Lymphedema Medicare - Progress Report

URGENT ADVOCATE ALERT: Trends in Risk Reduction Practices for the Prevention of Lymphedema * *
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Lymphedema Medicare - Progress Report

Postby patoco » Mon Jan 07, 2008 6:11 am

Lymphedema Medicare - Progress Report

Robert Weiss, M.S.
Lymphedema Treatment Advocate
National Lymphedema Network

Guess the definition of "good news" is "the absence of bad news".

After months of debate, Congress approved a Medicare "extenders" package just before the holidays which is expected to be signed by the President shortly and addresses three top disability rights priorities.

Medicare's 75% Rule: The legislation approved by the House and Senate will permanently freeze implementation of the 75% Rule at the 60% level as well as allow comorbid conditions to continue to count toward meeting the rule's threshold. Additionally, the bill requires that HHS study beneficiary access to inpatient rehabilitation services and make recommendations for classifying inpatient rehabilitation hospitals and units. These provisions constitute a huge victory for disability advocates!

Medicare's Outpatient Therapy Caps: The Medicare extenders package will extend the current exceptions process for Medicare's cap on outpatient rehabilitation therapy services through June 30, 2008. While this is not the longer-term fix the Coalition advocated for this year, it does allow continued access to outpatient rehabilitation therapy for individuals who need it most, and Congress is likely to address this issue again before this extension expires in six months.

Medicaid Rehabilitative Services Option:Â The bill places a six-month
moratorium on issuance of final regulations to restrict allowable services under the Medicaid Rehabilitative Services Option. Again, while this is not the longer-term moratorium the Coalition had promoted, it does allow advocates additional time to work with Congress to prevent final implementation of this harmful regulation.

Looks like we have to continue our fight to permanently remove therapy caps for lymphedema treatment.

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