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Lymphedema Treatment Law

The Case for a Lymphedema Treatment Law

    Millions of dollars are being spent unnecessarily by medical providers to treat cellulitis and lymphangitis resulting indirectly from denials by Medicare of the preventive treatment modalities accepted by NIH NCI, ACS, ISL, NLN, LRF and most other knowledgeable medical and therapeutic organizations;

     Hospital emergency facilities and personnel are being unnecessarily used by lymphedema patients in treating avoidable infections;

     Millions of dollars are being spent unnecessarily in needless appeals of Medicare denials around the country--many of which are being reversed by Administrative Law Judges who recognize that the current standard of lymphedema care includes CDT.

     Millions of dollars are being wasted because the expensive Medicare-approved pneumatic pumps are ending up unused by patients who find that they don't help or have caused further bodily damage--and these same patients are discouraged from seeking the treatment most likely to help them because there is no coverage of this treatment.
     Millions of dollars are being wasted in administering pharmaceuticals to manage the pain caused by the swelling of untreated or undertreated lymphedema.

     Millions of dollars are being wasted to compensate for the disability caused by inability to walk or drive or to do useful work with the arms and hands because of the swelling of untreated lymphedema, and the time-off during hospital stays to treat cellulitis.

     With the current Medicare crisis in the news, this may be a good time to present a new law to treat lymphedema from all causes, primary as well as secondary, as a means of REDUCING medical costs to citizens as well as the Government. Such legislation has been sponsored at the State level  by  Delegate Leo Wardrup in Virginia (in effect since January 1, 2004) and proposed by Senator Susan Fargo in Massachusetts and Assemblywoman Adele Cohen  in New York.

Elements of this new legislation should include:

     a. A mandate that all health insurance providers cover the costs of treatments for lymphedema;
     b. Treatment defined to include a complete course of manual lymph drainage/ complete decongestive therapy (Phase 1) when medically required  performed by nurses or physical, occupational, or message therapists licensed or certified by the appropriate governing board to perform treatments for lymphedema;
     c. Initial course of treatment (Phase 1) shall include training the patient to perform self treatment in a home setting (Phase 2), including self-manual lymphatic drainage, bandaging, wearing and care of compression garments, use of specialized manually adjustable devices, donning aids, and other  required ancillary equipment and techniques for self-measurement;
     d. Include coverage for follow-up treatments when medically required or to periodically validate home techniques;
     e. Include coverage of any compression sleeves and bandages recommended by the patient’s qualified caregiver with replacements when required to maintain the compressive function;
     f. The plan of treatment should be determined by a qualified physician knowledgeable of the diagnosis and current treatment of lymphedema, or a certified lymphedema therapist. Limitations on treatment shall be based on medical necessity, not rules for rehabilitative physical therapy;
     g. Denials of treatment of lymphedema shall only be made by a licensed physician or surgeon who is qualified to treat the condition for which treatment is being denied.
     h. Periodic measurements shall insure the effectivity of the treatment plan and patient compliance, and be used to modify the treatment plan as required or to determine the need for followup courses of treatment.
     i. The benefits under this law shall apply to the extent that benefits are covered under the general terms and conditions of the coverage policy, and are subject to the same deductable and co-insurance conditions applicable to other benefits.

Lymphedema treatment is a “win/win” situation. It is good medicine and good business.  The time has come to fight this "hidden epidemic" lymphedema.  I am prepared to support efforts with sample laws, back-up materials, cost-efficacy analyses, social/fiscal/medical impact statements, fact sheets, etc. Please feel free to contact us for any help you may need.

Robert Weiss
Lymphedema Treatment Advocate
National Lymphedema Network


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Lymphedema Glossary


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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 


Arm Lymphedema 

Leg Lymphedema 

Acute Lymphedema 

The Lymphedema Diet 

Exercises for Lymphedema 

Diuretics are not for Lymphedema 

Lymphedema People Online Support Groups 



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

Infections Associated with Lymphedema 

How to Treat a Lymphedema Wound 

Fungal Infections Associated with Lymphedema 

Lymphedema in Children 


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Magnetic Resonance Imaging 

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Page Updated: Dec 20, 2011