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Tuesday, January 28, 2014

“The Buck Stops here!”

From: Herbert Stein []
Sent: Tuesday, January 28, 2014 12:09 PM
To: Madam Secretary Kathleen Sebelius - HHS
Cc: 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; Chet Burrell, President & CEO CareFirst BlueCross BlueShield
Subject: The Buck Stops here!

Dear Madam Secretary Sebelius,

Is there not someone in all of the bureaucracy within your domain who remembers former President Harry Truman’s desk sign clip_image001  and who comprehends the intent of the message the sign was meant to convey.  Well I do remember the sign, intent and meaning and hopefully so will you.

After numerous past emails to both you and Mr. Jonathan Blum and his staff, Jonathan took the moral and rightful high ground in assuring medical coverage for the small group of VNS Therapy depression volunteer study subjects and patients.  These patients were egregiously, immorally, unconscionably and/or by oversight or stupidity on the part of CMS in their earlier decision of 2007 to not grandfather care.  These patients were implanted with medical devices and subsequently denied health insurance coverage which Jonathan recently understood and acted upon to do the morally correct thing by covering these patients; although it has only partially been successful.

In CMS more recent decision, which I now refer to as a “Stealth Decision”, a significant number of Medicare/Medicaid subscribers and 1 or 2 private insurance subscribers that I am aware of have obtained replacements and care covered by their health insurance.  Unfortunately the message and intent of the “Stealth Decision” has not reached all the health insurance carriers who at first were quick to jump upon the bandwagon of coverage denial based upon the earlier CMS 2007 decision.  Now that CMS has changed their position as indicated in the “Stealth Decision” it is now being brought to my attention that a number of private health insurance companies have been denying VNS patients their replacements and proper care.

Hopefully “The Buck Stops here!” will finally take effect with your understanding and that a message (mandate) goes forth from your agency to all the health insurance industry that this small group of VNS Therapy depression patients should rightfully be covered by their medical insurance carriers if they and their attending physicians choose to continue the therapy, care and/or explant.

I also think it incumbent upon you and your agency to also stress that non-compliance is both discriminatory and in violation of the intent of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

I have advocated vociferously this past year not to just see that only some of these VNS Therapy depression patients are cared for.  Instead all who were previously implanted and have responded and obtained efficacy from the therapy should rightfully be able to continue with the therapy if they so choose and not be outright discriminated against and/or denied by any health insurance company.

May I also take the liberty of reminding you and those who read my messages that The mission of the Department of Health and Human Services is to help provide the building blocks that Americans need to live healthy, successful lives…The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.”  Mr. Jonathan Blum and his agency have done their part and it is now your responsibility and that of your agency to execute your mission statement and mandate that all the health insurance companies follow CMS revised decision and immediately fulfill your mission statement to our fellow Americans to live healthy, successful lives.  It is your responsibility to not only protect the health of these Americans but to maintain and continue the wellness they’ve already achieved through their VNS Therapy.

Madam Secretary, it is time that you no longer sit back but rightfully vocalize and champion CMS newer decision for these patients.  Please inform all the health insurance carriers to comply and allow care to these patients, now! 

I am available 365/24/7 should you have any questions of me regarding this very urgent matter.

“The Buck Stops here!” with you and now!



Joyce and Herbert Stein

1008 Trailmore Lane

Weston, FL 33326-2816

(954) 349-8733




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