Lymphedema People Logo



 LYMPHEDEMA LEGISLATION   MASSACHEUSETTS

================================================

                                                        THREE                                          

PROVIDING COVERAGE FOR LYMPHEDEMA TREATMENTS 

Chapter 32A of the General Laws is hereby amended by inserting after section 17H the following section:-

            Section 17I. (a) The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the cost of treatment and follow-up treatment for lymphedema including but not limited to complete decongestive therapy, manual lymph drainage, surgical treatments, compression garments, bandages, replacement garments or bandages or other course of treatment recommended by a health care provider in accordance with generally accepted current medical standards.  The course of treatment for lymphedema shall be determined by a health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services, including but not limited to the prescribed number of visits for complete decongestive therapy, supplies required for complete decongestive therapy, bandages and the full range of compression garments, follow-up treatment, out-patient self-management training and education, lymphedema and lymphedema-related surgery, and hospitalization for third-stage lymphedema treatment  A health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services shall include, but not be limited to a health care provider licensed under chapter 112.  No person other than a health care provider health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services or licensed under chapter 112 and competent to evaluate the specific clinical issues involved in the treatment of lymphedema may deny requests for the payment of benefits under this section.  The commission shall also provide coverage for treatment of lymphedema by a physical therapist licensed under section 23B of chapter 112.

            (b) The commission shall not impose upon any person receiving benefits under this section any co-payment, fee or condition that is not equally imposed upon all individuals in the same benefit category.  The commission also shall not impose any policy year or calendar year dollar or durational benefit limitations or maximums for benefits or services provided to a person under this section.

SECTION 2.  Chapter 118E of the General Laws is hereby amended by inserting after section 10C the following section:-

            Section 10D.  (a) The division shall provide coverage for the cost of treatment and follow-up treatment for lymphedema, including but not limited to complete decongestive therapy, manual lymph drainage, surgical treatments, compression garments, bandages, replacement garments or bandages or other course of treatment recommended by a health care provider in accordance with generally accepted current medical standards.  The course of treatment for lymphedema shall be determined by a health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services, including but not limited to the prescribed number of visits for complete decongestive therapy, supplies required for complete decongestive therapy, bandages and the full range of compression garments, follow-up treatment, out-patient self-management training and education, lymphedema and lymphedema-related surgery, and hospitalization for third-stage lymphedema treatment  A health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services shall include, but not be limited to a health care provider licensed under chapter 112.  No person other than a health care provider health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services or licensed under chapter 112 and competent to evaluate the specific clinical issues involved in the treatment of lymphedema may deny requests for the payment of benefits under this section.  The commission shall also provide coverage for treatment of lymphedema by a physical therapist licensed under section 23B of chapter 112.

            (b)  The division shall not impose upon any person receiving benefits under this section any co-payment, fee or condition that is not equally imposed upon all individuals in the same benefit category.  The division also shall not impose any policy year or calendar year dollar or durational benefit limitations or maximums for benefits or services provided to a person under this section.

            SECTION 3.  Chapter 175 of the General Laws is hereby amended by inserting after section 47V the following section:-

            Section 47W.  (a) Any policy of accident and sickness insurance described in section 108 which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and policyholder in the commonwealth; any blanket or general policy of insurance described in subdivision (A), (C) or (D) of section 110 which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, except policies providing supplemental coverage to Medicare; or any employers’ health and welfare fund which provides hospital expense and surgical expense benefits and which is delivered, issued or renewed to any person or group of persons in the commonwealth, shall provide coverage for the cost of treatment and follow-up treatment for lymphedema, including but not limited to complete decongestive therapy, manual lymph drainage, surgical treatments, compression garments, bandages, replacement garments or bandages or other course of treatment recommended by a health care provider in accordance with generally accepted current medical standards.  The course of treatment for lymphedema shall be determined by a health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services, including but not limited to the prescribed number of visits for complete decongestive therapy, supplies required for complete decongestive therapy, bandages and the full range of compression garments, follow-up treatment, out-patient self-management training and education, lymphedema and lymphedema-related surgery, and hospitalization for third-stage lymphedema treatment  A health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services shall include, but not be limited to a health care provider licensed under chapter 112.  No person other than a health care provider health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services or licensed under chapter 112 and competent to evaluate the specific clinical issues involved in the treatment of lymphedema may deny requests for the payment of benefits under this section.  The commission shall also provide coverage for treatment of lymphedema by a physical therapist licensed under section 23B of chapter 112.

