Sunday, August 31, 2008

A few more suggestions

Congressman Dennis Moore has offered to look into this and I thought it would be nice just to say, "Thanks." I've included a link to his office. He only accepts email from KS constituents, but you can drop a little "Thank you" note in the mail to his Overland Park office if you don't live in KS.

Also, Governor Sebelius seems to be a compassionate and caring person. Perhaps a copy of your letter to KS HCC might make her aware of the situation for her state employees. You can write her here.

I'm being denied out of ignorance - a lack of understanding about the kinds of components and what they do. All they see is the bottom line which usually means money. Nonetheless, the bottom line is still about the disparity between Medicaid and State Employees and the Governor needs to be made aware that her State Employees with limb loss are under served - POLITELY made aware.

Monday, August 25, 2008

How you can help

I've been told to write the KS Health Care Commission if I want them to change their policy. If it's a letter they want, then let's get them some letters! The instructions are below. Here's the suggested letter, but write whatever you want. You can be as passionate as you like, but PLEASE - be polite!

Next, take a moment to check the prosthetic parity law in your state by going to the Amputee Coalition of America website. If your state has not passed a prosthetic parity bill, please send a letter (scroll to the bottom of the ACA link) to your state and/or federal representatives. The federal bill is House Resolution 5615. Senator Senator Elizabeth Dole of North Carolina is considering sponoring a senate bill. Please encourage her and don't forget this is an election year.

Giving "A Leg Up"

In the world of horses, giving someone “a leg up” has meant taking just a moment to give someone a boost up on their horse – so they can take over from there.

Taking a minute now to give Kathleen a leg up will help her retake charge of her own life and will subsequently benefit other amputees.

Instructions: Copy/paste the sample letter and personalize before printing and mailing – it might be just a short line about how you know Kathleen, or something special you know about her or how she has helped you. (Traditional paper and stamp letters have a very personal impact.) Remember to delete the red “insert here” sentence.

Thank you for taking the time to give Kat “A Leg Up”.

Sample Letter to KS Health Care Commission

(Insert Date)

Duane A. Goossen, Chair and Secretary of Administration
Kansas Health Care Commission
Room 900-N, Landon State Office Building
900 SW Jackson Street Topeka, KS 66612

Dear Mr. Goossen,

I am writing on behalf of Dr. Kathleen Gustafson, a state employee at Kansas University Medical Center. (Insert your personalized association with Kat here)

Dr. Gustafson was advised to write to you and ask that you reconsider the policy that refuses to cover a prosthetic microprocessor knee. Current policy considers the knee to be "deluxe" and therefore, a non-covered item. Concerned that Dr. Gustafson’s single voice may not be heard, I am writing to plead her case.

Prosthetists, the FDA, CMS/Medicare, AAOP, the VA, and over 150 insurance companies have recognized and accepted microprocessor-controlled knees as a standard level of prosthetic treatment. They have been used in thousands of above knee amputees - since 1997 in Europe and Canada and 1999 in the United States. Further indication of acceptance of microprocessor-controlled knees is Medicare’s assignment of L-Codes L5847 and L5989 in January 2002, the code L5848 in January 2003 and the code L5846 in January 1996. Research and patient reports show the microprocessor knee to be superior to simple hydraulic knees with improved patient function and mobility, fewer falls and injuries and less wear and tear on the sound limb.

Microprocessor knees are also standard of care for KS Medicaid recipients. Why is the standard of care different for KS State Employees? Dr. Gustafson is a valued employee of the State’s premiere medical and research center and her mobility is essential to her job and highly active lifestyle. Yet, the ability to walk normally, without assistance, is considered a luxury? Please reconsider and change this policy.


Your name and address

Monday, August 11, 2008

Disparity in Action

KS Health Policy Authority weighed in again and said that they will provide me with a prosthesis that is both medically and functionally necessary, no dollar limit, as long as it doesn't contain "electronic components." That's like saying, "We'll provide you with any car you need to drive to work, pick any car on the lot! Just pick one with no motor." When asked why it's denied the answer is the same, "Because it's electronic." Yes...but WHY? "Because it's electronic." Reminds me of my mother 50 years ago..."Because I said so."

I can understand adopting a policy and sticking to it, but here's the sticky wicket -

Not only do state employees fall under the umbrella of KHPA, but so do KS Medicaid recipients. Of course, since we all fall under the same policy, the rules apply to all. Right? Wrong again. KS Medicaid recipients, under the KHPA Policy, can, and do get the prosthesis along with the electronic components. KS State employees cannot.

So here we are again. My quality of life is decided by KHPA where disparity is openly practiced. Don't think for a minute that I'm saying that KS Medicaid recipients aren't entitled to full prosthetic coverage - that's not my point. The point is that KS State Employees should be afforded equal coverage.