Parity legislation (corrected version)

Parity legislation (corrected version)

Jim DeWees

5/30/2007

We are currently working on a parity bill in Indiana. We have had a couple
meetings so far, have made some good progress on organizing for this fight,
and how to accomplish the tasks that will be involved with this.

What I really need from all of you out there that have been involved with
this kind of issue in your states where you live/work, is a copy of the
bills that have passed, or ones that have not made it into law, or the
revised versions, amended ones, etc. I know that there are a few states
that have passed these laws, and that is good news to know that. I have
gotten some emails from some prosthetists in Rhode Island, New Hampshire,
and Oregon, and I think a couple others, and have learned a lot from these
people. Every bit of information really does help with this issue. One
state, for example, was not able to make the law applicable to ALL insurance
companies because they claimed that they were a national or regional
insurance company and therefore were not subject to any state ruling, and
therefore they are exempt from any kind of parity legislation. Have any of
you heard of this, or can you verify this for me?

Also, for those of you living and working in states that have passed the
bills, are there any issues that you look back on and wish you had done
differently? If you could do it over again, what would you change and do
better??? What were the biggest battles, or challenges for you? What
advice can you give me on this?

So, basically, any information that you can share with me, please do so.
But, I really do NEED copies of the bills, something that we can use in
Indiana for a good starting point. I have been in contact with the ACA
numerous times and cannot get any help from them on this for whatever
reason. Another person here in Indiana has also been trying to get some
help here, and has gotten nothing either. But, the ACA has been great about
sending brochures and pamphlets to hand out, and other kind of materials
that are very general and elementary level information, but as far as
language, templates, or copies of successful, good bills, I cannot get
anything at all on that.

Again, if you can email any copies from your states, please help me out
here.

Also, I hope to keep up on all the states battles with this, and hopefully I
can be a resource in the future for anyone that is working on this in their
own states in the future. We really need ONE person that is on top of all
these state battles, and someone that can share these documents and bills,
and make it easier for ALL states to get this passed.

On a side note, I have been reading about the Ebay issues, and amputees
buying components on Ebay and then needing a prosthetist to assemble them,
align them, or whatever. My question on that is: What is wrong with the
insurance issues here in this country that are forcing amputees to resort to
buying components on Ebay in the first place? What is wrong with our
healthcare system that makes it necessary for amputees to even LOOK on ebay
for medical devices?

I was in that situation this past winter, I had revision surgery in the
middle of January, and was then told that it would be 6 weeks before I could
wear my leg again. It was cold, lots of snow and ice, during this period,
and using crutches are extremely dangerous, and so the doctor advised me to
get a wheelchair and to use it so that I did not fall and really injure
myself. I got the prescription, got a pre-certification, etc. I went to a
DME company to order a chair (just a plain old, lightweight manual
wheelchair...not a big fancy power chair), and found out that my insurance
paid so little for a chair, that there was no way they would provide it to
anyone with this insurance. They showed me the fee schedule for my
insurance company (and I am very aware at how little this company pays for
O&P, DME, etc...but it is still the largest insurance company in the US),
and then they showed me the wholesale prices for these chairs....and pointed
out that they would end up eating at least $200 if they provided this for
me. And, they cannot afford to lose money while providing services and
devices, and I totally understand that, and they know that I am in the O&P
business as well. So, I ended up going to Ebay and I bought a demo chair
from a DME company in California, used my credit card, and had it shipped to
my office here.

Again, what is wrong with the system here that would force me to have to
resort to buying a wheelchair off the internet? I pay my premiums
faithfully every month, but yet I still do not have fair access to the
medical devices that I need. Something really needs to be done with these
insurance companies to force them to provide the care for everyone, not just
amputees, but everyone. But, for now, starting with amputees is a good
start at least.

Another question, have any states contacted any disability groups (such as
the ADA or anyone) when working on the legislation? I have not heard
anything about that happening, and was wondering if there is a reason that
they have not been used as a resource or for assistance.

Thanks in advance for your help and documents.

Jim DeWees, CP

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