            (b)  No insurer shall impose upon any person receiving benefits under this section any co-payment, fee or condition that is not equally imposed upon all individuals in the same benefit category.  No insurer shall impose any policy year or calendar year dollar or durational benefit limitations or maximums for benefits or services provided to a person under this section.

            SECTION 4.  Chapter 176A of the General Laws are herby amended by inserting after section 8V the following section:-

            Section 8W.  Any contract, except contracts providing supplemental coverage to Medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed in the commonwealth shall provide as benefits to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment within the commonwealth coverage for expenses incurred in the treatment and follow-up treatment for lymphedema, including but not limited to complete decongestive therapy, manual lymph drainage, surgical treatments, compression garments, bandages, replacement garments or bandages or other course of treatment recommended by a health care provider in accordance with generally accepted current medical standards.  The course of treatment for lymphedema shall be determined by a health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services, including but not limited to the prescribed number of visits for complete decongestive therapy, supplies required for complete decongestive therapy, bandages and the full range of compression garments, follow-up treatment, out-patient self-management training and education, lymphedema and lymphedema-related surgery, and hospitalization for third-stage lymphedema treatment  A health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services shall include, but not be limited to a health care provider licensed under chapter 112.  No person other than a health care provider health care provider authorized under law to prescribe or provide treatments, products, and services or licensed under chapter 112 and competent to evaluate the specific clinical issues involved in the treatment of lymphedema may deny requests for the payment of benefits under this section.  The commission shall also provide coverage for treatment of lymphedema by a physical therapist licensed under section 23B of chapter 112.

            (b) No corporation shall impose upon any person receiving benefits under this section any co-payment, fee or condition that is not equally imposed upon all individuals in the same benefit category.  No corporation shall impose any policy year or calendar year dollar or durational benefit limitations or maximums for benefits or services provided to a person under this section.

            SECTION 5.  Chapter 176B of the General Laws is hereby amended by inserting after section 4V the following section:-

Section 4W.  Any subscription certificate under an individual or group medical service agreement, except certificates which provide supplemental coverage to Medicare or other governmental programs, delivered, issued or renewed within the commonwealth shall provide as benefits to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment in the commonwealth, coverage for expenses incurred in the treatment and follow-up treatment for lymphedema, including but not limited to complete decongestive therapy, manual lymph drainage, surgical treatments, compression garments, bandages, replacement garments or bandages or other course of treatment recommended by a health care provider in accordance with generally accepted current medical standards.  The course of treatment for lymphedema shall be determined by a health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services, including but not limited to the prescribed number of visits for complete decongestive therapy, supplies required for complete decongestive therapy, bandages and the full range of compression garments, follow-up treatment, out-patient self-management training and education, lymphedema and lymphedema-related surgery, and hospitalization for third-stage lymphedema treatment  A health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services shall include, but not be limited to a health care provider licensed under chapter 112.  No person other than a health care provider health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services or licensed under chapter 112 and competent to evaluate the specific clinical issues involved in the treatment of lymphedema may deny requests for the payment of benefits under this section.  The commission shall also provide coverage for treatment of lymphedema by a physical therapist licensed under section 23B of chapter 112.

            (b) No corporation shall impose upon any person receiving benefits under this section any co-payment, fee or condition that is not equally imposed upon all individuals in the same benefit category.  No corporation shall impose any policy year or calendar year dollar or durational benefit limitations or maximums for benefits or services provided to a person under this section.

