IIB 
117TH CONGRESS 
2D SESSION 
H. R. 3630 
IN THE SENATE OF THE UNITED STATES 
NOVEMBER 17, 2022 
Received; read twice and referred to the Committee on Finance 
AN ACT 
To amend title XVIII of the Social Security Act to provide 
for coverage of certain lymphedema compression treat-
ment items under the Medicare program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Lymphedema Treat-
ment Act’’. 
SEC. 2. MEDICARE COVERAGE OF CERTAIN LYMPHEDEMA 
COMPRESSION TREATMENT ITEMS. 
(a) COVERAGE.— 
(1) IN GENERAL.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x) is amended— 
(A) in subsection (s)(2)— 
(i) in subparagraph (GG), by striking 
‘‘and’’ after the semicolon at the end; 
(ii) in subparagraph (HH), by strik-
ing the period at the end and inserting ‘‘; 
and’’; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(II) lymphedema compression treatment items 
(as defined in subsection (lll));’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(lll) LYMPHEDEMA
COMPRESSION
TREATMENT 
ITEMS.—The term ‘lymphedema compression treatment 
items’ means standard and custom fitted gradient com-
pression garments and other items determined by the Sec-
retary that are— 
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‘‘(1) furnished on or after January 1, 2024, to 
an individual with a diagnosis of lymphedema for the 
treatment of such condition; 
‘‘(2) primarily and customarily used to serve a 
medical 
purpose 
and 
for 
the 
treatment 
of 
lymphedema, as determined by the Secretary; and 
‘‘(3) prescribed by a physician (or a physician 
assistant, nurse practitioner, or a clinical nurse spe-
cialist (as those terms are defined in section 
1861(aa)(5)) to the extent authorized under State 
law).’’. 
(2) PAYMENT.— 
(A) IN GENERAL.—Section 1833(a)(1) of 
the Social Security Act (42 U.S.C. 1395l(a)(1)) 
is amended— 
(i) by striking ‘‘, and’’ before ‘‘(EE)’’; 
and 
(ii) by inserting before the semicolon 
at the end the following: ‘‘, and (FF) with 
respect to lymphedema compression treat-
ment 
items 
(as 
defined 
in 
section 
1861(lll)), the amount paid shall be equal 
to 80 percent of the lesser of the actual 
charge or the amount determined under 
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the payment basis determined under sec-
tion 1834(z)’’. 
(B) PAYMENT BASIS AND LIMITATIONS.— 
Section 1834 of the Social Security Act (42 
U.S.C. 1395m) is amended by adding at the 
end the following new subsection: 
‘‘(z) PAYMENT
FOR LYMPHEDEMA COMPRESSION 
TREATMENT ITEMS.— 
‘‘(1) IN GENERAL.—The Secretary shall deter-
mine an appropriate payment basis for lymphedema 
compression treatment items (as defined in section 
1861(lll)). In making such a determination, the Sec-
retary may take into account payment rates for such 
items under State plans (or waivers of such plans) 
under title XIX, the Veterans Health Administra-
tion, and group health plans and health insurance 
coverage (as such terms are defined in section 2791 
of the Public Health Service Act), and such other in-
formation as the Secretary determines appropriate. 
‘‘(2) FREQUENCY
LIMITATION.—No payment 
may be made under this part for lymphedema com-
pression treatment items furnished other than at 
such frequency as the Secretary may establish. 
‘‘(3) APPLICATION OF COMPETITIVE ACQUISI-
TION.—In the case of lymphedema compression 
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treatment items that are included in a competitive 
acquisition program in a competitive acquisition area 
under section 1847(a)— 
‘‘(A) the payment basis under this sub-
section for such items furnished in such area 
shall be the payment basis determined under 
such competitive acquisition program; and 
‘‘(B) the Secretary may use information on 
the payment determined under such competitive 
acquisition programs to adjust the payment 
amount otherwise determined under this sub-
section for an area that is not a competitive ac-
quisition area under section 1847, and in the 
case of such adjustment, paragraphs (8) and 
(9) of section 1842(b) shall not be applied.’’. 
(3) 
CONFORMING
AMENDMENT.—Section 
1847(a)(2) of the Social Security Act (42 U.S.C. 
1395w–3(a)(2)) is amended by adding at the end 
the following new subparagraph: 
‘‘(D) LYMPHEDEMA COMPRESSION TREAT-
MENT ITEMS.—Lymphedema compression treat-
ment items (as defined in section 1861(lll)) for 
which payment would otherwise be made under 
section 1834(z).’’. 
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(b) INCLUSION IN REQUIREMENTS FOR SUPPLIERS 
OF MEDICAL EQUIPMENT AND SUPPLIES.—Section 1834 
of the Social Security Act (42 U.S.C. 1395m) is amend-
ed— 
(1) in subsection (a)(20)(D), by adding at the 
end the following new clause: 
‘‘(iv) Lymphedema compression treat-
ment 
items 
(as 
defined 
in 
section 
1861(lll)).’’. 
(2) in subsection (j)(5)— 
(A) by redesignating subparagraphs (E) 
and (F) as subparagraphs (F) and (G), respec-
tively; and 
(B) by inserting after subparagraph (D) 
the following new subparagraph: 
‘‘(E) lymphedema compression treatment 
items (as defined in section 1861(lll));’’. 
SEC. 3. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 
1395iii(b)(1)) 
is 
amended 
by 
striking 
‘‘$7,308,000,000’’ and inserting ‘‘$6,738,000,000’’. 
SEC. 4. DETERMINATION OF BUDGETARY EFFECTS. 
The budgetary effects of this Act, for the purpose of 
complying with the Statutory Pay-As-You-Go Act of 2010, 
shall be determined by reference to the latest statement 
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titled ‘‘Budgetary Effects of PAYGO Legislation’’ for this 
Act, submitted for printing in the Congressional Record 
by the Chairman of the House Budget Committee, pro-
vided that such statement has been submitted prior to the 
vote on passage. 
Passed the House of Representatives November 17, 
2022. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
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