Re: Fwd: Paragraph 5 supercedes Texas HB 1676

[Guest guest]

To Ed and all others:

A couple of things. The insurance companies are going to be influenced by

whatever Medicare/Medicaid does. If Medicaid is paying for HBOT, the

insurance companies will soon follow.

Legally, we have more legs to stand on under the Medicaid law for children

than just on HB 1676. Perhaps the language of HB 1676 needs to be changed

to something similar to Paragraph 5?

To all the Texas parents on this list: I would strongly encourage you to

mobilize together as a group and seek Medicaid reimbursement as a group.

Contact your newspapers, tv newspeople etc. Do this in unison. Seek out and

find other parents who will join with you.

Take advantage of all the documentation on what the other states are doing

and have done as found on

medicaid/files/ . Download these

files, print them out, and get over to your Medicaid agency.

If your child is not on Medicaid, he/she will probably automatically

qualify because of disability. That's why Medicaid was created. To quote

another Texan:

When Medicaid for children was created in 1967, President Lyndon

stated " The problem is to discover, as early as possible, the ills that

handicap our children. There must be continuing follow-up and treatment so

that handicaps do not go untreated. " (13 Congressional Record 2883.

February 8, 1967).

A few days ago it was posted here that State Representative Gene Seaman

added the word " acquired " . Mr. Seaman was an insurance man for some 40+

years. The word " acquired " is standard procedure in the insurance

business--of course its use is predicated on the belief that a congenital

brain-injury cannot be helped.

Therein lies the confusion.

We are at the cutting edge of a new concept. For parents who have had their

children and other loved ones receive Hyperbaric Oxygen Therapy, we have

seen first-hand the gains made with HBOT.

These gains have yet to filter down to the insurance guys--unless we tell

them, show them before/after photographs, videos, and SPECT-scans.

On the advice of Bill Duncan, I urge all Texas residents to contact

immediately your representatives and senators. Straighten them out.

I called Mr. Seaman's office this morning and he has not spoken with Tom

Workman or any of the other bottom-feeders at the Undersea and Hyperbaric

Medical Society. He added acquired because that's just standard insurance

type language.

I faxed him a note explaining how that word changes everything for kids

like mine and yours. His fax number is 361/991-6578. I advise you to fax

him your thoughts too. Since the life of HB 1676 is still in it's infancy,

perhaps its future can also be changed and adjusted and tweaked--just like

the lives of our kids can change if they get some extra oxygen.

13 February, 2002

Representative Seaman:

It's come to my attention that you added the word " acquired " to the

language of Texas HB 1676, the bill for treatments for brain-injury. I've

also learned you're an insurance man, so my guess is that adding the word

" acquired " comes from your years of experience in the insurance business.

" Acquired " would exclude the people who could most use the help,

particularly children believed to be born with brain-injuries. It has now

been proven that brain-injured children can and will improve with a

treatment called Hyperbaric Oxygen Therapy (HBOT). Our son Jimmy is one of

those children. He is eight years old and suffers from mid-brain injury

that has impaired his mobility, balance, and speech. He is still not yet

sitting up or walking.

He was born nearly 12 weeks early with normal brain scans and

normal everything else. He was discharged from the hospital after 5 1/2

weeks--completely well. Children are given their first dpt vaccine at eight

weeks, as was Jimmy. However, though his chronological age was 8 weeks, his

gestational age was still 3 weeks in-utero. To further complicate matters,

the vaccine lot number has a long history of adverse reactions. It was like

pointing a gun to his head and pulling the trigger.

Now, if he were a Texas resident, under HB 1676, it could be

reasonably argued by many well-credentialed doctors and others that he

should be denied anything for his brain-injury. It's not unusual for

children born as premature as Jimmy to have neurological deficits. It

happens more often than not. Officially, on the record, in his file, that's

the reason given for his problems.

His parents know differently. But because federal law absolves the

pediatrician and vaccine manufacturer of any responsibility for the

vaccine, we would first have to go to court to prove that his brain-injury

was acquired through an adverse reaction to a vaccine. However, even if we

wanted to prove the injury was acquired to access benefits under HB 1676,

we couldn't. Bill Clinton changed the statute of limitations on making

claims for vaccine injuries from five years to two years. He also changed

the compensation structure for attorneys in such cases. I spoke to one of

three attorneys who still take on these cases. He said they are now nearly

impossible to win. He said that if we were not in the office of a pediatric

neurologist within 24 hours and saying the words " our child's brain-injury

is the result of yesterday's vaccine " , we would never win.

