117TH CONGRESS 

2D SESSION H. R. 3630 

AN ACT 

To amend title XVIII of the Social Security Act to provide 

for coverage of certain lymphedema compression treatment items under the Medicare program. 

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

2 This Act may be cited as the ‘‘Lymphedema Treat3 ment Act’’. 

4 SEC. 2. MEDICARE COVERAGE OF CERTAIN LYMPHEDEMA 

5 COMPRESSION TREATMENT ITEMS. 

6 (a) COVERAGE.— 

7 (1) IN GENERAL.—Section 1861 of the Social 

8 Security Act (42 U.S.C. 1395x) is amended— 

9 (A) in subsection (s)(2)— 

10 (i) in subparagraph (GG), by striking 

11 ‘‘and’’ after the semicolon at the end; 

12 (ii) in subparagraph (HH), by strik13 ing the period at the end and inserting ‘‘; 

14 and’’; and 

15 (iii) by adding at the end the fol16 lowing new subparagraph: 

17 ‘‘(II) lymphedema compression treatment items 

18 (as defined in subsection (lll));’’; and 

19 (B) by adding at the end the following new 

20 subsection: 

21 ‘‘(lll) LYMPHEDEMA COMPRESSION TREATMENT

22 ITEMS.—The term ‘lymphedema compression treatment 

23 items’ means standard and custom fitted gradient com24 pression garments and other items determined by the Sec25 retary that are— 
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1 ‘‘(1) furnished on or after January 1, 2024, to 

2 an individual with a diagnosis of lymphedema for the 

3 treatment of such condition; 

4 ‘‘(2) primarily and customarily used to serve a 

5 medical purpose and for the treatment of 

6 lymphedema, as determined by the Secretary; and 

7 ‘‘(3) prescribed by a physician (or a physician 

8 assistant, nurse practitioner, or a clinical nurse spe9 cialist (as those terms are defined in section 

10 1861(aa)(5)) to the extent authorized under State 

11 law).’’. 

12 (2) PAYMENT.— 

13 (A) IN GENERAL.—Section 1833(a)(1) of 

14 the Social Security Act (42 U.S.C. 1395l(a)(1)) 

15 is amended— 

16 (i) by striking ‘‘, and’’ before ‘‘(EE)’’; 

17 and 

18 (ii) by inserting before the semicolon 

19 at the end the following: ‘‘, and (FF) with 

20 respect to lymphedema compression treat21 ment items (as defined in section 

22 1861(lll)), the amount paid shall be equal 

23 to 80 percent of the lesser of the actual 

24 charge or the amount determined under 
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1 the payment basis determined under sec2 tion 1834(z)’’. 

3 (B) PAYMENT BASIS AND LIMITATIONS.— 

4 Section 1834 of the Social Security Act (42 

5 U.S.C. 1395m) is amended by adding at the 

6 end the following new subsection: 

7 ‘‘(z) PAYMENT FOR LYMPHEDEMA COMPRESSION

8 TREATMENT ITEMS.— 

9 ‘‘(1) IN GENERAL.—The Secretary shall deter10 mine an appropriate payment basis for lymphedema 

11 compression treatment items (as defined in section 

12 1861(lll)). In making such a determination, the Sec13 retary may take into account payment rates for such 

14 items under State plans (or waivers of such plans) 

15 under title XIX, the Veterans Health Administra16 tion, and group health plans and health insurance 

17 coverage (as such terms are defined in section 2791 

18 of the Public Health Service Act), and such other in19 formation as the Secretary determines appropriate. 

20 ‘‘(2) FREQUENCY LIMITATION.—No payment 

21 may be made under this part for lymphedema com22 pression treatment items furnished other than at 

23 such frequency as the Secretary may establish. 

24 ‘‘(3) APPLICATION OF COMPETITIVE ACQUISI25 TION.—In the case of lymphedema compression 
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1 treatment items that are included in a competitive 

2 acquisition program in a competitive acquisition area 

3 under section 1847(a)— 

4 ‘‘(A) the payment basis under this sub5 section for such items furnished in such area 

6 shall be the payment basis determined under 

7 such competitive acquisition program; and 

8 ‘‘(B) the Secretary may use information on 

9 the payment determined under such competitive 

10 acquisition programs to adjust the payment 

11 amount otherwise determined under this sub12 section for an area that is not a competitive ac13 quisition area under section 1847, and in the 

14 case of such adjustment, paragraphs (8) and 

15 (9) of section 1842(b) shall not be applied.’’. 

16 (3) CONFORMING AMENDMENT.—Section 

17 1847(a)(2) of the Social Security Act (42 U.S.C. 

18 1395w–3(a)(2)) is amended by adding at the end 

19 the following new subparagraph: 

20 ‘‘(D) LYMPHEDEMA COMPRESSION TREAT21 MENT ITEMS.—Lymphedema compression treat22 ment items (as defined in section 1861(lll)) for 

23 which payment would otherwise be made under 

24 section 1834(z).’’. 
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1 (b) INCLUSION IN REQUIREMENTS FOR SUPPLIERS

2 OF MEDICAL EQUIPMENT AND SUPPLIES.—Section 1834 

3 of the Social Security Act (42 U.S.C. 1395m) is amend4 ed— 

5 (1) in subsection (a)(20)(D), by adding at the 

6 end the following new clause: 

7 ‘‘(iv) Lymphedema compression treat8 ment items (as defined in section 

9 1861(lll)).’’. 

10 (2) in subsection (j)(5)— 

11 (A) by redesignating subparagraphs (E) 

12 and (F) as subparagraphs (F) and (G), respec13 tively; and 

14 (B) by inserting after subparagraph (D) 

15 the following new subparagraph: 

16 ‘‘(E) lymphedema compression treatment 

17 items (as defined in section 1861(lll));’’. 

18 SEC. 3. MEDICARE IMPROVEMENT FUND. 

19 Section 1898(b)(1) of the Social Security Act (42 

20 U.S.C. 1395iii(b)(1)) is amended by striking 

21 ‘‘$7,308,000,000’’ and inserting ‘‘$6,738,000,000’’. 

22 SEC. 4. DETERMINATION OF BUDGETARY EFFECTS. 

23 The budgetary effects of this Act, for the purpose of 

24 complying with the Statutory Pay-As-You-Go Act of 2010, 

25 shall be determined by reference to the latest statement 
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1 titled ‘‘Budgetary Effects of PAYGO Legislation’’ for this 

2 Act, submitted for printing in the Congressional Record 

3 by the Chairman of the House Budget Committee, pro4 vided that such statement has been submitted prior to the 

5 vote on passage. 

Passed the House of Representatives November 17, 

2022. 

Attest: 

Clerk. 
117TH CONGRESS 

2D SESSION H. R. 3630 

AN ACT 

To amend title XVIII of the Social Security Act to 

program. pression treatment items under the Medicare provide for coverage of certain lymphedema com-