In an interview with HME News, the COO of the Board of Certification/Accreditation (BOC) called a new law, the Lymphedema Treatment Act (LTA), “a game changer” for O&P providers. The policy goes into effect January 1, 2024, and provides more consistent Medicare coverage and reimbursement for compression garments and supplies for people with lymphedema.
Opportunities presented by the LTA may also include significant new business and revenue for mastectomy fitters, BOC COO Matthew Gruskin told the healthcare site.
“As we wait for the final rule on LTA implementation specifics, BOC is encouraged that CMS will establish a new product category for compression garment and supply billing,” Gruskin said in the interview. “It will be interesting to see the extent of the patient demand—this has the potential to open the door for new referral sources for [Durable Medical Equipment, Prosthetics, Orthotics and Supplies] providers. It also means there will be more opportunities for compression fitters and for healthcare professionals interested in expanding their education and skill set to include compression therapy. “Many mastectomy boutiques treat patients who are living with lymphedema, and the LTA could allow them to expand their reimbursable product categories with new compression garments and supplies that will be billable to CMS.”
Adam Miller, president of the Orthotic and Prosthetic Group of America was also encouraged by LTA’s potential impact on the O&P market.
“LTA provides coverage for a proven product where there was no prior Medicare billable,” Miller told HME News. “Providers can look to lymphedema treatment as an additional revenue stream, and it gives another billable service for providers to utilize for both patient base and referral sources.”
The LTA “is something that has been needed for a long time,” said Stephen O’Hare, president, Pedors Shoes, Georgia, which specializes in footwear for lymphedema patients.
“Any compression device that enables the patient to be more mobile only improves the overall health of the patient and is a healthcare cost-saving initiative,” he said. “The LTA should help improve access to care for patients with lymphedema that desperately need it.”
To read the complete HME News article, visit “LTA Could Be Game Changer For O&P” on its website.
