Sunday, October 19, 2008
Petition for KS Residents
If you're a resident of KS, please sign the petition to change the KS State Employee Health Policy prosthetic coverage so that it's on par with Medicare and State Medicaid. You can find the link here. Thanks go to Bob Barker of the Western KS Limb Loss Support Group for starting the petition drive. We need 10,000 signatures by December 15, 2008.
Saturday, October 11, 2008
Time is running out
We must get this policy changed before the new contract year! Here is a new letter for KS residents. Don't forget to change the text in [red]:
[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,
By now you are aware of the limitations in the state employee health care plan regarding prosthetic coverage for amputees. Despite our efforts to change the restrictions facing state employee amputees, the contract reads:
"Coverage is limited to the basic (standard) appliance or device which will restore the body part or function. If you elect to purchase a prosthetic appliance or device with deluxe enhancements or features such as electronic components, microprocessors or other features designed to enhance performance, the Plan is only responsible for the amount that would have been allowed for a basic (standard) appliance. You will be responsible for paying the additional cost of the deluxe enhancements, electronic components, microprocessors, performance enhancements, comfort, convenience or luxury items."
The wording in the contract is identical to the limitations placed on durable medical equipment (DME) despite assurances from KHPA that limb prostheses are under medical coverage. There is nothing deluxe, luxurious, comfortable, performance enhancing or convenient about a prosthetic limb. Who determines whether a prosthesis is comfortable or convenient and thereby denied? It reflects badly on the state of Kansas when state employees are not afforded the same quality of prosthetic care as KS Medicaid recipients.
At the present time, it is illegal in 17 states to sell policies having such arbitrary exclusions and parity laws are pending in 30 additional states. Federal legislation has been introduced in the House and Senate to make coverage at least equal to that offered by Medicare as a national requirement.
Please change this policy language before the beginning of the new contract year.
Sincerely,
[Your name and address]
Cc: Governor Mark Parkinson
Capitol, 300 SW 10th Ave., Ste. 212S
Topeka, KS 66212-1590
Doug Farmer
KHPA – State Employee Benefits Plan
Room 900-N, Landon State Office Bldg.
900 SW Jackson Street
Topeka, Kansas 66612
[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,
By now you are aware of the limitations in the state employee health care plan regarding prosthetic coverage for amputees. Despite our efforts to change the restrictions facing state employee amputees, the contract reads:
"Coverage is limited to the basic (standard) appliance or device which will restore the body part or function. If you elect to purchase a prosthetic appliance or device with deluxe enhancements or features such as electronic components, microprocessors or other features designed to enhance performance, the Plan is only responsible for the amount that would have been allowed for a basic (standard) appliance. You will be responsible for paying the additional cost of the deluxe enhancements, electronic components, microprocessors, performance enhancements, comfort, convenience or luxury items."
The wording in the contract is identical to the limitations placed on durable medical equipment (DME) despite assurances from KHPA that limb prostheses are under medical coverage. There is nothing deluxe, luxurious, comfortable, performance enhancing or convenient about a prosthetic limb. Who determines whether a prosthesis is comfortable or convenient and thereby denied? It reflects badly on the state of Kansas when state employees are not afforded the same quality of prosthetic care as KS Medicaid recipients.
At the present time, it is illegal in 17 states to sell policies having such arbitrary exclusions and parity laws are pending in 30 additional states. Federal legislation has been introduced in the House and Senate to make coverage at least equal to that offered by Medicare as a national requirement.
Please change this policy language before the beginning of the new contract year.
Sincerely,
[Your name and address]
Cc: Governor Mark Parkinson
Capitol, 300 SW 10th Ave., Ste. 212S
Topeka, KS 66212-1590
Doug Farmer
KHPA – State Employee Benefits Plan
Room 900-N, Landon State Office Bldg.
900 SW Jackson Street
Topeka, Kansas 66612
Friday, October 10, 2008
Bob Rocks!
Bob Barker is an activist for prosthetic parity. He was instrumental in passing the parity law in Massachusetts and then moved to KS. Lucky us! Visit his site to learn what you need to do as a KS citizen to bring prosthetic parity legislation to KS.
Wednesday, October 8, 2008
Pinched
What a crazy ride I'm on.
