FIGHT MEDICARE'S RULING ABOUT HOSPITALS!!

According to the news and the PA at the surgeon's office where I *had* an appointment for next week, on February 21st the announcement was made that "Medicare would cover some procedures only at hospitals considered "centers for excellence" by the American College of Surgeons and the American Society for Bariatric Surgery." Hospitals were given no time to apply for certification from either organization. We ALL need to contact our federal congressmen and senators about this. The more he11 we raise, the more likely it is the rule will be reversed or revised. Here are some things to point out in your communication (preferably by phone): 1. There was no notice given for this ruling. Hospitals should have had time to apply for certification. 2. Obesity is a life-threatening disease and this ruling has dramatically reduced the facilities available to perform bariatric surgery for months to come. 3. Waivers ARE available and you should urge your politicians to push for a waiver for your particular hospital. Here's the list of US Senators. Just find yours and slam them with emails & phone calls: http://www.senate.gov/general/contact_information/senators_cfm.cfm Here's the list of Congressmen. Ditto above: http://www.congress.org/congressorg/issuesaction/alertlist/?issue=30

Hospitals have their applications in for approval-just have not had time to get ceritfied yet. It's the government...it takes time. There will be more hospitals added to the approved care centers soon. Be patient. I have no problem with the strict guidelines Medicare/Medicaid is establishing for the safety of their patients...too many surgeons out there setting up shop to do bariatric surgery for a fast buck and they are killing people. Also-Medicaid is requiring very strict follow-up guidelines BRAVO!!!! I work hard for my money and being a contributor to the Medicaid program-I want to know that my tax dollars are not being wasted on programs that are going to fail. I personally do not want to pay for revisions for people after they have WLS because they had no follow-up program to help them NOT regain their weight. It is frustrating to have to wait for approval. It is hard when people pay $200-500 a month in insurance premiums and are still turned down. It is a long road sometimes....but the big picture is that more hospitals will be added to the list...and many more states. YES you may not get to choose the place you wanted....but rest assured you will get top of the line when they do begin approving hospitals in your area. This law just became active 2-3 weeks ago....The guidelines were published over 6 months ago. ALL hospitals have had adequate time to apply for certification....and those requests are being processed. It just takes time. Good luck with your journey

I will admit right off the bat that I could be wrong (and I will confirm with my health insurance professor tomorrow at school, they come in handy for things like this).... But I think the new ruling doesn't include people covered under MedicAID, only MedicARE. Medicare if totally federally funded so they set up teh rules and regulations for that. Medicaid is only partially funded by the fed and I believe each state makes it's own policies regarding coverage and procedures. That said, Indiana's Medicaid guidelines are very strict and getting stricter. When I started the process they only required 8 months of "supervised dieting." By the time my 8 months was up they were requiring 18 months of a "supervised program" whi*****ludes dietician, PCP, and even someone to monitor your exercise and fitness attempts! Fortunately I was grandfathered somehow and never had to deal with that. I do think it is a great idea though...certainly makes sure only the people who NEED it will have it. And yes, their follow-up plan is even pretty strict. I'm still pre-op but my WLS caseworker has told me that we will become very good friends post-op because she will be calling at least once a week to check on how things are going. I have to keep a food log for her, I believe they are trying to work something out with the YMCA to have a supervised exercise type program for post-ops and I think they are even trying to figure out a way to make sure we have access to the right kinds of foods and vitamins and such. It's a fairly new set up so not everything is in place yet...but at least they are trying. I know for me having Gloria call me will be even more motivation...she's a wonderful lady. She cried on the phone with me when we didnt' think I'd be approved....and then she cried when she told me I was approved. She rocks! I agree that it is a wonderful thing that the government is actually looking out for WLS patients and trying to get them the best care. Yes it changes things a bit and it might take some time for all the hospitals to be approved but in the end it's better for everyone.

