Medicare stinks

[cervie queen]

I have been disabled for five years and am on Medicare. So far, I have not met or heard of one person who has had Medicare pay for ARtificial disc. Now today I read an article in the Orange County Register that was published earlier this week that discussed the Bone Morphegenic Protein used in fusion. Yess, antiquated fusion. Guess what? It states that Medicare won't pay for the BMP, and that fusion without BMP has a 20% failure rate. And that's just at one level. So what good is a government health program for the elderly and disabled if it won't pay for any of the improved new technology with a much higher success rate. ARe we Blue light specials?

[Harrison]

CQ, that is puzzling, given that BMP is so effective -- and it also means that patients don't have to get a hole drilled in their hip for the donor bone!

Sorry about this turn of events. Maybe there are more ideas from the community....

http://adrsupport.org/groupee_common/emoticons/icon_confused.gif

[Mariaa]

CQ,
My current OSS in LB had told me that he would have to use BMP on me because I have osteoporosis in one hip and he didn't want to create pain in the good hip.

So I'm wondering if I were to have Medicare as my primary coverage for back probs, which I don't, would that make a difference in how they respond to paying for using BMP vs. not...

Seems like certain factors would make a difference vs. a flat out Universal NO?

WC had already approved the use of BMP for me should I have that 3 level global fusion which I so dearly don't want to have~

[cervie queen]

Here's the article. You will have to register (free) to read about it.

http://www.ocregister.com/ocr/2005/02/15/

[Poncho]

I'm not too sure about this, but thought I would throw it out there.

Re: BMP - Perhaps if the doc coded in one of the primary diagnosis with medicare as osteoporosis along with ddd et al (instead of only ddd as a primary diagnosis) - would this make a difference regarding reimbursement for such a procedure???

With ADR - I don't understand why there is such a resistance here for coverage. In my cynical mind - I can think of some, but they are unsubstantiated.