            SECTION 6.  Chapter 176G of the General Laws is hereby amended by inserting after section 4N the following section:-

Section 4O.  An individual or group health maintenance contract, except contracts providing supplemental coverage to Medicare or to other government programs, shall provide coverage and benefits for expenses incurred in the treatment and follow-up treatment for lymphedema, including but not limited to complete decongestive therapy, manual lymph drainage, surgical treatments, compression garments, bandages, replacement garments or bandages or other course of treatment recommended by a health care provider in accordance with generally accepted current medical standards.  The course of treatment for lymphedema shall be determined by a health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services, including but not limited to the prescribed number of visits for complete decongestive therapy, supplies required for complete decongestive therapy, bandages and the full range of compression garments, follow-up treatment, out-patient self-management training and education, lymphedema and lymphedema-related surgery, and hospitalization for third-stage lymphedema treatment  A health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services shall include, but not be limited to a health care provider licensed under chapter 112.  No person other than a health care provider health care provider authorized under law to prescribe or provide lymphedema treatments, products, and services or licensed under chapter 112 and competent to evaluate the specific clinical issues involved in the treatment of lymphedema may deny requests for the payment of benefits under this section.  The commission shall also provide coverage for treatment of lymphedema by a physical therapist licensed under section 23B of chapter 112.

            (b) No health maintenance organization shall impose upon any person receiving benefits under this section any co-payment, fee or condition that is not equally imposed upon all individuals in the same benefit category.  No health maintenance organization shall impose any policy year or calendar year dollar or durational benefit limitations or maximums for benefits or services provided to a person under this section.

================================================

Join us as we work for lymphedema patients everywehere:

Advocates for Lymphedema

Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.

http://health.groups.yahoo.com/group/AdvocatesforLymphedema/

Subscribe: AdvocatesforLymphedema-subscribe@yahoogroups.com

Pat O'Connor

Lymphedema People / Advocates for Lymphedema

===========================

Lymphedema People New Wiki Pages

Have you seen our new “Wiki” pages yet?  Listed below are just a sample of the more than 140 pages now listed in our Wiki section. We are also working on hundred more.  Come and take a stroll! 

Lymphedema Glossary 

http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing 

Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema 

Arm Lymphedema  

http://www.lymphedemapeople.com/wiki/doku.php?id=arm_lymphedema 

Leg Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=leg_lymphedema 

Acute Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=acute_lymphedema 

The Lymphedema Diet 

http://www.lymphedemapeople.com/wiki/doku.php?id=the_lymphedema_diet 

Exercises for Lymphedema  

http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema 

Diuretics are not for Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=diuretics_are_not_for_lymphedema 

Lymphedema People Online Support Groups 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_people_online_support_groups 

Lipedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema 

Treatment 

http://www.lymphedemapeople.com/wiki/doku.php?id=treatment 

Lymphedema and Pain Management 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pain_management 

Manual Lymphatic Drainage (MLD) and Complex Decongestive Therapy (CDT)

http://www.lymphedemapeople.com/wiki/doku.php?id=manual_lymphatic_drainage_mld_complex_decongestive_therapy_cdt 

Infections Associated with Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema 

How to Treat a Lymphedema Wound 

http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound 

Fungal Infections Associated with Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=fungal_infections_associated_with_lymphedema 

Lymphedema in Children 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children 

Lymphoscintigraphy 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphoscintigraphy 

Magnetic Resonance Imaging 

http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging 

Extraperitoneal para-aortic lymph node dissection (EPLND) 

http://www.lymphedemapeople.com/wiki/doku.php?id=extraperitoneal_para-aortic_lymph_node_dissection_eplnd 

Axillary node biopsy 

http://www.lymphedemapeople.com/wiki/doku.php?id=axillary_node_biopsy

Sentinel Node Biopsy 

http://www.lymphedemapeople.com/wiki/doku.php?id=sentinel_node_biopsy

 Small Needle Biopsy - Fine Needle Aspiration 

http://www.lymphedemapeople.com/wiki/doku.php?id=small_needle_biopsy 

Magnetic Resonance Imaging 

http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging 

Lymphedema Gene FOXC2

 http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_foxc2

 Lymphedema Gene VEGFC

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_vegfc

 Lymphedema Gene SOX18

 http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_sox18

 Lymphedema and Pregnancy

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pregnancy

Home page: Lymphedema People

http://www.lymphedemapeople.com

Page Updated: May 8, 2008