KHPA communications now contain language with words like "hope-wish-try" and the December HCC meeting "might" deal with prosthetics but now, even that sounds iffy. I'm not supposed to take the new contract language personally, but what's a person to think after months of communication - OK, I'll admit it was pretty one-sided communication - and then the contract language is reworded to become more arbitrary, archaic and capricious? We do get a $40 a month discount for not smoking though. At that rate, I should be able to recover the cost of the C-leg in about...375 months or a little over 31 years. Fortunately, I'll be eligible for Medicare before then.
The good news is that the KS parity activists, led by Bob Barker, now have their teeth in this thing and it's not just me, the annoying voice in the background. The more the merrier - party on, people.
All of this detracts from the joy of the new leg and there are some shining moments. The down side is that I have developed some bad habits from the old leg that I have to overcome. Fear of falling is the biggest and that keeps me from using the C-leg as it's designed. The socket is still giving me grief - seems I might have *gasp* stopped shrinking so there's this constant argument about who is going to conform first? My leg or the socket? Flesh or carbon fiber? Logic says flesh, but suddenly my flesh is no longer weak and is fighting back. Nonetheless, I've had a few glorious moments where everything worked perfectly and I saw my reflection in a glass window as I walked by. Beautiful! I couldn't believe I was walking so well! I know it's there, it will just take me a while to gain control.
So...sadly, I think we're back to square 1 in our fight with HCC/KHPA/BCBS of KS. I got that 800 pound gorilla off my back for about 24 hours, but it's back now!
KHPA communications now contain language with words like "hope-wish-try" and the December HCC meeting "might" deal with prosthetics but now, even that sounds iffy. I'm not supposed to take the new contract language personally, but what's a person to think after months of communication - OK, I'll admit it was pretty one-sided communication - and then the contract language is reworded to become more arbitrary, archaic and capricious? We do get a $40 a month discount for not smoking though. At that rate, I should be able to recover the cost of the C-leg in about...375 months or a little over 31 years. Fortunately, I'll be eligible for Medicare before then.
The good news is that the KS parity activists, led by Bob Barker, now have their teeth in this thing and it's not just me, the annoying voice in the background. The more the merrier - party on, people.
All of this detracts from the joy of the new leg and there are some shining moments. The down side is that I have developed some bad habits from the old leg that I have to overcome. Fear of falling is the biggest and that keeps me from using the C-leg as it's designed. The socket is still giving me grief - seems I might have *gasp* stopped shrinking so there's this constant argument about who is going to conform first? My leg or the socket? Flesh or carbon fiber? Logic says flesh, but suddenly my flesh is no longer weak and is fighting back. Nonetheless, I've had a few glorious moments where everything worked perfectly and I saw my reflection in a glass window as I walked by. Beautiful! I couldn't believe I was walking so well! I know it's there, it will just take me a while to gain control.
So...sadly, I think we're back to square 1 in our fight with HCC/KHPA/BCBS of KS. I got that 800 pound gorilla off my back for about 24 hours, but it's back now!
Wednesday, October 1, 2008
My Hair is on Fire!!
Today is October 1st, the day they roll out the insurance contract for 2009. There was ambiguous language in the '08 contract regarding prosthetics. I had several discussions about this with KHPA and was assured that it would be made "more clear" for '09. Still giddy from my phone call last night, but also realizing that the contract was written LONG before my phone call, I didn't expect a revision in my favor. Instead, what I found made it abundantly clear that the discrimination towards amputees continues:
"Coverage is limited to the basic (standard) appliance or device which will restore the body part or function. If you elect to purchase a prosthetic appliance or device with deluxe enhancements or features such as electronic components, microprocessors or other features designed to enhance performance, the Plan is only responsible for the amount that would have been allowed for a basic (standard) appliance. You will be responsible for paying the additional cost of the deluxe enhancements, electronic components, microprocessors, performance enhancements, comfort, convenience or luxury items."
You talking to ME?!
I feel really ripped off. I wanted the performance enhancing, comfort model with the convenience features, luxury socket, deluxe-enhanced toes and all I got after paying 25% of my after-tax, after-insurance-premium annual salary was this microprocessor. Dang.
I feel really ripped off. I wanted the performance enhancing, comfort model with the convenience features, luxury socket, deluxe-enhanced toes and all I got after paying 25% of my after-tax, after-insurance-premium annual salary was this microprocessor. Dang.
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