(repost) Medicaid and info about bill pending to mandate coverage

(This is a repost from a reply on the board, but I wanted to let you all know about a bill before the Louisiana legislature that would require the Office of Group Benefits to cover bariatric surgery.) Before Hurricane Katrina, there were several options available for Medicaid patients and the teaching hospitals in New Orleans provided surgery for Medicaid patients. After Katrinia, the surgeons who were doing bariatric surgery in New Orleans (like Dr. Daniel Scott) moved out of state and the few who were accepting Medicaid got overwhelmed until they had to drop Medicaid patients (like wonderful Dr. William Ordonyne).

I know of several doctors who did surgery on a case-by-case basis for Medicaid patients (a good friend of mine had surgery in Lake Charles), but eventually, the lack of true commitment from Medicaid made aftercare nearly impossible for the patients to afford. What I mean is if you get Lap Band surgery and can't get fills, you have been cut for nothing. The same goes for costly supplements and follow-up appointments for Sleeve and RNY patients.

You may not know it, but this fight isn't just starting -- it's well on it's well from a legislative standpoint. Laws will have to change this condition. The Department of Health and Hospitals does not have the power to change it, but legislators do.

Last year, Sen. Sharon Weston Broome authored a study resolution to mandate the treatment of obesity for those insured in the state of Louisiana. A hearing was held and there was great turnout from patients like Dorothy Hebert, nutritionists like Jan LeBlanc and doctors Louis Martin, Thomas Lavin and Drake Bellanger.

Right now, there is a bill before the Louisiana Legislature that would require the Office of Group Benefits to cover bariatric surgery. The thought is that if state employees are covered, other state and private insurers will follow suit.

I've recently been in contact with the author of the bill, Rep. Sam Jones, from Franklinton. He sits on the House insurance committee.

Here's his page with the Legislature: (note the legislature site is down on Tuesday morning)
http://house.louisiana.gov/h_reps/members.asp?ID=50

and email mailto:[email protected]?subject=Rep Sam Jones

Mandating coverage in the state of Louisiana will be the start of a great humanitarian effort here and the state will indeed "save" money (not make, sorry) from that they now spend on health care costs for the dangerous co-morbities like diabetes, degenerative back disease, sleep apnea and hypertension.

It has been observed that the Office of Group Benefits sets the standard for coverage in the state and since Medicare is already set amongst Louisiana providers, I think OGB is the best bet we have to getting Medicaid  in its truest sense for those suffering from obesity.

I encourage you to write your lawmakers, not state program administrators to get this law enacted and maybe next session we can tackle the inadequencies of the Medicaid program.

Onward,
Frances

Thanks Frances....I contacted all of those people plus more last year when I was trying to get approval for my lapband surgery. I'm a state employees and as such have an exclusion. It was a no win no win situation because my clients could get approval for the surgery thru medicaid but then couldn't find doctors and state employees couldn't get approval for the procedure even though the doctors were part of the network. OGB had meetings last year discussing this and decided that the cost of surgery put up against the money that they save thru better health was not significant enough.......you can imagine the emails that I generated over that disclosure. I'm glad it's being brought back to the table for discussion. I don't regret paying out of pocket though! Best money ever spent!