I 

113TH CONGRESS 

2D SESSION H. R. 3877 

To amend title XVIII of the Social Security Act to provide for Medicare 

coverage of certain lymphedema compression treatment items as items 

of durable medical equipment. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 15, 2014 

Mr. REICHERT (for himself, Mr. BLUMENAUER, Mr. LANCE, and Mr. BRALEY

of Iowa) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for Medicare coverage of certain lymphedema compression treatment items as items of durable medical equipment. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Lymphedema Treat5 ment Act’’. 


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1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Lymphedema is a chronic disease that re4 sults in an accumulation of protein-rich lymph fluid 

5 in parts of the body where lymph nodes or lymphatic 

6 vessels are damaged or inadequate. 

7 (2) Lymphedema afflicts millions of Americans, 

8 including men, women, and children who can be 

9 born with a primary form of lymphedema. The ma10 jority of cases, however, are secondary forms of 

11 lymphedema most often caused by cancer treatments 

12 that damage the body’s lymph transport and im13 mune functions. 

14 (3) A 2010 peer-reviewed study in the Amer15 ican Cancer Society’s Cancer journal stated 

16 ‘‘lymphedema is a common post-treatment condition 

17 [and] has been described as one of the most signifi18 cant survivorship issues’’. The study reported an 

19 overall cancer-related lymphedema incidence rate of 

20 15.5 percent, with specific rates as follows: sarcoma 

21 30 percent, breast 20 percent, gynecological 20 per22 cent, melanoma 16 percent, genital-urinary 10 per23 cent, and head and neck 4 percent. Risk increased 

24 22 percent after pelvic lymph node removal and 31 

25 percent after radiation therapy. 


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1 (4) Lymphedema is progressive when left un2 treated or under-treated and can put patients at 

3 greater risk for serious infections or other costly 

4 complications. 

5 (5) Congress acknowledged the importance of 

6 comprehensive lymphedema treatment coverage with 

7 passage of the Women’s Health and Cancer Rights 

8 Act of 1998, which requires group health plans, in9 surance companies, and health maintenance organi10 zations to cover breast cancer-related lymphedema 

11 treatment post mastectomy and reconstruction. 

12 (6) Medicare beneficiaries with lymphedema 

13 currently lack coverage for compression therapy, an 

14 essential component of care they must use to man15 age their chronic disease. As a result, many patients 

16 cannot maintain their condition and experience an 

17 unnecessary loss of health and of function in the ac18 tivities of daily living. 

19 (7) This Medicare coverage gap should be 

20 closed to help provide improved health care for 

21 lymphedema patients and in turn decrease the inci22 dence of costly complications, co-morbidities and re23 lated disabilities. 


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1 SEC. 3. MEDICARE COVERAGE OF CERTAIN LYMPHEDEMA 

2 COMPRESSION TREATMENT ITEMS AS ITEMS 

3 OF DURABLE MEDICAL EQUIPMENT. 

4 (a) IN GENERAL.—Section 1861 of the Social Secu5 rity Act (42 U.S.C. 1395x) is amended— 

6 (1) in subsection (n), in the first sentence, by 

7 inserting before the semicolon the following: ‘‘and in8 cludes lymphedema compression treatment items (as 

9 defined in subsection (iii))’’; and 

10 (2) by adding at the end the following new sub11 section: 

12 ‘‘(iii) LYMPHEDEMA COMPRESSION TREATMENT

13 ITEMS.—The term ‘lymphedema compression treatment 

14 items’— 

15 ‘‘(1) means, with respect to an individual, com16 pression garments, devices, bandaging systems, com17 ponents, and supplies— 

18 ‘‘(A) that are primarily and customarily 

19 used in the medical treatment of lymphedema; 

20 ‘‘(B) as prescribed by a physician (or a 

21 physician assistant, nurse practitioner, or a 

22 clinical nurse specialist (as those terms are de23 fined in section 1861(aa)(5)) to the extent au24 thorized under State law); and 


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1 ‘‘(C) which would not, other than under 

2 subsection (s)(6), be included as medical and 

3 other health services under this title; and 

4 ‘‘(2) includes— 

5 ‘‘(A) multilayer compression bandaging 

6 systems; 

7 ‘‘(B) custom or standard fit gradient com8 pression garments; 

9 ‘‘(C) non-elastic and low-elastic compres10 sion garments and compression wraps and di11 rectional flow pads; and 

12 ‘‘(D) any other compression garments, 

13 bandaging systems, devices, and aids deter14 mined by the Secretary to be effective in the 

15 prevention or treatment of lymphedema.’’. 

16 (b) EFFECTIVE DATE.—The amendment made by 

17 subsection (a) shall apply to lymphedema compression 

18 treatment items furnished on or after 180 days after the 

19 date of the enactment of this Act. 

Æ 


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