[Congressional Record Volume 168, Number 175 (Monday, November 14, 2022)]
[House]
[Pages H8469-H8471]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        LYMPHEDEMA TREATMENT ACT

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3630) to amend title XVIII of the Social Security Act to 
provide for coverage of certain lymphedema compression treatment items 
under the Medicare program, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3630

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     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) 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 ``(EE)''; and
       (ii) by inserting before the semicolon at the end the 
     following: ``, and (FF) 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));''.

     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 titled 
     ``Budgetary Effects of PAYGO Legislation'' for this Act, 
     submitted for printing in the Congressional Record by the 
     Chairman of the House Budget Committee, provided that such 
     statement has been submitted prior to the vote on passage.


[[Page H8470]]


  The SPEAKER pro tempore (Mr. Cuellar). Pursuant to the rule, the 
gentleman from New Jersey (Mr. Pallone) and the gentleman from Florida 
(Mr. Bilirakis) each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 3630.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.

                              {time}  1600

  Mr. PALLONE. Mr. Speaker, I rise to speak in support of H.R. 3630, 
the Lymphedema Treatment Act. This bipartisan legislation sponsored by 
Representative Schakowsky will help Medicare beneficiaries suffering 
from lymphedema access needed compression garments.
  Lymphedema is a condition caused by a chronic failure of the 
lymphatic system that results in the accumulation of lymph fluid and 
swelling in various parts of the body. Lymphedema can sometimes be a 
congenital condition but is more often a secondary complication of 
common health issues like burns or cancer.
  Altogether, an estimated 3 to 5 million Americans are affected by 
this chronic condition, and if left untreated, individuals have a 
higher risk of hospitalization, disability, and even death.
  While there is no known cure for lymphedema, it can be effectively 
treated and managed. Compression therapy is a critical component of 
treatment.
  While Medicare covers some lymphedema treatments like compression 
pumps, Medicare does not cover the compression garments needed for 
ongoing lymphedema management because it lacks the legislative 
authority to cover these items.
  The Lymphedema Treatment Act will close the unintended gap in 
coverage that prevents Medicare beneficiaries from accessing medically 
necessary, prescribed compression garments.
  I thank Representative Schakowsky for her longtime advocacy on this 
issue and the more than 350 bipartisan Members who signed on in support 
of this legislation. This bill passed out of the Energy and Commerce 
Committee in July by a unanimous vote, and it will help ensure that 
patients with lymphedema have access to the full range of treatment 
they need.
  Mr. Speaker, I urge its passage, and I reserve the balance of my 
time.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise today in support of H.R. 3630, the Lymphedema 
Treatment Act, introduced by my friend and fellow Committee on Energy 
and Commerce member Jan Schakowsky, as well as the Subcommittee on 
Health member Buddy Carter, along with myself and more than 350 Members 
on both sides of the aisle.
  This legislation would create a new Medicare benefit category, 
lymphedema compression treatment items, including standard and custom-
fitted garments, and other items determined by HHS, for treatment of 
lymphedema.
  As many of us know, thanks to a passionate and committed group of 
patient stakeholders, lymphedema is a chronic condition that may cause 
significant swelling and discomfort. It is often located in the arms 
and legs but can also occur in other parts of the body.
  Unfortunately, there is no cure today for this condition, but 
patients are able to receive care that can mitigate some of the 
symptoms caused by lymphedema. One of the most basic elements of care 
is the application of compression garments to swollen body parts.
  As it stands today, fee-for-service Medicare covers various forms of 
treatment for lymphedema but does not cover the basic compression 
supplies typically used in the regular treatment for this condition. 
This is a result of the outdated structure of traditional fee-for-
service Medicare, which does not have an existing benefit category that 
works for lymphedema compression garments.
  This legislation is yet another reminder that the fee-for-service 
Medicare as structured today under part B simply cannot keep pace with 
medical innovation. Private payers, including Medicare Advantage plans, 
have more flexibility to provide coverage for these products, 
especially if they add value to the care patients need.
  As the popularity of Medicare Advantage demonstrates, there is a 
built-in incentive to provide better value for patients, meaning better 
outcomes and lower costs. It has been proven.
  It has been discouraging to see an ever-growing number of situations 
where a particular drug--for instance, an entire class of Alzheimer's 
drugs recently restricted by CMS--or other medical products are not 
covered for seniors in Medicare fee-for-service when other patients in 
the private market, or even in Medicare Advantage, may have them 
covered.
  I am hopeful that bills like the one that we are here to discuss 
today, where Congress continues to patch the inefficiencies in the 
Medicare program, not only benefit seniors but also help all of us 
recognize that seniors deserve greater Medicare reforms. Those reforms 
should empower patients with greater control over their healthcare 
decisions and more ability to tailor their health benefits to their 
personal needs, all with the goal of no senior being denied or having 
to lobby Congress to get the medical products they need. It makes 
sense.
  Finally, I am encouraged to see that the new mandatory spending in 
this legislation will be fully offset, and I encourage my colleagues to 
continue to insist that we fully offset mandatory spending now and into 
the future. This is responsible. It is responsible legislating.
  Mr. Speaker, I thank the sponsors for this bill, H.R. 3630, and the 
chairman, of course, and the ranking member of the full committee. I 
fully support this legislation and recommend a ``yes'' vote on final 
passage.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Illinois (Ms. Schakowsky), the sponsor of this 
legislation and the chairwoman of the subcommittee.
  Ms. SCHAKOWSKY. Mr. Speaker, I thank the chairman of the committee 
for yielding.
  I am just so happy that we see the Lymphedema Treatment Act on the 
floor today.
  I thank my colleague on the Republican side, Buddy Carter, for being 
a cosponsor of the legislation and helping to put it forward with so 
many bipartisan sponsors of the legislation, over 350--what is it, 
366?--cosponsors of the bill.
  I look forward to passing it in the House today. There are enough 
Senators on the other side of the rotunda here that also have 
sponsored, so I look forward to it becoming the law of the land.

