This could just be the most important thing any of us ever do for people with CH.




Hello, we have been instructed to initiate a ACTION REQUIRED FOR CMS REIMBURSEMENT COVERAGE FOR CLUSTER HEADACHE PATIENTS.

A Formal Request for a National Coverage Assessment at CMS (Medicare) was filed on 4/9/2010 by Dr. Fred Sheftell, MD, President, American Headache Society and Dr. Robert C. Griggs, MD, FAAN, President, American Academy of Neurology. 

The goal of this National Coverage Assessment request is to overturn the present non-coverage determination on oxygen therapy for Medicare beneficiaries who suffer from cluster headaches. Comments from Neurologists who treat Cluster Headache sufferers as well as the Cluster Headache sufferers themselves who use high flow oxygen therapy have a vested interest in this coverage.   

This formal request is in part due to the latest evidence of High Flow Oxygen for the treatment of Cluster Headache. You can find this summary article from Neurology Now.  This article provides additional perspectives from some of the Nation's top neurologists specializing in the treatment of the acute and chronic Cluster Headache.  They list oxygen therapy as the first intervention of choice for the Cluster Headache due to its safety and effectiveness in aborting the most severe pain known to the medical profession. 

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Should you agree with thousands of oxygen prescribers and users of High Flow Oxygen for the treatment of Cluster Headache please find the link below to the CMS page announcing the NCA for Home Use of Oxygen to Treat Cluster Headache (CAG-00296R).  The comment period runs from 4/9/2010 to 5/9/2010. It is urgent to act today before the comment period is closed.   

Go to this link now for comment:
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You were "instructed" to do this?

Maybe that means something different in England than it does here.

Bobw

Pinkfloyd wrote on May 4^th, 2010 at 10:21pm:

You were "instructed" to do this? Maybe that means something different in England than it does here. Bobw

Actually Bob, I quoted the statement on the publicity thing without adding my own version. It was generated right here in the US so read it how you will! I wouldn't read anything into it than legalese though and frankly, there are more important issues involved than some jobsworth's wording!!  :)

Done!

Thank you!

I'd like to mention a side note to this discussion - while it focuses on Medicare/Medicaid coverage, I would ask that everyone please remember that Tricare, the military health care coverage, is based on Medicare.

If Medicare refuses coverage, so will Tricare, and there are a high number of active duty, retirees and veterans in our midst, as well as their family members.  They would all lose their home oxygen coverage.

Our service men and women and their families deserve better.

Cat

catlind wrote on May 6^th, 2010 at 10:11am:

I'd like to mention a side note to this discussion - while it focuses on Medicare/Medicaid coverage, I would ask that everyone please remember that Tricare, the military health care coverage, is based on Medicare. If Medicare refuses coverage, so will Tricare.......

.... along with all the private insurances. Cat is absolutely right. Anthem BC (Blue Cross/Blue Shield plans), CIGNA, United Healthcare, Humana, Amerigroup, Principal, Longshoreman's, etc, ALL take the lead from Medicare rulings. This is critically important for EVERYONE.

AdoreInVegas wrote on May 6^th, 2010 at 12:43pm:

.... along with all the private insurances. Cat is absolutely right. Anthem BC (Blue Cross/Blue Shield plans), CIGNA, United Healthcare, Humana, Amerigroup, Principal, Longshoreman's, etc, ALL take the lead from Medicare rulings. This is critically important for EVERYONE.

Not sure I understand. CIGNA is my insurance company, and I've never paid a dime for O2.

Brew,
If Medicare declines this initiative, private insurance companies normally follow suit. They can base their medical necessity decisions on Medicare guidelines, and if they are suffering like Blue Cross Blue Shield, they will use it as an excuse to not cover the service.

If anyone is on Medicare-based HMO or PPO plans (i.e. Secure Horizons, Humana Gold, etc), they will be directly affected by this initiative, also.