RE: Georgia Medicaid loses HBOT case

[Guest guest]

August 12, 2006

Hello Freels,

A Big CONGRATULATIONS to you for your relentless determination and continued

efforts for your son and for all special-needs children in the United States in

obtaining recognition and reimbursement of Hyperbaric Oxygen Therapy for Brain

Inujury.

Continued success, best regards.

Dr. Lane

drlanescott@...

Freels <dfreels@...> wrote:

After a lengthy 7-year fight for reimbursement of HBOT for pediatric

brain-injury, through a court order, Georgia Medicaid must now

reimburse. Despite refusal to publish the data on HBOT efficacy by

numerous peer-reviewed medical journals, it's now been proven in a

court of law that HBOT is " necessary to correct or ameliorate "

brain-injury as evidenced by (1) the Collet study, (2) observed

clinical improvements, and (3) before/after SPECT-scan imaging.

The decision appropriately came on Wednesday August 9, 2006, the 61st

anniversary of the atomic bomb drop on Nagasaki--for an explosion of

legal requirements of similar proportions has now landed on 2

Peachtree Street in Atlanta, Georgia. This decision is expected to

also directly impact the business of Pediatric Neurology itself where

malpractice decisions will follow continued denial of HBOT. The

Undersea and Hyperbaric Medical Society (UHMS) will also be forced to

acknowledge HBOT efficacy for brain-injury or lose whatever remaining

credibility they still have.

This legal victory for every special-needs child would have been

impossible were it not for the in-person expert witness testimony of

three internationally-recognized experts on the use of HBOT for

cerebral palsy: Dr Harch of New Orleans, Dr. Pierre Marois of

Canada, and radiologist Dr. Uszler of California who

testified on the use of SPECT-scan imaging to determine functional

brain improvements in CP children via Hyperbaric Oxygen Therapy.

Because the Administrative Law Judge ordered direct testimony be

provided in written form, this sworn testimony can now be used by

other children in other states by way of the listserv

(medicaid/). In addition, so as

to prepare parents and attorneys in other states--as ludicrous as it

is--the sworn testimony of three pediatric neurologists will also be

freely available to all members. This testimony and

the legal decision itself will be available at

medicaid/files/ within the next

few days.

From the decision:

" Three child neurologists supported Respondent's [Georgia Medicaid]

position. A specialist in pediatric Physical Medicine and

Rehabilitation [Dr Pierre Marois], a specialist in emergency medicine

and HBOT [Dr Harch], and a specialist in Nuclear Medicine [Dr

Uszler] supported Petitioner's side [Jimmy Freels]. Weighing

the evidence presented, Petitioner's arguments are more

cross-disciplinary and persuasive than those presented by Respondent.

Given that the standard is " corrective or ameliorative, " there is a

preponderance of the evidence that the HBOT treatments were necessary

to correct or ameliorate Petitioner's physical condition. "

Decision

Respondent's denial of Petitioner's request for reimbursement of HBOT

treatment is REVERSED and the Respondent is hereby ORDERED to honor

the Petitioner's request for reimbursement for HBOT.

SO ORDERED, this 9th day of August 2006.

W. Teate

Administrative Law Judge

--

Freels

2948 Windfield Circle

Tucker, GA 30084-6714

770-491-6776 (phone)

404-725-4520 (cell)

815-366-7962 (fax)

mailto:dfreels@...

medicaid/

http://www.freelanceforum.org/df

[Guest guest]

Congratulations to you for your long fight and the others that helped.

What does this mean for other " adult " medicaid recipients and reimbursement for

HBOT? My son is 25 yrs old and we live in Georgia also. What about insurance

companies having to follow suite now? What do we need to do to keep this going?

Thanks,

Marguerite McKinney

________________________________________________________________________

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[Guest guest]

Dear :

Congratulations on a huge victory and an incredible answer to prayers. Many

blessings, Tammy

[Guest guest]

My insurance BC/BS in Michigan just approved 30 dives, 100% coverage!!

Tami

" auntie_j@... " <auntie_j@...> wrote:

Really?? Honest?? Not a typo?? Are you sure?

In that case:

YEA LORD! YEA DAVID! YEA EVERYONE WHO HAS WORKED SO LONG AND SO HARD!

THANK YOU, THANK YOU, THANK YOU ALL!!!

JOANNE

[Guest guest]

Dear ,

CONGRATULATIONS!!!!! Congratulations on the win and for hanging in

there, never giving up -- great example! You are an awesome fighter

and great parent!

