Medicare says "No need for maggot therapy reimbursement code."
What do you say?
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I am writing to ask that you help us right now to get Medicare and Private Insurance to reimburse for maggot therapy. Maggot therapy was cleared by the FDA for marketing in the U.S. over 4 years ago, but to this day neither the treatment nor the maggots have been issued a code. As a result, neither patients nor their doctors can specifically bill their insurance carrier for maggot therapy using the national "CPT/HCPCS" coding system.
A few weeks ago, I asked several hundred doctors to write letters to the AMA supporting our request to issue a procedure code ("CPT Code") for maggot therapy. We received a handful of letters, but still the AMA Coding Committee again declined to issue a procedure code, stating that the maggots themselves should be coded ("HCPCS Code") by Medicare.
In just 10 days, Medicare will hold a public hearing at their headquarters to determine if anyone objects to Medicare's proposal that maggots NOT be given a reimbursement code. They did not dispute the scientific evidence that maggot therapy is safe and effective, nor did they dispute that maggot therapy saves limbs, saves lives, and can be less expensive than many treatments that are currently paid for by insurance companies. The stated reason for denying a reimbursement code is that "No [Private or public] insurer . . . identified a national program operating need to establish a code [for maggots]."
We object.
You should object, too.
There IS a need for maggot therapy.
There IS a need for maggot therapy reimbursement.
We must now demonstrate that need. If we don't, reimbursement for maggot therapy will remain difficult to obtain for at least 2 more years, and many patients and therapists will be unable or unwilling to risk paying out of pocket.
Here is how you can help -
1) Send a letter of support to the BTER Foundation. The letter must reach us within 7 days (by e-mail, fax, or post) in order to be presented to the government officials. A sample letter can be found on our web site . Note that there are hundreds of centers, treating thousands of patients each year. Describe any personal stories or situations where maggot therapy saved a life or limb. Describe the costs that may have been avoided by maggot therapy. Describe the difficulty you may have had getting therapy or getting paid for therapy, due to lack of reimbursement coding. Describe the use of maggot therapy in home-bound and out-patients, if you know of any cases.
2) Ask your friends, relatives and colleagues to do the same. You can even forward this newsletter to them.
3) If you can get to the Medicare Building (7500 Security Blvd, Baltimore (Woodlawn), Maryland) on Tuesday, April 22, 2008, 9:00 am, then be there for the meeting.
4) Of course, we can always use your financial support. We will send one or two Foundation representatives to make a presentation, on your behalf. Contributions to this effort, or to any of the other Foundation activities (therapist education, Patient Assistance Grants, etc) are always welcome and always needed.
5) Keep informed. We are setting up a blog for current BioTherapy information. The address will be: http://www.bterfoundation.blogspot.com
Remember: only 10 days until the public hearing. Only 7 days left to get your letter to us by e-mail, fax or post.
PLEASE HELP; PLEASE ACT NOW.
We were not successful without you last month.
Maybe YOU can make the difference this time.
More information can be found on our website at:
www.bterfoundation.org/indexfiles/HCPCS_code_request.htm .
Thank you for your support,
Ronald Sherman, Director,
BioTherapeutics, Education & Research Foundation
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BTER Foundation Address
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 BioTherapeutics,
Education & Research Foundation
36 Urey Court
Irvine, CA
92617
Fax: 949-679-3001
E-mail: [email protected]
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