  I thank all the advocates who worked so hard, including Heather 
Ferguson, who is the executive director of the Lymphedema Advocacy 
Group, and all the people whom she worked with to help make this pass. 
Heather is the mother of a son that has lymphedema. I thank all the 
constituents who worked so hard to make this happen.
  Here is what it is about lymphedema. It is not only painful and 
debilitating; it is also incurable. But we are lucky that there 
actually is a remedy, a treatment for lymphedema.
  Many of you may be familiar with it. You may not have known the name. 
Two-thirds of all lymphedema cases develop after cancer treatment. You 
see that swelling. But what we don't have is the kind of treatment that 
is actually needed.
  Currently, Medicare does not cover these important compression 
garments, which is what can really help people so very much. My bill 
will actually finally expand access to these garments for lymphedema 
patients on Medicare.
  This will absolutely help the 3 million Americans who have lymphedema 
to be able to have some of the relief that they need at a cost that 
they can afford. It will also reduce Medicare costs because instead of 
these people developing all kinds of other health

[[Page H8471]]

issues, they will be able to be treated with these compression 
garments.
  Again, I thank Chairman Pallone, Ranking Member Cathy McMorris 
Rodgers, Representative Buddy Carter, and all the Members on both sides 
of the aisle. Mr. Speaker, I urge everyone to endorse this wonderful 
bill and vote ``yes.''
  Mr. BILIRAKIS. Mr. Speaker, this is a real good bill, a bipartisan 
bill. We worked very hard on it, and we have a great sponsor here and a 
Republican sponsor in Representative Buddy Carter, and I urge that we 
pass this as soon as possible. I assume the Senate will get to work and 
get this done, as well.
  Mr. Speaker, I yield back the balance of my time.
  Mr. PALLONE. Mr. Speaker, I also urge passage of this bill, another 
bipartisan bill where we all worked together from the Energy and 
Commerce Committee, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 3630, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. ROSENDALE. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER. Pursuant to clause 8 of rule XX, further proceedings on 
this motion will be postponed.

                          ____________________