Lymphedema Treatment Act Update + Giveaway!

October is Breast Cancer Awareness Month. This month, BrightLife Direct will be spreading awareness about a condition that many breast cancer survivors face after a mastectomy – lymphedema. This condition refers to mild, moderate or severe swelling (edema), and is often caused by the removal of lymph nodes during cancer treatment. Blockage in the lymphatic system results in the buildup of lymph fluid, which is why swelling occurs.

Lymphedema can develop in the legs, arms and other parts of the body. Some people are born with this condition and others develop it. Approximately 10 million Americans suffer from lymphedema. Breast cancer survivors who develop lymphedema have to wear compression garments over their arms and hand everyday to increase circulation to help manage their condition.

In addition to sharing information on lymphedema this month, we will be doing a weekly giveaway in honor of the many brave Breast Cancer survivors. See below for more information and your chance to win!

Today we want to share information and updates on the Lymphedema Treatment Act.

According to lymphedema specialist, Sue Enerson, many of her patients who are covered by Medicare are only allowed one visit after being diagnosed with lymphedema and more often than not, compression garments are not covered. The financial burden on lymphedema patients is huge. Patients often require frequent visits to doctors and lymphedema therapists to receive treatment and also to learn how to manage lymphedema at home. Patients must also purchase a supply of compression garments to wear continuously, for the rest of their lives, which comes at no small cost.

The Lymphedema Treatment Act is a federal bill that will improve insurance coverage for treatment, mandating that insurance companies provide the medical supplies to patients that are required to manage lymphedema symptoms (including compression garments, bandages, etc.). This in turn will reduce the total healthcare costs associated with lymphedema by reducing the number of complications and disabilities that result from poor treatment of lymphedema symptoms. Currently, most insurance policies including Medicare do not cover lymphedema treatment.

Seniors who suffer from lymphedema should not be punished for taking the necessary steps to treat their condition,” said Reichert. “By rectifying Medicare’s failure to cover compression garments we give seniors their best chance and real hope to fight back against this chronic disease. I am pleased to be joined by my colleagues from both sides of the aisle in this fight against lymphedema. – Congressman Reichert

On March 26, 2015, the Lymphedema Treatment Act was introduced to the current Congress, including a “Findings” section to explain the need for medical coverage. Treatment for lymphedema includes manual lymphatic drainage, wearing compression garments and Complete Decongestive Therapy (CDT), which the bill will make the standard of care for lymphedema.

The Lymphedema Treatment Act currently has over 100 cosponsors. BrightLife Direct as well as many other compression garment companies are showing their support for the Lymphedema Treatment Act. Compression garment makers Sigvaris, Jobst, Medi, Juzo, Solaris and LympheDIVAS also support the bill.

How can you help? Contact your members of Congress to make sure they support the bill. Learn more here: http://lymphedematreatmentact.org/

Win A Prize Every Week!

juzo-soft-bc-giveaway

While there is no cure for lymphedema yet, compression garments help to provide relief. Every Friday during the month of October, we will be hosting a giveaway to win the featured armsleeve of the week. To kick of Breast Cancer Awareness Month, this week we are offering a Juzo Soft Compression Armsleeve. Juzo Soft is available in six different colors as well as a variety of new colors for fall and winter. Juzo Soft Armsleeves are available in three compression levels and in a variety of sizing options. Winners can choose the color, compression level and size.  Don’t forget to keep checking our blog for your chance to win!

You can enter below by logging in with an email address or through Facebook and following BrightLife Direct on Twitter, answering a question, commenting on the blog post or by tweeting a message in the giveaway box below. To tweet the message, click the “Tweet” button, then go to your profile. Next, click on the timestamp on the tweet and paste the url in the box below. Click here for more help.

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RESOURCES

Breast Cancer Navigator

Shop Lymphedema Products

Managing Lymphedema

Kathy Bates – Life With Lymphedema

March is Lymphedema Awareness Month

Sigvaris Supports the Lymphedema Treatment Act

Congressman Reichert’s Involvement in Reintroducing the Bill

Does Medicare pay for compression garments?

We’ve written a number of blog posts on this subject, but with all of the changes taking place in the world of healthcare, thought it was time for an update.

On a positive note, Representative David G. Reichert of Washington state introduced H.R.3877, the Lymphedema Treatment Act on Jan 15th of this year.  The bill would amend title XVIII (Medicare) of the Social Security Act (SSA) to cover certain lymphedema compression treatment items as durable medical equipment.  The bill is currently in committee, and has nine cosponsors.  Similar bills were introduced in 2010 (H.R. 4662) and in 2011 (H.R. 2499), but neither passed. Maybe the third time will be the charm.

With regard to compression stockings prescribed for edema (swelling), varicose veins, venous insufficiency, etc. nothing has changed.  Following is a list, updated in July of this past year, of compression garments that are NOT covered by Medicare.

compression garments not covered by medicareBy: Pete@BrightLife Direct
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Does Medicare cover compression garments?

This is a question that we are frequently asked.  The short answer is “No”.  However, there is legislation currently before congress that would direct Medicare to cover compression garments for the treatment of lymphedema.

There is one exception in the current Medicare policy.  Coverage may be provided if you are being treated by a doctor for a venous statis ulcer on your leg and have a prescription from your Doctor for compression stockings and liners for this condition. BrightLife Direct sells several ulcer care stockings including the Jobst UlcerCare with Zipper and Mediven Dual Layer Stocking System.  Here’s the nitty gritty from Medicare:

The beneficiary must have an open venous stasis ulcer that has been treated by a physician or other healthcare professional requiring medically necessary debridement.  The gradient stocking must be proven to deliver compression greater than 30 mm Hg. and less than 50 mmHg.  When a covered gradient compression stocking is provided to a patient with an open venous stasis ulcer, the modifier AW (item furnished in conjunction with a surgical dressing) must be appended or the claim will be denied as a non-covered service.  Gradient compression stockings are non-covered for the following conditions:
Venous insufficiency without stasis ulcers
Prevention of stasis ulcers

The Lymphedema Diagnosis and Therapy Cost Saving Act of 2010 (HR4662) was introduced in the House of Representatives by North Carolina Congressman Larry Kissell. This is a bi-partisan effort and currently has 58 co-sponsors in the House.  This bill would establish a new benefit category to cover the compression bandages, compression garments and compression devices used in the treatment of lymphedema.  The Medicare Evidence Development Coverage Advisory Committee (MEDCAC) concluded at their meeting last November that existing evidence gives reasonable confidence that use of compression bandage systems and compression garments improve the health of lymphedema patients.

To read a summary or a the entire bill click here.

You can help get this bill passed by emailing or phoning your congressperson.

Pete@BrightLife Direct
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