Wednesday, March 7, 2012

I, Like Ms. Fluke, Am Denied Free Access to Preventive Care

Dear  HHS Secretary  Sibelius:

After viewing Ms. Fluke’s testimony on her right to free access to contraception, I wish to bring to your attention that I am also being denied free access to vital preventive health care. Medical studies prove the reduced health-care costs of  senior citizens, who engage  in  moderate daily exercise in a proper facility under supervision of a physical therapist certified in geriatric care.

Medical research has clearly demonstrated that I – as a 71 year old male -- will have fewer hospitalizations and need fewer prescription medications as a result of daily moderate supervised aerobic and other exercise. I provide in the attached appendix actuarial calculations that demonstrate the discounted present value of health-cost savings over my projected lifespan exceeds the cost of the vital preventative medical care that I hereby petition.

I base my claim on HHS paragraph 13.1 - Medicare Policies (Rev. 71, 04-09-04), which clearly states that:

“The National Coverage Determinations (NCDs) are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device. NCDs generally outline the conditions for which a service is considered to be covered (or not covered) under §1862(a)(1) of the Act or other applicable provisions of the Act. NCDs are usually issued as a program instruction. Once published in a CMS program instruction, an NCD is binding on all Medicare carriers/DMERCS, FIs, Quality Improvement Organizations (QIOs, formerly known as Peer Review Organizations or PROs), Program Safeguard Contractors (PSCs) and beginning 10/1/01 are binding for Medicare+Choice organizations. NCDs made under §1862(a)(1) of the Act are binding on Administrative Law Judges (ALJ) during the claim appeal process. (See 42 CFR 405.732 and 42 CFR 405.860).

I am confident you will agree with my reading of HHS paragraph 13.1, rev. 71,04-09-04, that I am entitled to free access to this vital preventive medical care.



15 comments:

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