You asked for information regarding lymphedema and past bills introduced to require insurance coverage for its treatment.

SUMMARY

Bills were introduced, but not passed, in the 2005, 2007, and 2008 regular sessions that would have required private health insurance policies to cover medical supplies necessary for the treatment of lymphedema, a condition resulting in abnormal swelling of the limbs. Treatment focuses on minimizing swelling and controlling pain.

LYMPHEDEMA

According to the Mayo Clinic, lymphedema is a condition in which swelling occurs when a blockage in the lymphatic system prevents the lymph fluid in the arms or legs from draining adequately. Causes of lymphedema include infection, cancer, scar tissue from radiation therapy or surgical removal of lymph nodes, and inherited conditions in which lymph nodes or vessels are absent or abnormal. A precise incidence and prevalence of lymphedema is unknown, but it is estimated that 26% of breast cancer patients develop lymphedema.

No cure for lymphedema exists, but it can be controlled through diligent care of the affected limb. Treatment may consist of:

1. light exercises that require a person to move the affected arm or leg to encourage the lymph fluid to move out of the limb;

2. wrapping bandages around the entire limb to encourage lymph fluid to move out of the affected limb (a lymphedema therapist instructs patients on how to properly wrap bandages);

3. receiving a special massage technique called manual lymph drainage that involves special hand strokes on the affected limb to gently move lymph fluid to healthy lymph nodes where it can drain;

4. wearing pneumatic compression sleeves over the affected limb that is connected to a pump that intermittently inflates the sleeve, putting pressure on the limb to move lymph fluid away from the fingers or toes to reduce the swelling in the arm or leg;

5. wearing compression garments (long sleeves or stockings that compress the limb to encourage the lymph fluid out of the affected limb) that are sometimes custom-made to fit the patient; and

6. in cases of severe lymphedema, surgery to remove excess tissue in the arm or leg to reduce severe swelling.

Lymphedema can lead to serious complications, including (1) infections, (2) elephantiasis, which can cause chronic ulcers and repeat infections, and (3) lymphangiosarcoma, a rare form of soft tissue cancer.

For more information about lymphedema, see the Mayo Clinic website at http://www.mayoclinic.com/health/lymphedema/DS00609.

LEGISLATION INTRODUCED

Five bills were introduced in three recent legislative sessions, 2005, 2007, and 2008 (enclosed). Each would have required private health insurance plans to cover supplies necessary for the treatment of lymphedema. Table 1 provides the bill number, introducer, and co-sponsors for each.

All five bills had a public hearing either before the Public Health Committee (2005) or the Insurance and Real Estate Committee (2007 and 2008). One bill was reported favorably out of committee (2007 HB 5303, File No. 241), but died on the floor of the House.

Table 1: Bills Requiring Insurance Coverage for Lymphedema Supplies

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