Thank you for all your efforts that will benefit so many!

B.

>

> Dear :

>

> Congratulations on a huge victory and an incredible answer to

prayers. Many blessings, Tammy

>

>

>

[Guest guest]

Yeah !!! Awesome!! Congrats!!

Sunny

--- Freels <dfreels@...> wrote:

> After a lengthy 7-year fight for reimbursement of

> HBOT for pediatric

> brain-injury, through a court order, Georgia

> Medicaid must now

> reimburse. Despite refusal to publish the data on

> HBOT efficacy by

> numerous peer-reviewed medical journals, it's now

> been proven in a

> court of law that HBOT is " necessary to correct or

> ameliorate "

> brain-injury as evidenced by (1) the Collet study,

> (2) observed

> clinical improvements, and (3) before/after

> SPECT-scan imaging.

>

> The decision appropriately came on Wednesday August

> 9, 2006, the 61st

> anniversary of the atomic bomb drop on Nagasaki--for

> an explosion of

> legal requirements of similar proportions has now

> landed on 2

> Peachtree Street in Atlanta, Georgia. This decision

> is expected to

> also directly impact the business of Pediatric

> Neurology itself where

> malpractice decisions will follow continued denial

> of HBOT. The

> Undersea and Hyperbaric Medical Society (UHMS) will

> also be forced to

> acknowledge HBOT efficacy for brain-injury or lose

> whatever remaining

> credibility they still have.

>

> This legal victory for every special-needs child

> would have been

> impossible were it not for the in-person expert

> witness testimony of

> three internationally-recognized experts on the use

> of HBOT for

> cerebral palsy: Dr Harch of New Orleans, Dr.

> Pierre Marois of

> Canada, and radiologist Dr. Uszler of

> California who

> testified on the use of SPECT-scan imaging to

> determine functional

> brain improvements in CP children via Hyperbaric

> Oxygen Therapy.

>

> Because the Administrative Law Judge ordered direct

> testimony be

> provided in written form, this sworn testimony can

> now be used by

> other children in other states by way of the

> listserv

> (medicaid/). In

> addition, so as

> to prepare parents and attorneys in other states--as

> ludicrous as it

> is--the sworn testimony of three pediatric

> neurologists will also be

> freely available to all members.

> This testimony and

> the legal decision itself will be available at

> medicaid/files/

> within the next

> few days.

>

> From the decision:

>

> " Three child neurologists supported Respondent's

> [Georgia Medicaid]

> position. A specialist in pediatric Physical

> Medicine and

> Rehabilitation [Dr Pierre Marois], a specialist in

> emergency medicine

> and HBOT [Dr Harch], and a specialist in

> Nuclear Medicine [Dr

> Uszler] supported Petitioner's side [Jimmy

> Freels]. Weighing

> the evidence presented, Petitioner's arguments are

> more

> cross-disciplinary and persuasive than those

> presented by Respondent.

> Given that the standard is " corrective or

> ameliorative, " there is a

> preponderance of the evidence that the HBOT

> treatments were necessary

> to correct or ameliorate Petitioner's physical

> condition. "

>

> Decision

>

> Respondent's denial of Petitioner's request for

> reimbursement of HBOT

> treatment is REVERSED and the Respondent is hereby

> ORDERED to honor

> the Petitioner's request for reimbursement for HBOT.

>

> SO ORDERED, this 9th day of August 2006.

>

> W. Teate

> Administrative Law Judge

> --

>

>

> Freels

> 2948 Windfield Circle

> Tucker, GA 30084-6714

> 770-491-6776 (phone)

> 404-725-4520 (cell)

> 815-366-7962 (fax)

> mailto:dfreels@...

>

> medicaid/

>

> http://www.freelanceforum.org/df

>

> [Non-text portions of this message have been

> removed]

>

>

__________________________________________________

[Guest guest]

Tami,

I have BC/BS in KY, so I'm really interested in this. Did you just

submit your billing forms or did you get pre-approval?

, mom to Ean(Almost 7 year old, Superstar!)

> Really?? Honest?? Not a typo?? Are you sure?

> In that case:

> YEA LORD! YEA DAVID! YEA EVERYONE WHO HAS WORKED SO LONG AND SO

HARD!

> THANK YOU, THANK YOU, THANK YOU ALL!!!

