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  • 'Severe' Restriction on Compression Devices on Indefinite Hold

    A planned change to Medicare coverage of pneumatic compression devices (PCDs) that would have severely restricted patient access to the devices at home has been put on indefinite hold, thanks in part to the efforts of an alliance that includes APTA.

    Had it been implemented, the final local coverage determination (LCD) would have imposed restrictions for PCDs that would only allow their use after a 6-month period of "chronic and severe" lymphedema, and would have attached other requirements including the presence of lymphedema into the trunk or chest, the use of manual lymphatic drainage prior to PCDs, and the use of medications. Additionally, the new policy would have denied PCDs to patients who experience any kind of improvement through conservative therapy. The requirements were set to become effective on November 1.

    In an October 13 statement to the Medicare Durable Equipment Medicare Administrative Contractors (DME MACs) responsible for the change, the Alliance of Wound Care Stakeholders wrote that "many of the new requirements have no basis in either published medical literature or professional standards of practice," and that the proposed LCD "virtually eliminates access to medically necessary equipment for a significant portion of Medicare beneficiaries" who need the devices for treatment of lymphedema and venous ulcers. APTA is a member of the alliance.

    The alliance also asserted that the final policy released in October was "significantly different" from the draft policy released in 2011, and that no additional public comment period was provided.

    On October 16, the DME MACs announced that the change would be placed on indefinite hold. The brief announcement stated only that "Additional clinical information published since the release of the draft policy is being reviewed."

    "This is a significant victory for beneficiaries who need PCDs and the physical therapists who are providing treatment," said Gillian Leene, JD, senior regulatory affairs specialist at APTA. "In the end, the alliance was able to halt a policy that not only lacked support in medical literature, but also would have been damaging to patients and severely restricted access to an effective home treatment option for this progressive and chronic condition.”  

     

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