Discussing Lymphedema Treatment Act, Coverage With Patients

Healthcare teams should educate their patients about the Lymphedema Treatment Act, which went into effect on Jan. 1, 2024, and requires Medicare to cover lymphedema compression garments and other prescribed compression supplies.

Lymphedema is a condition of painful swelling in the arms or legs that results from the buildup of lymphatic fluid that occurs after the removal or trauma of lymph nodes. It is commonly observed in patients with breast cancer who have lymph nodes removed, but can also occur in patients with other conditions or cancer types.

“It is very exciting for patients who qualify for protection under this law to get access to this coverage. And so, we want healthcare teams to be making sure that they're passing this information along to patients,” Joanna Fawzy Doran, Esq., CEO of Triage Cancer, said in an interview with Oncology Nursing News.

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The act was signed into federal law on Dec. 23, 2022, before going into effect at the beginning of this year. According to its summary on congress.gov, “Specifically, the bill provides for coverage of standard and custom-fitted gradient compression garments and other approved items that are prescribed by a physician or other specified health care professional to treat lymphedema.”

According to Doran, this is the first time that Medicare Part B has offered clear coverage for devices to treat lymphedema. And while the law does not make it mandatory for private insurers to cover these garments, Doran also mentioned that other insurance companies will typically follow suit based on what the Centers for Medicare & Medicaid Services (CMS) does.

Doran emphasized that, “just passing the law was step 1. Now we need to make sure that people know about it.”