We WON! -- Medicaid Decision Reversed This Morning!
Four weeks of Twilight Zone in Iowa
R.I.P.
July7th 2011 - Aug 2nd, 2011
We (in a very extended collective sense) did it.
Thank you to all of you who wrote letters or lent any support or encouragement during the Iowa Crisis that took so many by complete surprise. While this pertained to (a) just Medicaid, in (b) just Iowa, it carried example-setting impact in all states and in the private payer setting as well.
The example set for the governors o*****her states? Completely bypass your own agencies and advisory groups to mandate a targeted discriminatory cost increasing measure in the name of cost savings, and four weeks is about all it takes for the pre-final debate backlash to grow so ominous that you'll back track before enough people have a chance to realize you were _actually_ serious. (Using clinical gobbledygook flail doesn't help either).
If you were interested but hadn't known, these were the details:
www.obesityhelp.com/forums/amos/4427377/Please-help-reverse- WLS-coverage-discrimination-meeting/
For balance...
..... Iowa did narrowly avert a government shut down (unlike its neighbor to the north).
And, granted there could be some "honesty" in the mistake. Gastric procedures are still pretty widely misunderstood.
So, allowing for the above, one message of the positive feedback variety (carrot OR stick... to have one on the PR front is to have the other) could be embodied by the art here:
images.obesityhelp.com.s3.amazonaws.com/docs/ThankYouGovernorBrandstad.pdf
If you do want to let the Governor's office know that people notice and care about him reversing bad decisions, and if you are in the state of Iowa, or have interested friends or relatives there (otherwise it would likely detract), then he can be reached here:
Governor Brandstad
State Capitol
1007 East Grand Ave.
Des Moines, Iowa 50319
Phone: 515.281.5211
Some of you -- on the cutting edge of our letter writing campaign just as it was about to really ramp up -- had written him stressing the NON-COSMETIC, COST-SAVING, HEALTH, and PRO-EMPLOYABILITY reasons why gastric surgeries were appropriate tools both in the overall clinical arsonal of metabolic interventions, but also in the overall arsenal of things good for the state economy and state in general. Thank you.
Some of you, when you stressed the above, did so while sharing your own particular history of and experiences of pre-op ill health and, where you could, post op challenges that weren't any nirvana, but which at least included a more fair chance at better health, better career success, and greater contributions to society.
For those of you who did the above -- we had started reaching out to our members in Iowa with Medicaid -- thank you, and, if you hadn't yet, but wanted to -- or better yet even if you were among those who did -- now would be a perfect time to write the Governor in acknowledgement of his setting the correct example for others to follow.
How did this come to be? Stay tuned for a more detailed description, but in a nut shell, as of yesterday two meetings were upcoming. On August 10th a council was set to meet to vote the measure up or down -- even though, technically, it had already been signed into law, after having been approved by a previous committee. On August 16th, a Rules committee was set to meet to vote on the rule, why by then would have been triply-pre-approved. The entire cascade, set in motion by the governors office, involved about four key groups each feeling it was being asked to confirm something that was already a done deal as per gubernatorial fiat, with the governor, on the other hand, referencing this entire set the locus of decision making. The rules committee consistend of five Republicans and five Democrats. 7 out of 10 votes there would have been enough to have delayed implementation.
Separate from but in parallel with the above, the Mediciad Advisory Committee had met on July 22nd. After being contacted by OH, a bariatric surgeon, Dr. Lamasters in the capitol, Des Moines, attended this hearing with her staff. This provided the opportunity to observe first hand, how Committee members felt broad sided by the rule which they were not consulted on and did not approve of. WLS was only one such example of this. Attendance by membes of the WLS community helped focus clear consensus on the topic, though it wasn't part of any agenda, and the Committee -- in charge of managing Medicaid coverage issues -- had no official role to play as it was not called upon to address the issue.
Prior to July 22, Committee members had been contacted on the topic. From then, and continuing after the 22nd, internal communications within that branch presumably percolated toward some head.
