The Lymphedema Treatment Act will cover what health insurance doesn’t

SAN ANTONIO – The Lymphedema Treatment Act that goes into effect Jan. 1, 2024, will cover what health insurance doesn’t, such as compression supplies to reduce the condition’s painful swelling.

“It not only approves coverage for wraps, but also the compression garments and the pumps as well,” said Cynthia Orr, a breast cancer survivor who developed lymphedema.

Orr had pushed for the federal legislation in August to expand Medicare coverage of lymphedema treatments.

A successful criminal defense attorney, Orr could afford the treatments, unlike many others who cannot and risk their lives by not getting treatment.

“That just really angered me,” Orr said. “It doesn’t make any sense.”

Adopted as a last-minute amendment to the 2023 omnibus appropriations legislation, Orr said, “Without debate, the act passed with wide margins in support and was stronger than when we had first proposed.”

She said the act would also cover any additional treatment if needed, such as massage therapy, microsurgery to replace damaged lymph nodes, and plastic surgery to tighten loose skin when swelling subsides.

Orr said he was thrilled when the legislation went through.

“I thought we were going to have to fight another year,” she said.

Orr said the next step would be increasing awareness about the act and the medical advances that could give hope to lymphedema sufferers.

“Medical science has advanced, and it’s right here in San Antonio,” Orr said.

Among the leaders in treating lymphedema is Dr. Anton Fries, chief of the Division of Plastic Surgery at UT Health San Antonio.

“Outcomes are better if you treat it earlier. If you treat the disease milder, the outcome will be better too,” Fries said.

He said having the cost covered for the compression coupled with surgery could help save lives.

Fries showed Orr’s story to one of his patients, Linda Hill, a retired teacher who is also a breast cancer survivor with lymphedema.

He said it helped to reassure Hill to hear one of his patients had undergone the surgery he was considering.

When Hill met Orr, she thanked him saying, “I don’t think I would have had the courage.”

Hill said all it took was being “nipped lightly” by her dog to trigger the swelling three years ago after her breast cancer diagnosis in 2011.

Like Orr, the lymphedema was a delayed side effect to the radiation and chemotherapy she’d undergone for her breast cancer.

Hill said he’s now looking forward to the kind progress Orr has made.

Orr said she’d been told she “might” see some improvement in about a year.

“Well, I’ve got my old arm back,” Orr said. “My arm is so small that my compression garment is sliding off.”

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