1608, 2015)
(S. 2372, 2015)
Clients with lymphedema are required to pay out of pocket.
Includes three sections:
(1) Short Title
(2) Findings
(3) Medicare Coverage of Certain Lymphedema Compression Treatment Items as Items of Durable Medical Equipment
Lymphedema compression treatment items are defined as:
According to House Bill 1608 (2015),
California and Louisiana have already recognized the importance of comprehensive treatment and require that private plans include coverage
(Lymphedema Treatment Act, 2011)
(H.R. 1608, 2015)
Lymphedema compression treatment items include:
The bill will become effective 180 days after being enacted
(H.R. 1608, 2015)
H.R.2499 - Lymphedema Diagnosis and Treatment Cost-Saving Act of 2011
H.R.4662 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2010
Two sections:
(1) Short Title
(2) Coverage of Lymphedema Diagnosis and Treatment Services Under Medicare
Lists additional compression treatment items:
Includes a payment subsection
Two sections:
(1) Short Title
(2) Coverage of Lymphedema Diagnosis and Treatment Services Under Medicare
Lists physicians, OTs, PTs, nurse practitioners, PAs, clincial nurse speicalists, and chiropracters as adequate performers of treatment
Also includes subsections for:
Effective date is 90 days after bill is enacted
(H.R. 2499, 2011)
(H.R. 4662, 2010)
Establishment of EBP
Reimbursement of compression treatment
Improvement of quality of life and outcomes for clients
(Thrift & Squire, 2013)
The impact has the potential to be wide spread
Lymphedema can be caused by various means; PVD, DVT, late affects of CHF, late affects of renal failure, chronic obesity, paralysis, and dependency positioning ...therefore, it can be observed in a variety of settings.
Settings could include acute, sub-acute, SNF, and homecare
(Rice, 2013)
Lymphedema Diagnosis and Treatment Cost Saving Act of 2011, H.R. 2499,
112d Cong. (2011). Retrieved from https://www.congress.gov/bill/112th-congress/house-bill/2499/text
Lymphedema Diagnosis and Treatment Cost-Saving Act of 2010, H.R. 4662,
111d Cong. (2010). Retrieved from https://www.congress.gov/bill/111th-congress/house-bill/4662/text
Lymphedema Treatment Act (2011). Retrieved on March 18th from http://
lymphedematreatmentact.org/about-the-bill/
Lymphedema Treatment Act, H.R. 1608, 114d Cong. (2015). Retrieved from
https://www.congress.gov/bill/114th-congress/house-bill/1608/text
Lymphedema Treatment Act, S. 2373, 114d Cong. (2015). Retrieved from
https://www.congress.gov/bill/114th-congress/senate-bill/2373/text
Lymphedema Treatment Act, H.R. 3877, 113d Cong. (2014). Retrieved from
https://www.congress.gov/bill/113th-congress/house-bill/3877/text
Rice, L. (2013). Lymphedema in the skilled nursing setting. Retrieved on March
19th from http://www.allied-services.org/resources/lymphedema-treatment-in-the-skilled-nursing-setting/
Thrift, K., Squire, D. (2013). Utilizing complete decongestive therapy to treat
lymphedema: Evidence from contemporary literature: National Lymphedema Network, (25) 3. Retreived from http://www.lymphnet.org/membersOnly/dl/reprint/Vol_25/Vol_25-N3_Utilizing_CDT.pdf
Beneficence and Justice for all!
As OTs, we need to do the most good for our patients, as well as providing them equal opportunities to receive the best treatment options.
If the LTA is enacted, clients will be able to receive the treatment items they deserve through insurance. Today, only the clients that have the financial resources can receive the care that all individuals should have access to.