117 HR 3630 RH: Lymphedema Treatment Act
U.S. House of Representatives
2022-07-22
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Union Calendar No. 336
117th CONGRESS
2d Session
H. R. 3630
[Report No. 117–430, Part I]
IN THE HOUSE OF REPRESENTATIVES
May 28, 2021
Ms. Schakowsky (for herself, Mr. Carter of Georgia, Mr. Blumenauer, Mr. Kelly of Pennsylvania, Mr. Fitzpatrick, Ms. Sewell, Ms. DeGette, Mr. Levin of Michigan, Mr. Aderholt, Mrs. Axne, Mr. Ferguson, Mr. Wilson of South Carolina, Mr. Joyce of Pennsylvania, Mr. Brown of Maryland, Ms. Newman, Mr. Smith of Washington, Mr. Mullin, Ms. Wild, Ms. Ross, Ms. Wasserman Schultz, Mr. Brendan F. Boyle of Pennsylvania, Mr. Grijalva, Ms. Titus, Mrs. Lawrence, Ms. Velázquez, Ms. McCollum, Mr. O'Halleran, Mr. Suozzi, Mr. Michael F. Doyle of Pennsylvania, Mr. Price of North Carolina, Mr. Meeks, Mr. Butterfield, Ms. Barragán, Ms. Herrera Beutler, Mr. Doggett, Mr. Castro of Texas, Mr. Larson of Connecticut, Ms. Garcia of Texas, Ms. Scanlon, Mr. Johnson of Ohio, Mr. McNerney, Mr. Wittman, Mr. Austin Scott of Georgia, Mr. Tonko, Mr. Cicilline, Ms. Matsui, Mr. Connolly, Miss González-Colón, Mr. Vela, Ms. Pressley, Ms. Lee of California, Mr. Burchett, Mr. Carbajal, Mr. Deutch, Ms. DelBene, Mr. Pascrell, Ms. Pingree, Mr. Carson, Mr. McHenry, Ms. Bonamici, Mr. Kilmer, Mrs. Miller-Meeks, Mr. Vicente Gonzalez of Texas, Mr. DeFazio, Mrs. Napolitano, Mr. Thompson of California, Mr. Rodney Davis of Illinois, Ms. Jacobs of California, Mr. Dunn, Ms. Williams of Georgia, Ms. Clark of Massachusetts, Mr. Crow, Mr. Budd, Ms. Blunt Rochester, Mr. Trone, Mr. Kildee, Mr. Van Drew, Mr. Cohen, Mr. Bacon, Mr. Hollingsworth, Mr. Amodei, Mr. Phillips, Mr. Wenstrup, Mr. McKinley, Ms. Sherrill, Mr. Westerman, Mr. Delgado, Ms. Underwood, Mr. Posey, Ms. Schrier, Mr. Massie, Mr. Cole, Mr. Hice of Georgia, Mr. Rutherford, Mr. Yarmuth, Mr. Payne, Ms. Houlahan, Ms. Davids of Kansas, Mr. Kind, Mr. Guest, Mr. Foster, Ms. Cheney, Mr. Ruppersberger, Ms. Brownley, Mr. LaHood, Mr. Allen, Mr. Johnson of Georgia, Mr. Bishop of Georgia, Mr. Cooper, Mr. Mann, Mr. Rice of South Carolina, Mr. Pocan, Ms. Meng, Ms. Dean, Mr. Armstrong, Mr. Thompson of Mississippi, Mrs. McBath, Mr. Grothman, Mr. Evans, Mr. Reschenthaler, Mr. Sires, Mr. Timmons, Ms. Tenney, Ms. Bourdeaux, Mr. Nadler, Mr. Higgins of New York, Mr. Lamb, Mrs. Carolyn B. Maloney of New York, Mr. Morelle, Mr. Bera, Mr. Lucas, Mrs. Kirkpatrick, Mr. Fleischmann, Mr. Gallego, Mr. Meuser, Mr. McCaul, Mr. Correa, Ms. Strickland, Mr. Rouzer, Ms. Van Duyne, Mr. David Scott of Georgia, Mr. Allred, Mr. Young, Mr. Gottheimer, Ms. Adams, Mr. Levin of California, Mr. Moulton, and Mr. Taylor) 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
July 22, 2022
