WLS on recommendation list!!

I recently got an email from a member of the Kansas Health Policy Authority (KHPA) and it appears that WLS and other Obesity Mangement Services WILL BE on the recommendation list in the healthcare reform bill at the statehouse on November 1st.  What that means is that they are going to recommend that coverage of WLS and other OBS be included on insurance plans.   So that means it will be in the legislators hands soon, I urge EVERYONE to contact your legislators and urge them to adopt the KHPA's recommendations!!!  It's in our hands!!  Call, email, write, them, let's get this done!!! ************************************************************** 1.  ************Find your current state senator/congressmen at  www.congress.org you'll have to put in your zip code. ************* 2.  Write to them either by email or snail mail. 3.  Don't forget to also contact Governor Sebelius and the State Insurance Commissioner Sandy Praeger to voice your concerns too. Governor Kathleen Sebelius Capitol, 300 SW 10th Ave., Ste. 212S Topeka, KS 66612-1590 Phone: (785) 296-3232 Fax: (785) 368-8788 www.ksgovernor.org (to send email go to her website and send email via her webform) and Sandy Praeger State Insurance Commissioner 1-800-432-2484 or e-mail [email protected] 4.  (Don't forget to tell them that you want WLS as part of their major Health Care Reform that they will bepushing through next legislative session!) 5.  Below are few sample letters you can send (cut and paste), but make it your own personal story: ************************************************************** from our friends at www.obesitylawyers.com Sample Letter: Dear _____________: I am writing to you as your constituent and a member of an invisible majority. I wish to call your attention to a serious and growing problem in this country. The problem of Obesity and Morbid Obesity is a chronic physiological disorder suffered by countless Americans. In April 2003, Dr. Julie Gerberding, Director of the Center's for Disease Control stated in no uncertain terms that Obesity is the Number 1 health threat in the United States today topping deaths caused by smoking. In 1991 the National Institute of Health found that very low calorie diets simply do not work long term when dealing with Obese and Morbidly Obese people. The Consensus report went on to hold that the only option in these situations is gastric restrictive surgery. In fact, the Dartmouth-Hitch**** Medical Center has released research that shows that gastric bypass not only helps patients take excess weight off and keep it off, it may also increase life expectancy by three years or more. I must tell you, on a personal level I have experience humiliation, health defects and personal difficulties as a result of my obesity. My co-morbidities, to wit: health conditions that are caused or worsened by my obese condition will be lessened if not cured as shown by recent medical studies. The health savings are tremendous. The financially savings to this Country in terms of medical expenses are enormous. Yet, despite the forgoing, Insurance Companies have continued to deny coverage for this life saving surgery. Post Operative patients are discriminated against by being rejected for disability and life insurance. I urge you to contact Gary Viscio of Viscio & Associates at 145 Willis Avenue, Mineola, New York 11501, 516-742-5300 and further discuss this situation. Your help is desperately needed. It is truly a matter of life or death. Thank you. ******************************************************************************************************** and another sample from our friends at www.obesityaction.org Below, please find a sample letter that will help you get started: Your Full Name Your Full Address Your City, State and Zip Your Phone Number with Area Code Current Date The Honorable (Insert Legislator or Public Official Name Here) Legislator or Official’s Address Legislator or Official’s City, State, Zip Dear Title (Governor, Senator, Representative, Commissioner, etc.), In your first paragraph, mention the following points: 1. You are writing to request their assistance in improving access to bariatric (weight-loss) surgery and other obesity management services in the state of Kansas. If writing specifically about state-employee program, mention it here. 2. Discuss how this specific issue affects you and your family. In your second and third paragraphs, mention the following items: 1. Further elaborate how the issue affects or has affected you. 2. Share your personal connection with the issue in question. (Remember to remain brief. A short letter can accomplish just as much as a long one.) In your last paragraph, discuss the following closing items: 1. Urge them to help restore access to obesity management services. 2. Request that the individual write you back, informing you on their position regarding the issue. 3. Thank the individual. Sincerely, Your Full Name Very truly yours, ******************************************************************************************************** Good luck!! Together we will make progress!