> JOANNE

>

>

>

[Guest guest]

,

Would it be possible to get a copy of the final judgement (the legal nitty

gritty). We have a battle brewing in Ohio and I have been told that if Ohio

is in the same district as Georgia a legal battle may be avoided due to

your success. Judges tend to accept the rulings of other judges in their

district rather than allow litigation to take place.

Thank you for your enduring efforts for our children and in advance for any

information that you might provide to this effort.

Judith Ann Burkholder

16701-AC

Wauseon, Ohio 43567

419-267-5134

>From: Freels <dfreels@...>

>Reply-medicaid

>medicaid

>CC: rmedows@..., " Mark Trail " <MTrail@...>,

>dhall@..., ljones@..., abranch@...,

>nchilders@..., krobinson@...,

>GA-ParentNetwork , CPPARENT@..., Mark_@

>shepherd.org, campores@..., gvezzhyper@...,

>Neil.Hampson@..., rwarriner@...,

>cfife@..., sthom@..., execdir@...,

>BHARTMD1@..., wound_doc@..., ramyers@...,

>jab9000@..., jmchimiak@..., hboman@...,

>uhmsqara@..., dear0001@..., kvanhoesen@...,

>steve@..., dick.clarke@...,

>kmail@..., moon0002@..., mlang@...,

>psheffield@..., rsheffield@..., JFeldmeier@...,

>Caroline.E.Fife@..., folke.lind@..., vann0001@...,

>AukerC@..., bbutler@..., erick@...,

>ldlweave@..., celehner@..., wound_nurse@...,

>pbaker8065@...

>Subject: [ ] Georgia Medicaid loses HBOT case

>Date: Sat, 12 Aug 2006 13:22:39 -0400

>

>After a lengthy 7-year fight for reimbursement of HBOT for pediatric

>brain-injury, through a court order, Georgia Medicaid must now

>reimburse. Despite refusal to publish the data on HBOT efficacy by

>numerous peer-reviewed medical journals, it's now been proven in a

>court of law that HBOT is " necessary to correct or ameliorate "

>brain-injury as evidenced by (1) the Collet study, (2) observed

>clinical improvements, and (3) before/after SPECT-scan imaging.

>

>The decision appropriately came on Wednesday August 9, 2006, the 61st

>anniversary of the atomic bomb drop on Nagasaki--for an explosion of

>legal requirements of similar proportions has now landed on 2

>Peachtree Street in Atlanta, Georgia. This decision is expected to

>also directly impact the business of Pediatric Neurology itself where

>malpractice decisions will follow continued denial of HBOT. The

>Undersea and Hyperbaric Medical Society (UHMS) will also be forced to

>acknowledge HBOT efficacy for brain-injury or lose whatever remaining

>credibility they still have.

>

>This legal victory for every special-needs child would have been

>impossible were it not for the in-person expert witness testimony of

>three internationally-recognized experts on the use of HBOT for

>cerebral palsy: Dr Harch of New Orleans, Dr. Pierre Marois of

>Canada, and radiologist Dr. Uszler of California who

>testified on the use of SPECT-scan imaging to determine functional

>brain improvements in CP children via Hyperbaric Oxygen Therapy.

>

>Because the Administrative Law Judge ordered direct testimony be

>provided in written form, this sworn testimony can now be used by

>other children in other states by way of the listserv

>(medicaid/). In addition, so as

>to prepare parents and attorneys in other states--as ludicrous as it

>is--the sworn testimony of three pediatric neurologists will also be

>freely available to all members. This testimony and

>the legal decision itself will be available at

>medicaid/files/ within the next

>few days.

>

> From the decision:

>

> " Three child neurologists supported Respondent's [Georgia Medicaid]

>position. A specialist in pediatric Physical Medicine and

>Rehabilitation [Dr Pierre Marois], a specialist in emergency medicine

>and HBOT [Dr Harch], and a specialist in Nuclear Medicine [Dr

> Uszler] supported Petitioner's side [Jimmy Freels]. Weighing

>the evidence presented, Petitioner's arguments are more

>cross-disciplinary and persuasive than those presented by Respondent.

>Given that the standard is " corrective or ameliorative, " there is a

>preponderance of the evidence that the HBOT treatments were necessary

>to correct or ameliorate Petitioner's physical condition. "

>

>Decision

>

>Respondent's denial of Petitioner's request for reimbursement of HBOT

>treatment is REVERSED and the Respondent is hereby ORDERED to honor

>the Petitioner's request for reimbursement for HBOT.