So Jimmy would be excluded--even though he could be helped.

The following pages prove it. He is a Georgia Medicaid recipient

because of his circumstances. Under the federal Medicaid law for children,

what's important and most relevant is will a treatment help? If it helps,

the child gets it.

I believe adding the word " acquired " is an unfortunate mistake, and

I encourage you to correct it. I also believe use of the word acquired is

predicated on the mistaken belief that a brain-injury from birth cannot be

corrected. While the neurologists might believe this, it is in fact not

true.

I can give you hundreds and hundreds and hundreds of examples of

children brain-injured from birth who have improved with Hyperbaric Oxygen

Therapy.

May I suggest revising the language to something similiar to

Paragraph 5 of the Medicaid law for children, as found on the following

pages. Following this is a copy of a recent Georgia court decision where we

proved HBOT efficacy for brain-injury--despite the contradictory opinions

of 3 or 4 or 5 pediatric neurologists hired by the state of Georgia as

consultants in our case.

Thank you for your time and attention to this issue. If you would

like to discuss this further, I would be more than happy to do so. In

addition, if you are interested in speaking with expert physicians who are

competent in treating brain-injury with Hyperbaric Oxygen Therapy, I can

also put you in touch with them too.

Thank you very much and God bless.

and Sara Freels

2948 Windfield Circle

Tucker, GA 30084-6714

770/491-6776 (phone and fax)

509/275-1618 (efax, sends fax as email attachment)

mailto:dfreels@...

>To All Concerned About Texas Legislation:

>

>This is to clarify some of the issues, legislative intent and steps that

>have to be taken to move forward to help " Friends of " (CP/TBI kids)

>in Texas.

>

>Ken Locklear (who is traveling and cannot respond right now) forwarded

>information to me for our group.

>

>Ken Locklear: (note bold and underlined)

>

> " Ed, I spoke with Rep. Harryette Ehrhardt (Co author of the bill:

>Harryette.Ehrhardt@...) and I spoke with her about your

>contacts in California and she said she would whatever she could to support

>these efforts. Not only did HBO help her husband, she drives her Grandson to

>treatment every day in a Fort Worth trial. She is on board! Contact her and

>let her know your contacts and cause and I will contact her as well.

>

>I spoke with her on the language and " legislative intent " unless people

>understand this, they will not know how this bill was so easily passed. She

>knows (as do you and I) that it will take a law suite to set precedence on

>the law. "

>

>Now, Ed's words:

>So, the legislative intent is clear to those who put the Texas Legislation

>forward. However, it will take a lawsuit to determine this in court to

>enforce the legislation to be properly implemented.

>

>While this is frustrating, this is also part of our political and legal

>system of checks and balances. I don't like it; esp. when kids can gain

>therapies today that will change and improve their lives today. But, it is

>our system.

>

>So, there has to be a parent that gets the therapies for a CP child, and

>then sues their Insurance co, or HMO and has the court define the extend

>and intent of the legilstion.

>

>I will help a family to do this.... but they must find an exceptional

>medical litigation law firm to implement the lawsuit (either pro-bono, or

>upon winning the lawsuit.)

>

>Therefore, the action items are:

>1 a parent with a CP child must pay for HBOT,

>2 they must get declined by their third party payer,

>3 they then sue the third party payer to fully define and enforce the

>legislation.

>4 Then everyone is covered under the intent of the law.

>

>But, we must remember to be positive with these challenges..... trust me, I

>understand the frustrations all of us parents feel.

>

>But, for the good and bad, this is our American legal and political system

>of checks and balances with all of it's greatness and failings.

>

>Can anyone step forward?

>

>Warm Regards for everyone!

>

>Ed Nemeth

>

>

>At 10:50 PM 2/12/2002 -0500, you wrote:

>>

>>

>>

>>

[Guest guest]

>Greetings! It is my understanding and experience, that if your child

>was not automatically put on Medicaid or SSI as a newborn, that you will

>automatically denied the 1st time. It's just SOP. Apeal it through

>channels they are supposed to provide. There is also the Institutional

>Deeming waiver that is provided for our loved ones in the event that we

>as their parents make too much money. The concept is that it costs the

>Medicaid branch less money to keep the child home and not living in an

>institution. This eligibility is based on the childs monthly income.