On Jul 29th, OH made contact with one member of the Council (set to meet Aug 10th), asking for input. That council member indicated that the council was in favor of contined coverage of WLS and, moreover, that it would not be inappropriate for mass letter writing campaigns to be addressed to council members themselves in addition to members of the Rules committee.
The offices of Dr. Lamasters and Dr. Ver Steeg, just to name two, had collected many petition signitures by this time.
Over the weekend, Joe at the OAC meet with members of the Iowa delgation in Washington D.C.
On August 1st and 2nd, a public radio program aired that had been pre-recorded by Dr. Lamasters two weeks earlier, after having written the Governor with materials prepared by the ASMBS.
By this time, the first wave of letters had started to reach the governor's office and lawmakers. Bariatric centers and OH staff had identified some of the best Medicaid patient stories from amongst patient ranks. Full letter writing mobilization hadn't started yet, since Aug 16th was the scheduled do-or-die last chance.
Meanwhile, regional legislative affairs staff working for Allergan, Covidien and Ethicon had been in contact, non-stop since July 7th with the various parties mentioned above.
Early this morning, Ethicon staff were among the first to relay the following message:
I wanted to let you know that we received word this morning from Nancy Freudenberg with Iowa Medicaid informing us that the proposed rule to eliminate coverage of bariatric procedures has been pulled. She said the Governor and Medicaid Director met yesterday and decided to not move forward with the cost containment rule for bariatric procedures. She said this rule would not be on the August agenda for the Council on Human Services or the ARRC.
At that point, a wide range of entities poised for very massive patient letter writing mobilization was able to "stand down", last minute. Some opportunity to redirect / reorganize that momentum from a "please/you had better" message to many in government into a "thank you" signal just to the Governor's office.
Some backlash can be expected from interested parties who say their particular Medicaid programs cut, who might cry foul that arbitrary preference was given to "fat people". In proactive counter to this, it is important that as many people as possible continue to emphasize the role of gastric proceedures as a treatment for various disease states. One need not mention "obesity" or "weight" at all when discussing such procedures.
The details above could no doubt be improved for future reading. If they seem a bit of a dizzying mess, such is consistent with how it felt to many of us over the past four weeks. Time to take stock and plan ahead.
R.I.P.
July7th 2011 - Aug 2nd, 2011
We (in a very extended collective sense) did it.
Thank you to all of you who wrote letters or lent any support or encouragement during the Iowa Crisis that took so many by complete surprise. While this pertained to (a) just Medicaid, in (b) just Iowa, it carried example-setting impact in all states and in the private payer setting as well.
The example set for the governors o*****her states? Completely bypass your own agencies and advisory groups to mandate a targeted discriminatory cost increasing measure in the name of cost savings, and four weeks is about all it takes for the pre-final debate backlash to grow so ominous that you'll back track before enough people have a chance to realize you were _actually_ serious. (Using clinical gobbledygook flail doesn't help either).
If you were interested but hadn't known, these were the details:
www.obesityhelp.com/forums/amos/4427377/Please-help-reverse- WLS-coverage-discrimination-meeting/
For balance...
..... Iowa did narrowly avert a government shut down (unlike its neighbor to the north).
And, granted there could be some "honesty" in the mistake. Gastric procedures are still pretty widely misunderstood.
So, allowing for the above, one message of the positive feedback variety (carrot OR stick... to have one on the PR front is to have the other) could be embodied by the art here:
images.obesityhelp.com.s3.amazonaws.com/docs/ThankYouGovernorBrandstad.pdf
If you do want to let the Governor's office know that people notice and care about him reversing bad decisions, and if you are in the state of Iowa, or have interested friends or relatives there (otherwise it would likely detract), then he can be reached here:
Governor Brandstad
State Capitol
1007 East Grand Ave.
Des Moines, Iowa 50319
Phone: 515.281.5211
Some of you -- on the cutting edge of our letter writing campaign just as it was about to really ramp up -- had written him stressing the NON-COSMETIC, COST-SAVING, HEALTH, and PRO-EMPLOYABILITY reasons why gastric surgeries were appropriate tools both in the overall clinical arsonal of metabolic interventions, but also in the overall arsenal of things good for the state economy and state in general. Thank you.
