Lymphedema Treatment Act will cover what health insurance doesn’t


SAINT ANTONIO – The Lymphedema Treatment Act, which takes effect on January 1, 2024, will cover what health insurance does not, 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,” says Cynthia Orr, a breast cancer survivor who developed lymphedema.

In August, Orr pushed for federal legislation to expand Medicare’s coverage of lymphedema treatments.

Orr, a successful criminal defense attorney, was able to afford the treatments, unlike many others who cannot and risk their lives by not getting treatment.

“It just made me really angry,” Orr said. “It makes no sense.”

Passed as a last-minute amendment to the 2023 omnibus appropriations legislation, Orr said, “Without debate, the bill passed with wide margins of support and stronger than when we first proposed it.”

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

Orr said she was delighted when the legislation passed.

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

Orr said the next step will be awareness about the act and the medical advances that can give lymphedema sufferers hope.

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

Among the leaders in the treatment of 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 milder the disease, the outcomes are also better,” said Fries.

He said covering the cost of the compression along 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 hearing one of his patients had the surgery she was considering helped reassure Hill.

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

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

Like Orr, the lymphedema was a delayed side effect of the radiation and chemotherapy she underwent for her breast cancer.

Hill said she is now looking forward to the good progress Orr has made.

Orr said she was told she “may” see some improvement in about a year.

“Well, I have my old arm back,” Orr said. “My arm is so small that my compression garment is slipping off.”

Orr said a lymphedema support group will have its first meeting at 6 p.m. Feb. 8 in the patient services office on the second floor of the Mays Cancer Center. She said the group will meet every second Wednesday of the month.

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