The Lymphedema Treatment Act (LTA) has significantly broadened access to care, yet important coverage gaps persist.
Effective Jan. 1, 2024, the law requires Medicare to cover compression garments, wraps, and bandages—critical tools in lymphedema management. However, it stops short of covering the specialized footwear that many patients need to remain mobile and fully benefit from treatment.
A measurable impact
The LTA has already made a difference for a complex patient population, many of whom face overlapping health conditions.
“It’s had a positive impact and brought increased attention to the need for proper documentation, patient evaluation, and fitting processes related to compression garments,” said Matt Gruskin, MBA, BOCPD, CDME, COO of BOC. “We’ve seen a growing number of suppliers expand their services to meet these needs, which aligns with the act’s original intent.”
According to Gruskin, BOC has supported more than 500 facilities this year in adding compression garment services. The patient base is both large and growing, particularly among cancer survivors and individuals with comorbidities such as obesity and chronic venous insufficiency.
“This presents a broader opportunity for suppliers to address multiple needs within the same patient population,” he added.
The footwear gap
Still, without coverage for footwear, many patients face barriers to mobility—an essential element of successful lymphedema therapy.
“Without appropriate, accommodative footwear that may also add some degree of compression, the results and benefits of the covered items may be somewhat diminished,” said Stephen O’Hare, president of Pedors Shoes.
Pedors has long offered the XXXW 6E Classic MAX shoe, which works for about 70% of lymphedema patients. With the rollout of the LTA, the company introduced the Pedors Super MAX in a 10E XXXXXW width to serve most of the remaining 30%.
“We have a shoe version ideal for physical therapy and outdoor use, along with an open-backed slide/slipper for in-home wear—designed for patients with limited reach and range of motion,” O’Hare explained.