Some of you, when you stressed the above, did so while sharing your own particular history of and experiences of pre-op ill health and, where you could, post op challenges that weren't any nirvana, but which at least included a more fair chance at better health, better career success, and greater contributions to society.
For those of you who did the above -- we had started reaching out to our members in Iowa with Medicaid -- thank you, and, if you hadn't yet, but wanted to -- or better yet even if you were among those who did -- now would be a perfect time to write the Governor in acknowledgement of his setting the correct example for others to follow.
How did this come to be? Stay tuned for a more detailed description, but in a nut shell, as of yesterday two meetings were upcoming. On August 10th a council was set to meet to vote the measure up or down -- even though, technically, it had already been signed into law, after having been approved by a previous committee. On August 16th, a Rules committee was set to meet to vote on the rule, why by then would have been triply-pre-approved. The entire cascade, set in motion by the governors office, involved about four key groups each feeling it was being asked to confirm something that was already a done deal as per gubernatorial fiat, with the governor, on the other hand, referencing this entire set the locus of decision making. The rules committee consistend of five Republicans and five Democrats. 7 out of 10 votes there would have been enough to have delayed implementation.
Separate from but in parallel with the above, the Mediciad Advisory Committee had met on July 22nd. After being contacted by OH, a bariatric surgeon, Dr. Lamasters in the capitol, Des Moines, attended this hearing with her staff. This provided the opportunity to observe first hand, how Committee members felt broad sided by the rule which they were not consulted on and did not approve of. WLS was only one such example of this. Attendance by membes of the WLS community helped focus clear consensus on the topic, though it wasn't part of any agenda, and the Committee -- in charge of managing Medicaid coverage issues -- had no official role to play as it was not called upon to address the issue.
Prior to July 22, Committee members had been contacted on the topic. From then, and continuing after the 22nd, internal communications within that branch presumably percolated toward some head.
On Jul 29th, OH made contact with one member of the Council (set to meet Aug 10th), asking for input. That council member indicated that the council was in favor of contined coverage of WLS and, moreover, that it would not be inappropriate for mass letter writing campaigns to be addressed to council members themselves in addition to members of the Rules committee.
The offices of Dr. Lamasters and Dr. Ver Steeg, just to name two, had collected many petition signitures by this time.
Over the weekend, Joe at the OAC meet with members of the Iowa delgation in Washington D.C.
On August 1st and 2nd, a public radio program aired that had been pre-recorded by Dr. Lamasters two weeks earlier, after having written the Governor with materials prepared by the ASMBS.
By this time, the first wave of letters had started to reach the governor's office and lawmakers. Bariatric centers and OH staff had identified some of the best Medicaid patient stories from amongst patient ranks. Full letter writing mobilization hadn't started yet, since Aug 16th was the scheduled do-or-die last chance.
Meanwhile, regional legislative affairs staff working for Allergan, Covidien and Ethicon had been in contact, non-stop since July 7th with the various parties mentioned above.
Early this morning, Ethicon staff were among the first to relay the following message:
I wanted to let you know that we received word this morning from Nancy Freudenberg with Iowa Medicaid informing us that the proposed rule to eliminate coverage of bariatric procedures has been pulled. She said the Governor and Medicaid Director met yesterday and decided to not move forward with the cost containment rule for bariatric procedures. She said this rule would not be on the August agenda for the Council on Human Services or the ARRC.
At that point, a wide range of entities poised for very massive patient letter writing mobilization was able to "stand down", last minute. Some opportunity to redirect / reorganize that momentum from a "please/you had better" message to many in government into a "thank you" signal just to the Governor's office.
Some backlash can be expected from interested parties who say their particular Medicaid programs cut, who might cry foul that arbitrary preference was given to "fat people". In proactive counter to this, it is important that as many people as possible continue to emphasize the role of gastric proceedures as a treatment for various disease states. One need not mention "obesity" or "weight" at all when discussing such procedures.
The details above could no doubt be improved for future reading. If they seem a bit of a dizzying mess, such is consistent with how it felt to many of us over the past four weeks. Time to take stock and plan ahead.
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