lisa lady you are so right this crap is not fare in any way shape or form you no everyone keeps talking about what a good thing this is gonna be for all of those just gettin started but what about thise who have already been fightin and beggin and runnin and tryin to get all they demand .you no i understand im asking for assistance and god knows im so thankful for all that was about to happen i was about to go to clarion to send my packet to medicade for what im pretty sure would have been approved i have been doing this for a solid year and now because of this change they say they wont even send my packet at this time unfair is just bull crap this aent right anyway you look at it but im gonna get on the phone just like you said and so should everyone else thanks your friend cim

by the way just as a foot note people should not assume that because you are a medicade or a medicare recipient that you are a bum i was injured and left disabled through no fault of my own and yes i do at this time recieve medicade but im not a bum in any way i worked my whole life and i payed and continue to pay those same taxes that everyone else are talking about im sorry i dont mean to be a smart.........! but people really should think a bit more about the way they say things sometimes thank you

its my fight to help anyone in any way to get approved and I will email Gary on this to check it out and you can know i will sure email or write to anyone....and i have in the past and will keep right on doing so...anyone who wants this surgery should be able to have it with out the fight for their life...

Cimberly hun...I wasn't implying that Medicaid recipients are bums...on the contrary-I think they are deserving of the best of care Which is why I am glad they are setting such high standards for their clients. As a taxpayer-I would hate to see the money go for crack-pot doctors out there trying to catch some quick bucks and putting their patients in danger. Medicaid should be applauded for only wanting the most reliable programs being offered out there-and the safest. As a taxpayer-you too would not want your money being tossed out the window to fund those unethical surgeons who look at WLS as way to make fast dollars at the expense of their disabled patients either would you? I was nearing diaability too as an extremely obese person and I would have wanted the best of care and not the bottom of the barrell had I become disabled and reliant on Medicaid. I was making the statement in support of the patients and the desire to have the best treatment possible and not to just let the lowest bidder so to speak handle the surgeries. Sorry if you took my statements wrong....ya know I have been praying for you to get approved and get your life back...as I am for all the people struggling to get approval. Once more hospitals get approved as surgery centers....they will begin accepting Medicaid and Medicare patients again and you will know you are getting the best and SAFEST surgery centers possible. Again...my apologies if you took my statements wrong. I am just glad that tax dollars are being used at the highest standards for this surgery-and knowing that the government cares enough to set strict guidelines to ensure the safety and success of their WLS patients. There is so much Medicaid/Medicare fraud out there by doctors...and they butcher their patients....this should help those unsuspecting patients from loosing their lives. Keep up the good fight....there is hope in all of this...keep up the doctor supervised diet so that you have your records in order when the hospitals here start getting their approval. And please forgive me sweety-I wasn't being condensending towards people on disability-I was just trying to point out that I am in favor of the program offering only the best without wasting money and lives. Take care

In response to your footnote. I want you to know that the people *****gularlly post on this board.. the OLDTIMERS, the ones who have gone on before us, are the best!!! Do they HAVE to post on here once they get goal and share their wisdom?? NO, Do they HAVE to organize clothing exchanges for those of us who are still loosing a size a month? NO. Do they HAVE to deliver gift bags to new surgery patients just to let them know they are not alone?? NO! They do it out of LOVE, LOVE for people.. Love for YOU and ME who have questions. THEY share what they think too and have EVERY RIGHT, even more than some because THEY HAVE BEEN THERE!! IT is TRUE some Dr.s take advantage of Medicare and Medicad patients. They Don't always give the best care. Medicare and Medicad patients are no better and no worse than others but deserve quality care, just like anyother WLS patient. I have private insurance thru where I work but my husband has Socical Security Disability Insurance because he too was disabled do to an injury,(not medicaid, he paid in enough to qualify for SSDI) so I know how they both work. Most insurance companies are going to 18 months and dragging their heels..It is awful to have to wait and jump thru hoops for anything so worthwhile as WLS.. But I want to know my friends.. no matter who pays for it get quality care. BECAUSE people DO DIE from WLS. some right in the hospital and some months out.. But they still die, some from lack of education, lack of follow up care and some just because... I DO NOT KNOW one person on this board who would post to discriminate, hurt feelings or think that they are better than anyone else.. And to lash out the way you did... shows you dont know anyone who posts on this board. This board does not need drama.. it needs the love and education that only comes from those of us who have gone on before us. Do you know the "oldtimers" have more love, more wisdom and fight in them for you (and me) than any Dr, or Insurance company. And I would stand beside or behind anyone of these people!! Don't be hurtin my friends feelings they work hard for us... Just incase you are interested in MY OPINION, Linda