US Codex
Bill
Notes

Lymphedema Treatment Act

S. 1315 · 117th Congress · Apr 22, 2021 · Lineage

A BILL

To amend title XVIII of the Social Security Act to provide for coverage of certain lymphedema compression treatment items under the Medicare program.

Section 1 Short title

This Act may be cited as the “Lymphedema Treatment Act”.

Sec. 2 Medicare coverage of certain lymphedema compression treatment items

(a)
In general— Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—
(1)
in subsection (s)(2)—
(A)
in subparagraph (GG), by striking “and” after the semicolon at the end;
(B)
in subparagraph (HH), by striking the period at the end and inserting “; and”; and
(C)
by adding at the end the following new subparagraph:

“(II) lymphedema compression treatment items (as defined in subsection (lll));”

(2)
by adding at the end the following new subsection:

“(lll) Lymphedema compression treatment items—The term lymphedema compression treatment items means—

“(1) standard and custom fitted gradient compression garments that are—

“(A) furnished on or after January 1, 2023, to an individual with a diagnosis of lymphedema for the treatment of such condition;

“(B) primarily and customarily used in the medical treatment of lymphedema, as determined by the Secretary; and

“(C) prescribed by a physician (or a physician assistant, nurse practitioner, or a clinical nurse specialist (as those terms are defined in section 1861(aa)(5)) to the extent authorized under State law); and

“(2) other devices determined by the Secretary to be effective in the prevention or treatment of lymphedema.”

(b)
Effective date— The amendments made by subsection (a) shall apply to lymphedema compression treatment items furnished on or after January 1, 2023.