NY A01713

Mandates health insurance policies providing hospital, surgical, medical, or major medical coverage to cover differential diagnosis and treatment of both primary and secondary lymphedema

Required coverage includes manual lymph drainage therapy, complex decongestive therapy, out-patient self-management training, and equipment such as bandages, compression garments, pads, and orthotic shoes with replacements as needed

Lymphedema therapy must be administered only by therapists certified by the Lymphology Association of North America (LANA) or equivalently certified providers

Only licensed physicians or surgeons competent to evaluate the specific clinical issues may deny authorization requests for lymphedema care services

Patients undergoing surgery or radiotherapy must receive information about lymphedema risks, and informed consent agreements must include lymphedema risk information for alternative procedures

Expands existing mastectomy coverage to include prostheses and physical complications including lymphedema at all stages