>There are other names ( Beckett-so named after the child who the

>lawsuit involved) and I think they are state specific. I highly doubt

>that it is advertised even to your average social worker employed at the

>local Medicaid office. I would start with your local office and ask for

>the paperwork every day until you get it.

>I'm sure that Freels knows the ins and outs of it, much more than

>I.

>With Much Respect,

>Marlena Orndorff

>

Actually I don't know that much other than each state has their own rules

and can run the show however they want--but they all are supposed to follow

the same rules.

If all else fails there are still avenues to getting your child enrolled

even if you're restricted by income. Just tell them you want to enroll your

child in school because most states are using brain-injured children to

deliver Medicaid services through the school systems. The states then seek

federal reimbursement to pay for the " administrative " costs of delivering

the Medicaid services.

On average states make 350% from reimbursement of the administrative costs.

In other words your child is a money-maker, a revenue source, a gold mine

for the state. Take advantage of that. Start talking about enrolling them

in school and they'll get on Medicaid in no time.

Beckett's mother was one of those persons originally subscribed

to this list. I have hoped for a long time that she would put in a

chamber. As far as I know is still at home on a ventilator and

oxygen-dependent. I think it would make national news if she were weaned

off both through Hyperbaric Oxygen Therapy.

Her email address is mailto:waivermom@... in case somebody else

can be more persuasive than me.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

" I have sworn upon the altar of God, eternal hostility against every form

of tyranny over the mind of man. " -- Jefferson, probably an early

advocate of Hyperbaric Oxygen Therapy.

----------------------------

Freels

2948 Windfield Circle

Tucker, GA 30084-6714

USA

770/491-6776 (phone and fax)

509/275-1618 (efax, sends fax as email attachment)

mailto:dfreels@...

mailto:medicaid-subscribe

mailto:HBOTnow-subscribe

[Guest guest]

To All Concerned About Texas Legislation:

This is to clarify some of the issues, legislative intent and steps that

have to be taken to move forward to help " Friends of " (CP/TBI kids)

in Texas.

Ken Locklear (who is traveling and cannot respond right now) forwarded

information to me for our group.

Ken Locklear: (note bold and underlined)

" Ed, I spoke with Rep. Harryette Ehrhardt (Co author of the bill:

Harryette.Ehrhardt@...) and I spoke with her about your

contacts in California and she said she would whatever she could to support

these efforts. Not only did HBO help her husband, she drives her Grandson to

treatment every day in a Fort Worth trial. She is on board! Contact her and

let her know your contacts and cause and I will contact her as well.

I spoke with her on the language and " legislative intent " unless people

understand this, they will not know how this bill was so easily passed. She

knows (as do you and I) that it will take a law suite to set precedence on

the law. "

Now, Ed's words:

So, the legislative intent is clear to those who put the Texas Legislation

forward. However, it will take a lawsuit to determine this in court to

enforce the legislation to be properly implemented.

While this is frustrating, this is also part of our political and legal

system of checks and balances. I don't like it; esp. when kids can gain

therapies today that will change and improve their lives today. But, it is

our system.

So, there has to be a parent that gets the therapies for a CP child, and

then sues their Insurance co, or HMO and has the court define the extend

and intent of the legilstion.

I will help a family to do this.... but they must find an exceptional

medical litigation law firm to implement the lawsuit (either pro-bono, or

upon winning the lawsuit.)

Therefore, the action items are:

1 a parent with a CP child must pay for HBOT,

2 they must get declined by their third party payer,

3 they then sue the third party payer to fully define and enforce the

legislation.

4 Then everyone is covered under the intent of the law.

But, we must remember to be positive with these challenges..... trust me, I

understand the frustrations all of us parents feel.

But, for the good and bad, this is our American legal and political system

of checks and balances with all of it's greatness and failings.

Can anyone step forward?

Warm Regards for everyone!

Ed Nemeth

At 10:50 PM 2/12/2002 -0500, you wrote:

>

>

>

>

[Guest guest]

Contact me for the top attorney for this. It is the guy who defended

Bryzinski in Texas, who is curing cancer patients with a straightforward

non-cytotoxic cancer treatment that would be available to all of us now,

were it not for the extraordinary steps the FDA and the pharmaceutical

companies have taken to first, destroy, and then block his efforts to get

the treatment approved for wider distribution. If I had cancer, I'd be

headed to Texas tomorrow. Anyway, I'll be happy to share his information

with a reputable representative of the group, but am reluctant to post it

for all (since he currently returns my calls :-)) Bill

----------

From: Ed Nemeth [sMTP:nemeth@...]