>

>SO ORDERED, this 9th day of August 2006.

>

> W. Teate

>Administrative Law Judge

>--

>

>

> Freels

>2948 Windfield Circle

>Tucker, GA 30084-6714

>770-491-6776 (phone)

>404-725-4520 (cell)

>815-366-7962 (fax)

>mailto:dfreels@...

>

>medicaid/

>

>http://www.freelanceforum.org/df

>

>

[Guest guest]

I believe that was put on the files page.

--- medicaid

<judith_burkholder@...> wrote:

> ,

> Would it be possible to get a copy of the final

judgement (the legal nitty

> gritty). We have a battle brewing in Ohio and I

have been told that if Ohio

> is in the same district as Georgia a legal battle

may be avoided due to

> your success. Judges tend to accept the rulings of

other judges in their

> district rather than allow litigation to take place.

> Thank you for your enduring efforts for our children

and in advance for any

> information that you might provide to this effort.

> Judith Ann Burkholder

> 16701-AC

> Wauseon, Ohio 43567

> 419-267-5134

>

>

>

> >From: Freels <dfreels@...>

> >Reply-medicaid

> >medicaid

> >CC: rmedows@..., " Mark Trail "

<MTrail@...>,

> >dhall@..., ljones@...,

abranch@...,

> >nchilders@...,

krobinson@...,

> >GA-ParentNetwork ,

CPPARENT@..., Mark_@

> >shepherd.org, campores@...,

gvezzhyper@...,

> >Neil.Hampson@..., rwarriner@...,

> >cfife@...,

sthom@..., execdir@...,

> >BHARTMD1@..., wound_doc@...,

ramyers@...,

> >jab9000@...,

jmchimiak@..., hboman@...,

> >uhmsqara@..., dear0001@...,

kvanhoesen@...,

> >steve@...,

dick.clarke@...,

> >kmail@..., moon0002@...,

mlang@...,

> >psheffield@..., rsheffield@...,

JFeldmeier@...,

> >Caroline.E.Fife@..., folke.lind@...,

vann0001@...,

> >AukerC@...,

bbutler@..., erick@...,

> >ldlweave@..., celehner@...,

wound_nurse@...,

> >pbaker8065@...

> >Subject: [ ] Georgia Medicaid loses

HBOT case

> >Date: Sat, 12 Aug 2006 13:22:39 -0400

> >

> >After a lengthy 7-year fight for reimbursement of

HBOT for pediatric

> >brain-injury, through a court order, Georgia

Medicaid must now

> >reimburse. Despite refusal to publish the data on

HBOT efficacy by

> >numerous peer-reviewed medical journals, it's now

been proven in a

> >court of law that HBOT is " necessary to correct or

ameliorate "

> >brain-injury as evidenced by (1) the Collet study,

(2) observed

> >clinical improvements, and (3) before/after

SPECT-scan imaging.

> >

> >The decision appropriately came on Wednesday August

9, 2006, the 61st

> >anniversary of the atomic bomb drop on

Nagasaki--for an explosion of

> >legal requirements of similar proportions has now

landed on 2

> >Peachtree Street in Atlanta, Georgia. This decision

is expected to

> >also directly impact the business of Pediatric

Neurology itself where

> >malpractice decisions will follow continued denial

of HBOT. The

> >Undersea and Hyperbaric Medical Society (UHMS) will

also be forced to

> >acknowledge HBOT efficacy for brain-injury or lose

whatever remaining

> >credibility they still have.

> >

> >This legal victory for every special-needs child

would have been

> >impossible were it not for the in-person expert

witness testimony of

> >three internationally-recognized experts on the use

of HBOT for

> >cerebral palsy: Dr Harch of New Orleans, Dr.

Pierre Marois of

> >Canada, and radiologist Dr. Uszler of

California who

> >testified on the use of SPECT-scan imaging to

determine functional

> >brain improvements in CP children via Hyperbaric

Oxygen Therapy.

> >

> >Because the Administrative Law Judge ordered direct

testimony be

> >provided in written form, this sworn testimony can

now be used by

> >other children in other states by way of the

listserv

> >(medicaid/).

In addition, so as

> >to prepare parents and attorneys in other

states--as ludicrous as it

> >is--the sworn testimony of three pediatric

neurologists will also be

> >freely available to all members.

This testimony and

> >the legal decision itself will be available at

> >http://groups.yaho

=== Message Truncated ===

__________________________________________________