I forgot to mention if you use the above sample letters DON"T FORGET to add that they should move to adopt the Kansas Health Policy Authorities recommendations on November 1st.

Thanks so much for the info and suggestions for response.  Now is the time for us to speak up - too many times we sit by quietly and think that our legislators will somehow magically know what actions we want them to take!!  I can't believe that this won't be a cost saving measure for insurance companies when you look at the research on how many health issues that WLS resolves or at least helps reduce.  I was reading about a program in Australia where they pay rebates to people willing to have WLS because they know the cost savings in terms of medical care when people get weight under control.  A little different than in Kansas where most health care plans don't cover ANYTHING related to obesity.  Crystal

That sounds great Chad!  As a self-pay I would welcome coverage.  Forgive my ignorance, but some people in Kansas are aready covered, right?  Will this make it mandatory that all Kansas insurance companies provide WLS coverage?  Does it only apply to federal employees?  I'm just a little confused as to the exact nature of this effort. Any ideas on how long before coverage is available if they decide to move forward? Jim

Sorry BigLoserWannaBe, all I know is that this is a recommendation, not a mandatory law.  This doesn't apply to federal employees at all, most federal employees are covered already under their own healthcare plans.  Some people in Kansas ARE covered, but usually they are covered because they have insurance from a company NOT headquartered in the state of Kansas.  IF the statehouse approved it during the 08 legislative session, that would implement it starting in January 09 I believe.  BUT we have to pass the big hurdle at the statehouse first. The recommendation list would be something that the statehouse says these tools should be here so we can fight obesity, and then they would recommend to insurance companies operating in the state what they recommend.  I could definitely be wrong here, but I think the concensus is that right now they have the exclusion as recommended.  I know for the state employee healthcare plan this is the case.  So having the recommendation to allow coverage for the surgery would be a major step forward.  Currently most insurance companies realize that this is a major cost cutting tool for them as well as life saving for the patients, so it would take the decision making away from the legislators into the hands of insurance companies. At least this is the way I understand it.  But I am not a professional.  :)

Chad, Can you send or post a copy of that email. I would like to see it in writning. What size groups are they going to make it a mandate. How much will it increase the cost of health insurance?  What guide lines will they add to the mandate? Will it be required that the providers be a center of Excellence? Will it still require a 6 months proven diet prior to approval?  Thanks, Mike

To clarify. It doesn't look like it will be a mandate.  This is not for federal employees.  I'm kind of confused how it works because it's a very broad statement that was included, but the way it looks is the Kansas Health Policy Authority is simply going to recommend that coverage of weight loss surgery be ALLOWED, not mandated.  At least I didn't think it does.  That would mean that individual insurance companies may be more likely to drop the exclusion. BUT the statehouse still has to vote whether to allow the recommendation.  But it affects state employees the most I believe because chances are that the state insurance programs would be more directly affected.  But it could rollover to other insurance companies in the state to allow coverage as well.  But I think we will know more on November 1st, when they actually present their recommendations to the statehouse.  But the statehouse will not vote on any of the recommendations until the start of the 08 legislative session starting in January. I am not allowed to post the email due to privacy laws that were written on the email.  The disclaimer is included below:

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But I think I can say that the plan includes multiple intiatives to combat obeisty, that we don't have now.  And is a major step forward in healthcare for the obese.  And to be completely honest, the primary goal of the healthcare intiative is personal responsibility, so people can try to regain control over their weight and bring down the costs of healthcare for all Kansans.  Weight Loss Surgery doesn't look like is a major part of the initiative.  And could technically still be cut from the recommendation list.  
If you would like more information or would like to contact the Kansas Health Policy Authority directly, you may do so here:
http://www.khpa.ks.gov/

Well it's official.  WLS was cut from the recommendation list from the Kansas Health Policy Authority!!!  They said that it will be debated in future years.  :(  Not sure what to do now or if there is anything that can be done.  Moving on with my life, WLS just isn't going to happen for me at this point in time.  Good luck everyone!  I am happy for each and every one of you who have the chance to make this happen for yourself!  If you have the opportunity, and it's what you want, do it!!!  If you want to contact the Kansas Health Policy Authority you can reach them at www.khpa.org