Additional sponsors: Ms. Omar, Mr. Jones, Mr. Malinowski, Ms. Chu, Ms. Jackson Lee, Mr. Fortenberry, Mrs. Bice of Oklahoma, Mrs. Dingell, Mrs. Harshbarger, Mr. Aguilar, Mr. Emmer, Mr. Ruiz, Mr. Turner, Mr. Cleaver, Ms. Manning, Mr. Murphy of North Carolina, Mr. Cartwright, Mr. Waltz, Ms. Porter, Mr. Krishnamoorthi, Mr. Schrader, Mr. Casten, Ms. Craig, Ms. Mace, Mr. Bilirakis, Mrs. Luria, Mr. Lawson of Florida, Mr. Luetkemeyer, Mr. Loudermilk, Mr. Crist, Mr. Welch, Mr. Langevin, Mr. Gallagher, Ms. Spanberger, Mr. Palazzo, Mr. Kahele, Mr. Rush, Mr. Thompson of Pennsylvania, Mr. Lynch, Mr. Griffith, Mr. Diaz-Balart, Mr. Neguse, Mr. Estes, Mr. Smith of Missouri, Mr. Smucker, Mr. Bergman, Mr. DeSaulnier, Ms. Jayapal, Mr. Peters, Mr. Kim of New Jersey, Mr. Huizenga, Mr. Hudson, Mr. Smith of Nebraska, Ms. Leger Fernandez, Mr. Case, Mr. Schiff, Mr. Lieu, Mr. Larsen of Washington, Mr. Steil, Mr. Sarbanes, Mr. Banks, Mrs. Watson Coleman, Ms. Slotkin, Mr. Crawford, Mr. Sablan, Mr. Lowenthal, Mr. Panetta, Mr. Kelly of Mississippi, Mr. Jeffries, Mr. Balderson, Mr. Graves of Missouri, Ms. Moore of Wisconsin, Ms. Roybal-Allard, Mr. Cárdenas, Mr. Gibbs, Mrs. Trahan, Mr. Lamborn, Mr. Auchincloss, Mr. Himes, Mrs. Hartzler, Mrs. Hayes, Ms. Lois Frankel of Florida, Mr. Hill, Mr. Duncan, Mr. Brooks, Ms. Sánchez, Mrs. Demings, Mr. Meijer, Ms. Salazar, Mr. Valadao, Mrs. Torres of California, Mr. Katko, Mrs. Hinson, Ms. Kelly of Illinois, Ms. Castor of Florida, Mr. Simpson, Miss Rice of New York, Mr. C. Scott Franklin of Florida, Ms. Clarke of New York, Mr. Soto, Ms. Stefanik, Mr. García of Illinois, Mr. Espaillat, Mr. Bost, Mrs. Steel, Mr. McGovern, Mrs. Walorski, Mr. Horsford, Ms. Kaptur, Mr. Ryan, Mr. Calvert, Mr. Raskin, Mr. Pappas, Mr. Tiffany, Mr. Norcross, Mr. Walberg, Mr. Swalwell, Mr. Huffman, Mr. Gooden of Texas, Mr. Stauber, Mr. Johnson of Louisiana, Ms. Norton, Mr. Costa, Mr. Joyce of Ohio, Mr. Stanton, Mr. Quigley, Mr. Mrvan, Mr. Steube, Mr. Newhouse, Mr. Takano, Mr. Perlmutter, Mr. Harder of California, Mr. Gonzalez of Ohio, Ms. Johnson of Texas, Mr. Womack, Mr. Cuellar, Mr. Schneider, Ms. Kuster, Mr. Danny K. Davis of Illinois, Mr. Khanna, Mr. Vargas, Mr. Jackson, Mr. Keller, Mr. Gohmert, Ms. DeLauro, Mr. Schweikert, Ms. Tlaib, Mr. Garbarino, Mr. Gimenez, Ms. Brown of Ohio, Mrs. Radewagen, Mr. Courtney, Mr. Ellzey, Ms. Granger, Mr. LaTurner, Mr. Veasey, Mrs. Fletcher, Mr. DesJarlais, Mrs. Beatty, Mrs. Murphy of Florida, Mr. Hern, Mr. Graves of Louisiana, Ms. Bass, Mr. LaMalfa, Ms. Wexton, Mr. Keating, Ms. Letlow, Mrs. Kim of California, Mr. Fitzgerald, Mr. Green of Tennessee, Mr. Smith of New Jersey, Mr. Bishop of North Carolina, Ms. Stevens, Ms. Malliotakis, Mr. Garamendi, Mr. Gomez, Mr. McEachin, Mr. Long, Mr. Feenstra, Mr. Burgess, Ms. Speier, Mr. Sean Patrick Maloney of New York, Mr. Norman, Mr. Moore of Alabama, Mrs. Cammack, Mr. Owens, Mr. Torres of New York, Mr. Williams of Texas, Mr. Mast, Ms. Wilson of Florida, Mrs. Cherfilus-McCormick, Mr. Perry, Mr. Cawthorn, Mr. Beyer, Mr. Davidson, Mr. Golden, Ms. Stansbury, Ms. Lofgren, Mr. Carter of Louisiana, Mrs. Wagner, Mr. Gaetz, Mr. Scott of Virginia, Mr. Webster of Florida, Mr. San Nicolas, Mr. Sherman, Mr. Green of Texas, Ms. Herrell, Mr. Zeldin, Mr. Arrington, and Mr. Donalds
July 22, 2022
