Please send a comment to Medicare to have them pay for HIV facial wasting options, from Nelson Vergel Options

[J_Berry]

We have been trying to get reimbursement for facial wasting options for the past 10 years, and now it is your chance to give some important input to Medicare about why it is important to cover options like Sculptra, Radiesse and Silikon microdroplets plus the labor required to inject them in people's faces. Most facial reconstructions cost over $5000 dollars and most people cannot afford it.

For a review of products and costs: http://facialwasting.org/products.htm

Private insurance companies usually follow Medicare's decision, so even if you do not have Medicare, please send a comment about the fact that HIV facial lipoatrophy is caused by AZT and D4T and that facial reconstruction should be paid due to its effects on self esteem and quality of life

Due date for comments to Medicare: Feb 16

Actions Taken: CMS opens BCD NCD process. 30-day public comment period begins.

Add your comment by clicking on the link here. *
*A couple of things to keep in mind or the form will not work for you. You must click on the link CMS PHI Posting Policy to read the policy. Then, you must check the checkbox that says you have read the policy (it won't let you check the checkbox until you have actually clicked on the link for the policy!)

Reconstructive Treatments for Facial Lipodystrophy Syndrome
January 16, 2009
Issue: Reconstructive treatments for Facial Lipodystrophy Syndrome generally involve injecting various substances to supplement or fill out certain contours of the face. Lipodystrophy Syndrome (LDS) is characterized by abnormal redistribution of fat. Facial LDS refers to a wasting of the fat stores in the face in some individuals with the Human Immunodeficiency Virus (HIV) taking anti-retroviral medication.
A requestor has asked CMS to open a national coverage determination (NCD) to determine that reconstructive treatments for Facial LDS are covered under Medicare.
The first inquiry after a request for an NCD is made it to determine whether the requested item or service is statutorily excluded and whether there is a benefit category. Therefore, we will first determine whether or not the reconstructive treatmen ts as requested are statutorily excluded as cosmetic surgery under section 1862(a)(10) of the Social Security Act. See also 42 CFR 411.15(h). If we were to determine that these treatments are not statutorily excluded by 1862(a)(10), we would then need determine whether this service falls within one or more statutory benefit categories under part A or part B. If so, we would also need to determine whether the treatment is reasonable and necessary to treat "illness or injury or to improve the functioning of a malformed body member" under section 1862(a)(1)(A) of the Social Security Act in order to be covered under the Medicare program.

Benefit Category: To be determined.
Requestor Name(s):
Dr. Bruce Wilder, Esq., Wilder & Mahood, PC
Stella L. Smetanka, Esq. and Amber L. Trischler, Certified Legal Intern, University of Pittsburgh School of Law Health Law Clinic
Expected Completion Date: October 14, 2009.
PDM Due Date: July 16, 2009.
Lead Medical Officer(s): E. L. Hambrick, M.D.
410.786.5340
ReconstructionNCD@ cms.hhs.gov
Actions Taken: CMS opens BCD NCD process. 30-day public comment period begins.

TO VIEW A SURVEY CONDUCTED BY PROGRAM FOR WELLNESS RESTORATION ABOUT THE IMPACT OF LIPODYSTROPHY ON QUALITY OF LIFE, CLICK HERE:

results of Impact of Lipodystrophy Survey

Thank you

Please forward it to your friends and doctors

Nelson Vergel
powerusa.org