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FOR IMMEDIATE RELEASE
Thursday, May 3, 2001 Contact: HCFA Press Office
(202) 690-6145
MEDICARE TO EXPEDITE COVERAGE FOR LYMPHEDEMA PUMPS
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BALTIMORE -- HHS Secretary Tommy G. Thompson announced today that Medicare
will expedite coverage of pneumatic compression pumps to make it easier for
Medicare beneficiaries with lymphedema to take advantage of the technology.
Secretary Thompson announced the expanded Medicare coverage while working at
the Baltimore offices of the Health Care Financing Administration (HCFA). The
Secretary moved HHS headquarters to the Health Care Financing Administration's
offices in Baltimore this week to give HHS and HCFA staff an opportunity to
work together to build a stronger HCFA.
Medicare's new coverage policy eliminates language that made these
compression pumps the treatment "of last resort" for beneficiaries suffering
from
lymphedema, an accumulation of lymphatic fluid causing abnormal swelling of the
arms, legs, breast, neck or head that often develops when lymph nodes are
removed
during surgery. Breast cancer surgery is the most common cause of the
condition in the United States.
"It's important to make effective technologies available to Medicare
beneficiaries when it helps them the most," Secretary Thompson said. "This
coverage
decision simplifies Medicare policy to allow older Americans who need these
pumps to get them more quickly and easily."
Under the new coverage policy, Medicare will cover the pump if a beneficiary
first undergoes an initial therapy of conservative care, which includes
elevation, exercise and the use of a compression garment, for at least four
weeks
without results. The new policy eliminates the need for a Medicare beneficiary
to purchase a more expensive, custom-made garment before being eligible to
receive a pump.
Although lymphedema is not life-threatening, it can significantly impact the
quality of life for sufferers. The condition can be uncomfortable and painful,
as well as disfiguring and disabling. In some cases, it can lead to
cellulitis or lymphangitis.
"HCFA's new coverage process is helping Medicare make the right decisions,
based on scientific evidence, on when the program should cover new items,
services and procedures," said Jeffrey Kang, M.D., director of HCFA's Office of
Clinical Standards and Quality. "By getting this device, which is proven
effective, to beneficiaries sooner, we are improving the health care available
to the
senior citizens and disabled Americans who rely on Medicare."
Details of today's coverage decision are available at
cms.hhs.gov/coverage/8b3-z.htm
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