To all VNS depression patients and their attending physicians,
Word trickles back to me by way of my collaborations with both patients and physicians and I’d like to share the following information in order to help expedite the replacement process and lessen the stress and anxiety on the patients.
The patient should first make arrangements for replacement of the VNS prosthesis through his/her attending surgeon and/or hospital facility. Should there be any initial question as to whether or not the patient’s health insurance covers the procedure the patient should direct the surgeon and/or hospital facility to contact:
MAC (Medicare Administrative Contractor) in the local region and have the physician and/or hospital ask MAC if the particular patient’s procedure would be coverable.
This from my understanding would be a normal procedure. The hospitals and doctors I am told are very familiar with this process and they should receive a reasonably quick response.
At that time should there be any questions or issues obtaining coverage I would then recommend calling Ms. Amy Larrick with all the pertinent information as stated in my earlier posting.
It is my understanding that CMS has been reaching out to MAC (Medicare Administrative Contractor) in the local regions so that these regional offices are covering Medicare/Medicaid and Medicare Advantage insured subscribers. I’ve also learned that CMS has no control over private health insurance carriers although they generally follow the guidance of CMS. CMS will help go to bat for those patients with private insurance who encounter similar coverage difficulties. I learned of a patient whose husband had insurance coverage through his workplace and CMS did assist that patient.
I’ve also learned from several patients that CMS has been honoring their word and when necessary have assisted the VNS depression patients. A number of patients have informed me that they have already undergone surgery and received their replacement prosthesis.
Once again, see your surgeon and/or hospital facility first to schedule the replacement procedure. They should contact MAC for patient coverage acknowledgement. If there remains any coverage issues then contact Ms. Larrick.
Joyce and Herbert Stein
1008 Trailmore Lane
Weston, FL 33326-2816