The Derby City Chapter of the National Spinal Cord Injury Association Network- Serving Kentuckiana.
Message From the President
Dear Members & Friends-
February's meeting will be held at Frazier Institute, 220 Abraham Flexnor Way, Louisville, in the 10th floor dining room at 6:30 p.m. We will either have a speaker, or a video will be shown. Refreshments will be provided. March's meeting will be held at Frazier Institute, 220 Abraham Flexnor Way, Louisville, in the 10th floor dining room at 6:30 p.m.
- David Allgood
From the Internet-ed.
INSURERS OFTEN CAP COVERAGE FOR THE LATEST SCI TREATMENTS By Patricia Ansett
New technologies and more aggressive approaches to treating spinal cord injuries pioneered in Detroit are giving patients new independence and improved mobility. But the innovations come at a big price at the very time insurers are trying to hold down rising health costs. While some advocates see progress in getting insurance to cover the treatment, patients are finding that insurers are willing to pay only so much for only so long.
Bob Smith of Harrison Township, injured in a diving accident on July 4, 1999, learned in December that Health Alliance Plan would no longer pay for his therapy at the Rehabilitation Institute of Michigan in Detroit, as it had for 2 1/2 years.
In 2003, Smith became the first American to go t China for experimental surgery to repair his spinal cord. The health plan paid told Smith that his gains had plateaued, and it would no longer pay for his rehabilitation.
ìI'm worried I won't be able to maintain the strength and health I have,î said Smith, a former Chevy salesman. Though he can't walk unassisted, he has gained considerable strength, has improved bladder function and hand movement and even has
begun to feel sensation in his toes, he said early in January.
Insurers say that Physical Therapy is an extra health benefit that companies and individuals must purchase. Once people exceed the lifetime cap on those benefits, the expense far exceeds the cost of the policy.
ìWe try to do the right thing,î said Dr. Mumtaz Ibrahim, senior associate medical director at HAP, noting that he could not talk specifically about Smith's case without Smith's consent. He said coverage decisions are reviewed by two levels of physicians and a board of directors committee.
ìThis is a huge issue,î said Erica Nader of Bloomfield Hills, who was injured in a 2001 auto accident. She has been undergoing intensive therapies since, and in March 2003, she became the first American to undergo experimental stem-cell surgery in Portugal.
For five years, her therapy at the Rehabilitation Institute of Michigan was paid for through her auto insurance.
ìThis isn't a six-month to 12-month rehab process. Look at Mike Utley,î she said, referring to the former Detroit Lions player paralyzed from the middle of his chest down during a 1991 game. ìWe need long term aggressive therapies that make us less dependent.î
Intensive physical therapy for spinal cord injury is most associated with the late actor Christopher Reeve, the one-time movie Superman who became paralyzed in a 1995 horse-riding accident.
