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-   -   Re: cms (https://www.adrsupport.org/forums/showthread.php?t=7481)

02-16-2006 03:04 PM

well that sure isn't good. http://adrsupport.org/groupee_common...icon_frown.gif http://adrsupport.org/groupee_common...icon_frown.gif http://adrsupport.org/groupee_common...icon_frown.gif
chuck

02-16-2006 03:25 PM

i find being a person at 46 yrs old with DDD and even without being on ssi facing spine surgery.and still managing to work like i have for the last 30 yrs.paying taxes etc...that cms call on disc replacement will affect all person as such pivite insurers look at medicare coverage for alot of there coverage outlooks.and medicare doesn't just cover older people but also disabled people also the most with back problems.total disc replacement allows in most cases to get the person back to work faster less time in the hospitol.and mantaining the spines movement.after fighting with BCBS about TDR and losing it seems unfair that if i were a fed employee they would have to pay because its fda approved.and knowing many people whom have had spinal fusion and only being pain free for 5 yrs or so. i find it hard to believe that in all the patinet is the one who has to live
with this call.
all in all i see medacare and pivite insurers forcing people to go overseas for these procedures. shame on us {USA} high tech what?
thanks charles swenson
my coment to cms above..

02-16-2006 03:36 PM

yea know lbp
what worst even with this call and you get on ssi you will just become part of the system nothing to get you back on your feet its very sad.. indeed and this call by the cms will afect all insurers it down right suxs
chuck

letteski 02-16-2006 03:51 PM

If it is truly a "public comment" then I have something to say....this is what I submitted lets see if they will accept it.

I am 41 years old and a recipient of an Artificial Disc (ProDisc) on Aug 23, 2005 as part of the FDA Clinical Trial. I would like to share my successful out come. On Feb 23 I will be 6 months post surgery and have returned to work full time as an Adapted Physical Education Specialist of individuals with Severer Disabilities. This is a very physical job that I was totally disabled from before my surgery. Artificial Disc Replacement has given me my life back and I am happy to say I am completely medication/drug free and truly living life again. I have even been out skiing downhill and cross-country. Artificial Disc Replacement is a great option for the right candidate and should be covered by all insurance companies.

(Amy thanks for keeping us so well informed) http://adrsupport.org/groupee_common...icon_smile.gif

Harrison 02-17-2006 08:46 AM

See the article library...

Feds seek to exclude J&J disc from coverage
Friday, February 17, 2006
BY JEFF MAY
Star-Ledger Staff

andromeda1111 02-18-2006 11:11 AM

You know this really P###$#$ me off! What in the world is health insurance for??? only for people who are presumed NEVER to get ill, you know people who are basically immortal!

I was looking into some health ins recently, health net and after reading the app, I would have to lie on approximately 5 questions in order to be insured, so basically I am uninsurable, so yes I would lie on the damn thing, then after reading the benefits... there are NONE! you pay $124-$155 or more per month for simple doctor checkups and prescription coverage, THAT IS IT! my prescription is $14 per month, Why should I pay hundreds of dollars per month for a $14 prescription! how many people go to a routine checkup EVERY MONTH for $124! so I would be losing money! a doctor visit is about $75-$100, There were no coverage for x-rays, MRI's, hospitalization, health insurance is nothing but a scam.

Alastair 02-18-2006 11:39 AM

Well I have to be careful what I say here because I'm not a USA Citizen. I'm not entirely sure of the implications and the legal position either but it looks as if some of the major insurance companies have decided to put a block on the Charitee ADR device. My guess is it's a "money thing" again.

I think you've got to put evidence to these people that this device has been used in Europe with huge success since 1989. It is still being used their in addition to the Pro Disk. At one time the Alpha clinic were claiming 92% success with the Charitee. You cannot hide these past successes just by pretending that the USA has not done the appropriate research which it should have done many many years ago.

To all of you that are affected, I send my heartfelt commiserations. I sit here with my Charitee disk implanted over 3 years ago and I'm doing absolutely fine and been given a new life.
Best,
Alastair http://adrsupport.org/groupee_common...icon_frown.gif

02-18-2006 12:11 PM

I don't know Alastair, maybe you could post your story as a public comment to CMS. Even though you are not a US citizen you are over 60 and would be part of the medicare population if you were a US citizen. CMS is considering all studies in English including European data...so why not your success story???? do you know any others who are similar to your situation?

Alastair 02-18-2006 01:03 PM

My Story is here as a Public statement to ADR and the Charitee disc.

Is medicare just stopping this for the over 65`s it looked like it was stopping it for everyone.

I have over 400 UK people who have had ADR over both in Germany and in the UK. If they all would post or be considered as a posting I don`t know.I am the oldest though

It looks to me as if this is "Big Business" taking you all for a ride until some newfangled ADR is made.

In my humble opinion this should slide to Lawyers given a few days. Some one pop this on Monday to Lawyers in the USA ? You are being deprived of you rights following you payment of Health Insurance?

I note in this letter they quote Prof Van Ooij who believes in nothing but fusions plus they regard VERY lightly the publications in the Spine magazine.There are records kept in Europe (Zeegers 1000 ADR) they just don`t want to find it. Age 65 is the published maximum age for the alphaklinik for ADR - -- -I think you have people not wanting to see
Best
Alastair http://adrsupport.org/groupee_common...icon_frown.gif

Alastair 02-19-2006 05:55 AM

This entire matter about the insurers not wanting to use the Charite ADR is one which must be addressed by all you USA members. If someone would like the PDF file stating that Zeegers has done over a thousand ADRs and that was a while ago, he must've done nearly 2000 by now, then someone e-mail me. LBP I cannot send stuff as attachments from the board.

If the FDA approved the Charite, then there must be loads of stuff on the internet and references to your medical and legal people who did approve it. The UK body known as the National Institute for Clinical Excellence (NICE) approved it for the UK sometime ago.

There are over 600 members here of which over 400 are USA members. I can't do all this research for you as I assist on 3 other boards. You all have communication systems and you've all got computers and you've all got the Internet on most computers so you're just going to have to do this job yourself I'm afraid.

I would think apart from tackling lawyers about this, your political senators and people like that would be a very good call to make in the not too distant future.
Cheers,
Alastair http://adrsupport.org/groupee_common...icon_smile.gif


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