Sent: Wednesday, February 13, 2002 1:05 PM

medicaid

Subject: Re: Fwd: [ ] Paragraph 5 supercedes Texas HB

1676

To All Concerned About Texas Legislation:

This is to clarify some of the issues, legislative intent and steps

that

have to be taken to move forward to help " Friends of "

(CP/TBI kids)

in Texas.

Ken Locklear (who is traveling and cannot respond right now)

forwarded

information to me for our group.

Ken Locklear: (note bold and underlined)

" Ed, I spoke with Rep. Harryette Ehrhardt (Co author of the bill:

Harryette.Ehrhardt@...) and I spoke with her about

your

contacts in California and she said she would whatever she could to

support

these efforts. Not only did HBO help her husband, she drives her

Grandson to

treatment every day in a Fort Worth trial. She is on board! Contact

her and

let her know your contacts and cause and I will contact her as well.

I spoke with her on the language and " legislative intent " unless

people

understand this, they will not know how this bill was so easily

passed. She

knows (as do you and I) that it will take a law suite to set

precedence on

the law. "

Now, Ed's words:

So, the legislative intent is clear to those who put the Texas

Legislation

forward. However, it will take a lawsuit to determine this in court

to

enforce the legislation to be properly implemented.

While this is frustrating, this is also part of our political and

legal

system of checks and balances. I don't like it; esp. when kids can

gain

therapies today that will change and improve their lives today.

But, it is

our system.

So, there has to be a parent that gets the therapies for a CP child,

and

then sues their Insurance co, or HMO and has the court define the

extend

and intent of the legilstion.

I will help a family to do this.... but they must find an

exceptional

medical litigation law firm to implement the lawsuit (either

pro-bono, or

upon winning the lawsuit.)

Therefore, the action items are:

1 a parent with a CP child must pay for HBOT,

2 they must get declined by their third party payer,

3 they then sue the third party payer to fully define and

enforce the

legislation.

4 Then everyone is covered under the intent of the law.

But, we must remember to be positive with these challenges.....

trust me, I

understand the frustrations all of us parents feel.

But, for the good and bad, this is our American legal and political

system

of checks and balances with all of it's greatness and failings.

Can anyone step forward?

Warm Regards for everyone!

Ed Nemeth

At 10:50 PM 2/12/2002 -0500, you wrote:

>

>

>

>

[Guest guest]

Sorry, I guess this program strips out the bold and underlining..... here

is a modified email:

At 10:05 AM 2/13/2002 -0800, you wrote:

>To All Concerned About Texas Legislation:

>

>This is to clarify some of the issues, legislative intent and steps that

>have to be taken to move forward to help " Friends of " (CP/TBI kids)

>in Texas.

>

>Ken Locklear (who is traveling and cannot respond right now) forwarded

>information to me for our group.

>

>Ken Locklear: (note bold and underlined)

>

> " Ed, I spoke with Rep. Harryette Ehrhardt (Co author of the bill:

>Harryette.Ehrhardt@...)

>Not only did HBO help her husband, she drives her Grandson to

>treatment every day in a Fort Worth trial. She is on board!

>I spoke with her on the language and " legislative intent " unless people

>understand this, they will not know how this bill was so easily passed. She

>knows (as do you and I) that it will take a law suite to set precedence on

>the law. "

>

>Now, Ed's words:

>So, the legislative intent is clear to those who put the Texas Legislation

>forward. However, it will take a lawsuit to determine this in court to

>enforce the legislation to be properly implemented.

>

>While this is frustrating, this is also part of our political and legal

>system of checks and balances. I don't like it; esp. when kids can gain

>therapies today that will change and improve their lives today. But, it is

>our system.

>

>So, there has to be a parent that gets the therapies for a CP child, and

>then sues their Insurance co, or HMO and has the court define the extend

>and intent of the legilstion.

>

>I will help a family to do this.... but they must find an exceptional

>medical litigation law firm to implement the lawsuit (either pro-bono, or

>upon winning the lawsuit.)

>

>Therefore, the action items are:

>1 a parent with a CP child must pay for HBOT,

>2 they must get declined by their third party payer,

>3 they then sue the third party payer to fully define and enforce the

>legislation.

>4 Then everyone is covered under the intent of the law.

>

>But, we must remember to be positive with these challenges..... trust me, I

>understand the frustrations all of us parents feel.

