- Employment
- Sex, Wheels & Relationships
- Health
- Attendant Services
- Travel
- Disability Rights
- Arts & Culture
- Spirituality & Religion
- Spinal Cord Injury
- Multiple Sclerosis
- Post-Polio
- Products & Equipment
- 12th Annual Day on the Lake
Carefree, AZ
May 30 2008 - WCD Expo
Reading, PA
Jul 11 2008 -
Submit an event
See all events
 |
|
|
|
|
|
 |
|||||
 |
|
||||
|
Prescription Co-Pays Rise Sharply
An April 14 New York Times article warned that health insurance companies have a new pricing system for expensive specialty prescription "Tier 4" drugs. For this class of drugs, instead of paying co-pays in the $10-30 range, beneficiaries are being charged a higher percentage, resulting in co-pays of hundreds of dollars for prescriptions used to treat MS, rheumatoid arthritis and other conditions.
The Tier 4 system helps employers keep down employee health insurance costs. When those insured pay more for specialty drugs, other insured employees pay less for coverage. As one economist put it, "The more the sick person pays, the less the healthy person pays."
"I take Copaxone for MS," says Ann Serafin, chair of Ferndale Disability Advisory Committee, Ferndale, Mich. "And last year Blue Cross Blue Shield of Michigan almost barnstormed through the state House a 'high risk pool' plan to cover high costs incurred by the elderly and disabled." Serafin said BCBS was planning to charge much higher individual insurance rates to the "high risk pool" so costs would even out for other, healthier customers.
A 2006 Rand Corp. study, Benefit Design and Specialty Drug Use, found that people who need expensive specialty prescription drugs will continue to take them even if the costs rise: "Increasing co-payments for specialty drugs used to treat cancer, rheumatoid arthritis, multiple sclerosis ... only reduced usage by 1-21 percent."
"Generally, people are very responsive to co-payment increases," said Dana Goldman, chair and director of health economics at Rand and co-author of the study. "When companies increase co-pays, people tend to back off on their use of most medicines. ... [but] people will use [expensive specialty drugs] regardless of cost, because there just aren't any other options."
"We got the Senate to stop BCBS," Serafin adds. "But just because someone has a disability or is older, they shouldn't have to pay higher rates for insurance or prescriptions."
People in the News: Tomas Young
Tomas Young, a Kansas City, Mo., veteran wounded five days after arriving in Iraq, has created Body of War, a documentary that follows his recovery from a T4 SCI and his self-discovery as an anti-war activist. The documentary, made with the help of Phil Donahue, whom Young met while at Walter Reed Medical Center, premiered April 4 in Washington, D.C. Home-Based Services Eligibility Improves
The Centers for Medicare and Medicaid Services announced on March 31 a proposed rule that would allow Medicaid recipients with incomes that are less than 150 percent of the federal poverty level, or $15,600 per individual in 2008, access to home- and community-based services if they satisfy needs-based criteria. The rule would amend Medicaid regulations to help states implement the Deficit Reduction Act of 2005, which gives states options to provide HCBS to Medicaid recipients without applying for waivers.
The rule would also give individuals more control of their own services, including choosing case management, homemaking, home health aides and personal care options. Advocates say that the new rule's flexibility will help those people who might otherwise be institutionalized get needed services sooner
"Thousands more Medicaid beneficiaries may now be able to opt for needed long-term support services in their homes rather than institutions," said Kerry Weems, CMS acting administrator.
If implemented, the rule will allow states to set their own eligibility for needs-based criteria to qualify individuals for HCBS. Previously, individuals were required to be at "imminent risk of institutionalization" to qualify for certain assistance and services.
Air Travelers Sue Northwest Airlines, Detroit Airport
Five Michigan residents with disabilities filed a lawsuit in U.S. District Court on April 14, claiming Northwest Airlines and Detroit Metro Airport Authority did not comply with the ADA, the Air Carriers Access Act and the 1973 Rehabilitation Act, after Northwest and the Airport Authority failed to act on a 2006 out-of-court agreement.
Four of the five plaintiffs use wheelchairs. One woman said she was forced to stand in line though physically unable; a quadriplegic was dropped to the floor because of improper assistance; another said he was tilted parallel to the floor by handlers who also damaged his wheelchair; and another woman's wheelchair was given to the wrong passenger.
Medical Facilities Promise Changes
Sutter Health, with 31 health care facilities in northern California, agreed on April 18 to create a plan to improve accessibility. When approved by the court, it will resolve a class action suit brought by Disability Rights Advocates, Oakland, Calif., and improvements will be enforceable by the court.
"A number of people brought complaints to our attention," says Melissa Kasnitz, managing attorney at DRA. "We were investigating Sutter when Sutter contacted us to move forward. We hadn't sent them a letter or filed a complaint."
Three areas will be studied for improvement within 10 years: architectural barrier removal, access to medical equipment and improved policy and procedures.
"We think it will be a model for facilities around the country," Kasnitz says. DRA will accept settlement comments or objections via formal notice provision at www.dra.legal.org.
Mainstream Athletic Programs in Maryland
Thanks to the efforts of 18-year-old wheelchair racer Tatyana McFadden, who has spina bifida [see "People" in May 2006 News], the Maryland legislature passed a bill on April 14 that requires Maryland high schools to provide athletic facilities for students with disabilities.
The Fitness and Athletics Equity for Students with Disabilities bill, approved at the close of the Maryland General Assembly, states that programs can be just for those with disabilities or students with disabilities can be in "mainstream" programs. All schools must ensure that all athletes be given opportunity to try out for, and if selected, participate in mainstream athletic programs. The bill provided an exception when inclusion of a disabled student "presents an objective safety risk to the student or to others." Schools have three years to comply. Shepherd Center Expands
On March 25, Shepherd Center in Atlanta, Ga., celebrated completion of a seven-story, 171,480-square-foot addition called the Jane Woodruff Pavilion. The new pavilion includes an SCI day program unit, therapy, treatment and therapeutic recreation areas and a larger intensive care unit. Construction is also slated for another building, which will feature 84 wheelchair-accessible suites to provide complimentary housing for out-of-town families and day program attendees. |
