From: Herbert Stein [mailto:firstname.lastname@example.org]
Sent: Monday, January 27, 2014 2:27 PM
To: Chet Burrell, President & CEO CareFirst BlueCross BlueShield
Cc: Madam Secretary Kathleen Sebelius – HHS; Jonathan Blum, Deputy Administrator and Director for the Center of Medicare at the Centers for Medicare and Medicaid Services; Amy Larrick, Senior Advisor to the Principal Deputy Administrator Centers for Medicare & Medicaid; Stephen J. Hemsley – CEO, United Healthcare
Subject: Once again another life hangs in the balance…
Dear Mr. Burrell,
Apparently you and your company are also unaware of a recent informal decision rendered by CMS to insure that all VNS Therapy depression patients implanted on or before May 4, 2007, the date CMS rendered a determination to not cover VNS Therapy for the depression indication, would receive medical care, replacement and/or explant. CMS egregiously, immorally, unconscionably and/or by oversight or stupidity rendered that 2007 decision without grandfathering care for these volunteer study subjects and patients now implanted with a medical device.
In their more recent decision CMS conscionably is trying to rectify this oversight as they’ve come to learn that those patients wishing to continue with the therapy are long-term responders obtaining efficacy over multiple years and from the standpoint of economics saving considerable sums of monies for the government (Medicare/Medicaid) as these patients no longer require very costly multiple-yearly hospitalizations, numerous doctor visits and exorbitant sums of money for ineffective and refractory psychotropic medications and other therapies.
To which I also add that in all likelihood your company is discriminating and in violation of the intent of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
More specifically, I am a very, very long-time mental health advocate and activist for my spouse and others and currently advocating on behalf of one of your subscribers.
Kimberly Elizabeth Meek
618 Lexington Place NE
Washington, DC 20002
CareFirst Blue Choice POS Open Access
PO Box 14115
Lexington, KY 40512-4115
Member ID: GOM830 17 4726
Group #: 5800049-DC10
Ms. Kimberly Meek requires an immediate favorable decision from your company to obtain surgery for the replacement of her depleted pulse generator and a re-implant of her VNS prosthesis in order to maintain her previous wellness and to prevent her possible death.
I ask that you and/or your appropriate subordinate(s) immediately contact Mr. Jonathan Blum, Deputy Administrator and Director for the Center of Medicare at the Centers for Medicare and Medicaid Services at either of his two offices [(202) 690-6301 DC or (410) 786-4164 Baltimore)] or Ms. Amy Larrick, Senior Advisor to the Principal Deputy Administrator Centers for Medicare & Medicaid at either of her two offices [(202) 690-5742 DC or (410) 786-2585 Baltimore] to validate that which I have presented to you.
More importantly, your immediate assistance and cooperation in trying to save Ms. Kimberly Meek’s life is a matter of grave urgency easily rectified by your company’s prompt authorization and approval of her rightful surgery.
Joyce and Herbert Stein
1008 Trailmore Lane
Weston, FL 33326-2816
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