Deleted sponsor: Mr. Perry (added March 18, 2022; deleted March 30, 2022)
July 22, 2022
Reported from the Committee on Energy and Commerce with an amendment
Strike out all after the enacting clause and insert the part printed in italic
July 22, 2022
Committee on Ways and Means discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed
For text of introduced bill, see copy of bill as introduced on May 28, 2021
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.
1.

Short title
This Act may be cited as the “Lymphedema Treatment Act”.
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 striking the period at the end and inserting “; and”; and
(iii)
by adding at the end the following 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 compression garments and other items determined by the Secretary that are—
(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 specialist (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 “(DD)”; and
(ii)
by inserting before the semicolon at the end the following: “and (EE) with respect to lymphedema compression treatment 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 the payment basis determined under section 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 determine an appropriate payment basis for lymphedema compression treatment items (as defined in section 1861(lll)). In making such a determination, the Secretary may take into account payment rates for such items under State plans (or waivers of such plans) under title XIX, the Veterans Health Administration, 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 information as the Secretary determines appropriate.
(2)

Frequency limitation
No payment may be made under this part for lymphedema compression treatment items furnished other than at such frequency as the Secretary may establish.
(3)

Application of competitive acquisition
In the case of lymphedema compression 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 subsection 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 subsection for an area that is not a competitive acquisition 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 treatment items
Lymphedema compression treatment items (as defined in section 1861(lll)) for which payment would otherwise be made under section 1834(z).” .
(b)

Inclusion in requirements for suppliers of medical equipment and supplies
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended—
(1)
in subsection (a)(20)(D), by adding at the end the following new clause:
“(iv)
Lymphedema compression treatment items (as defined in section 1861(lll)).”.
(2)
in subsection (j)(5)—
(A)
by redesignating subparagraphs (E) and (F) as subparagraphs (F) and (G), respectively; and
(B)
by inserting after subparagraph (D) the following new subparagraph:
“(E)
lymphedema compression treatment items (as defined in section 1861(lll));”.
July 22, 2022
Reported from the Committee on Energy and Commerce with an amendment
July 22, 2022
Committee on Ways and Means discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed