Key Change in Indiana Law

I am new to posting here, but just had to reply with some new information I just learned. I am a health insurance attorney, and I'm also hoping to have WLS, depending on the answer to a lot of prayers and a long overdue pre-determination decision from Anthem, my health insurer. I wanted to let everyone know about a very important - and extremely positive - change in Indiana's statutes related to bariatric surgery. Effective July 1, 2006, health insurers covered by state law (including anyone employed by state or local government, HMOs and fully-insured plans) can no longer require the super long physician-supervision timeframes that many of them have as a prerequisite to approving WLS. In fact, the 18 month provision previously in the Indiana Code has been changed to a 6 month provision. Your health plan (if covered under Indiana law) will not be allowed to require a longer time period after July 1, and this should apply retroactively. That means that anyone going to the doc since January should meet the requirement after July, and so forth. I'm thrilled with this news, and I'm happy to help out anyone that needs more information in pursuing a pre-D or appeal on this basis. I think that waiting one more year would be like waiting an eternity, so this change may potentially have a really positive impact for many of us hoping to have WLS as soon as possible!

this would be great news...and soon it should be anyone and everyone will be allowed this should it be the road they want and no one else with the right of our lives in their hands

Thanks Katy... I am a state employee but I already had 18 months with Dr Piatek before I even tried to get WLS approval... with a total count of the $7000.00 + I paid him to help me loose 50 pounds.. So Many people needed to hear what you just wrote... so many people have been denied and desperately need the surgery to get on with their lives.. Thank You again for your message of hope!! Good luck with your surgery too!!!! Linda

Thanks for the terrific info and the offer for help. My pre-determination letter is under review and I was told to call them (Anthem) back Monday. Hopefully all goes well! Good luck to you as well! Take care!

Katy, This is awesome, I'm wondering if this is posted anywhere on the web, I'm always trying to keep up with these things and wondering if there was additional information on the web anywhere. Thanks! Amy

Unfortunately, I am not aware of any particular place on the web where you can get this kind of specific information regarding laws and regualtions effecting obesity. I've done general searches before and don't come up with much as far as a clearinghouse of information. Indiana statutes may be found at www.in.gov under the subsection "laws" - and you can do a search that will connect you with the General Assembly's website, which has all of the proposed and newly enacted bills.

Thanks Katy!

Hi my name is KAY AND I LIVE IN PENNSYLVANIA.i STARTED IN jANUARY FOR MY WLS AND I'M IN MY 3RD MONTH DIETICIAN.I GO ON THE 18 AGAIN.I WAS TOLD MY BMI IS LOW .ITS 38.5 AND 53 YEARS OLD 5 FT. 5 AND I HAVE HIGH BLOOD PREASURE,HIGH CHOLESTEROL,CHRONIC BACK PAIN,AND SEVERE SLEEP APNEA.MY INSURANCE IS SELECT BLUE i HAVE IT THROUGH MY HUSBAND. I AM ON DISABILITY DUE TO MY BACK AND DEPRESSION.I HAVE HAD ALL MY PRE OPT TEST DONE.I HAD TO DO THE SLEEP APNEA.tHEY TURNED ME DOWN BECAUSE I WASNT IN REM LONG ENOUGH,bOTH SLEEP STUDYS SHOWED I HAVE SEVERE APNEA.I'M NOT GOOD AT WRITING LETTERS AND SOMEONE TOLD ME I MIGHT HAVE TO WRITE AN APPEAL.COULD YOU HELP ME? tHANK YOU KAY p.s. HAPPY EASTER

I wish that was true for bcbs of ill they are hard to work with the also want a 12 month supervised diet.