Patients, Clinics Decry Medicare Ruling; Government to Stop Paying for Lymphedema Therapy Given by Massage Therapists and Nurses

By Karkaria, Urvaksh | The Florida Times Union, November 27, 2005 | Go to article overview

Patients, Clinics Decry Medicare Ruling; Government to Stop Paying for Lymphedema Therapy Given by Massage Therapists and Nurses


Karkaria, Urvaksh, The Florida Times Union


Byline: URVAKSH KARKARIA

The federal government's decision to stop paying for lymphedema therapy provided by massage therapists and nurses could shut down a major Jacksonville lymphedema clinic -- stranding Cheryl Bogacki and 300 other patients without treatment.

Starting in June, the Centers for Medicare & Medicaid Services decided to quit paying for lymphedema therapy provided by massage therapists and nurses, even though they account for 34 percent of the providers nationwide, according to Cheri Hoskins, president of the Lymphedema Stakeholders Political Action Committee, a non-profit that protects lymphedema patients' rights.

The ruling means that the Jacksonville Lymphedema Clinic, staffed by four certified massage therapists, cannot treat its Medicare patients -- who account for 40 percent of business.

"It's a medical atrocity that these patients can't be treated for a condition that there's no cure for," said Preston Parkerson, president of the Jacksonville Lymphedema Clinic.

Lymphedema is a chronic swelling of the body most often because of cancer treatment when lymph nodes and vessels are surgically removed or damaged by radiation. The disease -- which affects up to 5 million nationwide -- if not treated properly, can immobilize the patient and require hospitalization.

The CMS ruling prohibits Medicare reimbursement for therapy services provided "incident to a physician's services" by anyone other than a physical therapist, occupational therapist or speech and language pathologist. Such "incident to" therapy services are those services provided by qualified, certified and usually state-licensed health care personnel under the supervision of a physician while in his or her office. In issuing the ruling, CMS said the change was mandated by the Medicare law adopted in 1997 as part of the Balanced Budget Act.

Critics of the ruling are fighting back.

The Coalition to Preserve Patient Access to Physical Medicine and Rehabilitation Services, which includes 23 health care organizations including the National Athletic Trainers' Association (NATA) and Hoskins group, is encouraging Congress to overturn the ruling.

The group has found a sponsor to introduce a bill in Congress, Hoskins said, adding: "We've probably got a 65 to 70 percent chance of having it reversed."

Medicare's decision will have much wider implications because private insurers typically follow Medicare's playbook on what treatments they cover, Parkerson said.

If private insurers decide not to reimburse massage therapists for lymphedema therapy, Parkerson said he could be out business within six to 12 months.

Parkerson, who said he was blind-sided by the Medicare ruling, just last fall relocated his business into a larger building to keep up with demand that grew two-thirds in 2004 compared with the previous year. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Patients, Clinics Decry Medicare Ruling; Government to Stop Paying for Lymphedema Therapy Given by Massage Therapists and Nurses
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.