>

>But, for the good and bad, this is our American legal and political system

>of checks and balances with all of it's greatness and failings.

>

>Can anyone step forward?

>

>Warm Regards for everyone!

>

>Ed Nemeth

>

>

>At 10:50 PM 2/12/2002 -0500, you wrote:

> >

> >

> >

> >

[Guest guest]

We have been denied Medicaid in Tx. but my daughter is disabled with a TBI. How

can I get Medicaid for her due to disability - she is 10. I've been told there

is no waiver. Due to job

loss, we've lost our insurance coverage, COBRA was too $$, and I'm worried she

will be uninsurable if we don't get something quick. BTW She did get HBOT

covered by insurance in the past,

before the HB came into effect.

Thanks, Ellen

>

> If your child is not on Medicaid, he/she will probably automatically

> qualify because of disability. That's why Medicaid was created. To quote

> another Texan:

>

> When Medicaid for children was created in 1967, President Lyndon

> stated " The problem is to discover, as early as possible, the ills that

> handicap our children. There must be continuing follow-up and treatment so

> that handicaps do not go untreated. " (13 Congressional Record 2883.

> February 8, 1967).

[Guest guest]

Greetings! It is my understanding and experience, that if your child

was not automatically put on Medicaid or SSI as a newborn, that you will

automatically denied the 1st time. It's just SOP. Apeal it through

channels they are supposed to provide. There is also the Institutional

Deeming waiver that is provided for our loved ones in the event that we

as their parents make too much money. The concept is that it costs the

Medicaid branch less money to keep the child home and not living in an

institution. This eligibility is based on the childs monthly income.

There are other names ( Beckett-so named after the child who the

lawsuit involved) and I think they are state specific. I highly doubt

that it is advertised even to your average social worker employed at the

local Medicaid office. I would start with your local office and ask for

the paperwork every day until you get it.

I'm sure that Freels knows the ins and outs of it, much more than

I.

With Much Respect,

Marlena Orndorff

Ellen Bashore-Elley wrote:

> We have been denied Medicaid in Tx. but my daughter is disabled with

> a TBI. How can I get Medicaid for her due to disability - she is 10.

> I've been told there is no waiver. Due to job

> loss, we've lost our insurance coverage, COBRA was too $$, and I'm

> worried she will be uninsurable if we don't get something quick. BTW

> She did get HBOT covered by insurance in the past,

> before the HB came into effect.

>

> Thanks, Ellen

>

>

> >

> > If your child is not on Medicaid, he/she will probably automatically

>

> > qualify because of disability. That's why Medicaid was created. To

> quote

> > another Texan:

> >

> > When Medicaid for children was created in 1967, President Lyndon

>

> > stated " The problem is to discover, as early as possible, the ills

> that

> > handicap our children. There must be continuing follow-up and

> treatment so

> > that handicaps do not go untreated. " (13 Congressional Record 2883.

> > February 8, 1967).

>

>

>

[Guest guest]

>

***I'm sorry, I don't understand. My daughter IS enrolled in public school. Last

year I fought to change her classification from " other health impaired " to

" traumatic brain injury " , as it

better fits her condition (viral encephalitis at 6 mos. of age, subsequent

intractable seizures), but she gets no medical services at school. Please tell

me if I'm missing something. Thank

you, Ellen

> Just tell them you want to enroll your

> child in school because most states are using brain-injured children to

> deliver Medicaid services through the school systems. The states then seek

> federal reimbursement to pay for the " administrative " costs of delivering

> the Medicaid services.

>

> On average states make 350% from reimbursement of the administrative costs.

[Guest guest]

>>

>

>***I'm sorry, I don't understand. My daughter IS enrolled in public

>school. Last year I fought to change her classification from " other health

>impaired " to " traumatic brain injury " , as it

>better fits her condition (viral encephalitis at 6 mos. of age, subsequent

>intractable seizures), but she gets no medical services at school. Please

>tell me if I'm missing something. Thank

>you, Ellen

>

>

Which state are you in?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

" I have sworn upon the altar of God, eternal hostility against every form

of tyranny over the mind of man. " -- Jefferson, probably an early

advocate of Hyperbaric Oxygen Therapy.

----------------------------

Freels

2948 Windfield Circle

Tucker, GA 30084-6714

USA

770/491-6776 (phone and fax)

509/275-1618 (efax, sends fax as email attachment)

mailto:dfreels@...

mailto:medicaid-subscribe

mailto:HBOTnow-subscribe