Post by Batch on Apr 12th, 2010 at 11:28pm
Good people of Clusterville, as most of you know, cluster headache sufferers have always been their own strongest advocates when it comes to asking their physicians for treatments that work effectively in treating our disorder.
For all you members and guests who use oxygen therapy and reside here in the US and its Territories, we have a golden opportunity to help ourselves and all the other CH'ers here in the US in a very big way.
Dr. Fred Sheftell, MD, President, American Headache Society and Dr. Robert C. Griggs, MD, FAAN, President, American Academy of Neurology have submitted a Formal Request to the Centers for Medicare & Medicaid Services (CMS) for a National Coverage Assessment and Determination on the use of home oxygen therapy for the cluster headache.
For those of you unaware of the CMS role in obtaining a prescription for oxygen therapy, they do not cover home oxygen therapy for Medicare beneficiaries suffering from cluster headache.
That's right… the biggest health insurance company in the world and the centerpiece for Obamacare, the US Government, will not cover the expense of oxygen therapy for your cluster headaches when you turn 65 and become a Medicare beneficiary… This CMS policy also impacts many with Medicaid or private health insurance regardless of age as too many of these payers tend to follow CMS policy.
You may not be 65 at this point, but if you stick around long enough… it will happen.
Wouldn't it be nice to see some that payroll tax you pay into social security each month come back to you in Medicare coverage for oxygen therapy for your cluster headaches when you turn 65?
Perhaps you'd prefer to pay for your oxygen therapy out of your pocket and have your payroll tax payments go to illegal aliens who will be granted amnesty and instant citizenship by a rogue congress and a president out to redistribute your wealth.
Here's the deal. Opportunities like this, to really help yourself and others, don't come around all that often…
You need to contact your Primary Care Physician and/or the neurologist who gave you the prescription for oxygen therapy as soon as possible this week and give them the following link:
START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!! You need to
or 
END PRINTPAGE
Then ask them make a public comment to CMS strongly encouraging a coverage determination that covers the use of home oxygen therapy as a safe and effective method of intervention for your cluster headaches.
The comment period for this National Coverage Assessment and Determination review is 4/9/2010 through 5/9/2010… That's less than 30 days, so notify your PCP and/or neurologist about this matter at the soonest and for sure not later than this coming Friday to give them ample time to respond. I've already notified my doctor and I've provided a sample public comment below.
Please feel free to ask questions about this post if you have any… Otherwise, a simple "Done" will do. That way I can have a rough count until CMS publishes the public comments.
The action is over to all of you oxygen therapy users here in the US and its Territories… please don't waste this opportunity to help yourself and other cluster headache sufferers.
Take care,
V/R, Batch
The CMS representative at CMS/OCSQ responsible for fielding these public comments is listed below:
Jean Stiller, MA
jean.stiller@cms.hhs.gov
1-410-786-0708
The format for the public comment to CMS follows:
Commenter: Last Name, MD, First Name
Title:
Organization:
Date: 04/--/2010
Comment: (Note. It's best if your PCP/neurologist uses his or her own words in preparing the public comment to CMS on this CSA. Having said that, the following example provides some of the key points that need to be made so I suggest you send this along with your request for their public comment if you have their email address. Call or fax them with this message if they don't have an email address.)
1. Thank your for the opportunity to provide a public comment on this important NCA for home oxygen therapy as an abortive for the cluster headache.
As a primary care physician / neurologist with N + years experience in treating patients with episodic or chronic cluster headaches, I frequently see many instances where oxygen therapy is clearly indicated as a safe and effective method of intervention for this very painful disorder. However, all too often home oxygen therapy is unavailable to these cluster headache sufferers as a result of the current CMS non-coverage determination for Medicare beneficiaries. Coverage for home oxygen therapy is also frequently denied due to guideline criteria for the cluster headache used by too many medical insurance companies/payers that subscribe to same CMS policy on non-coverage for the cluster headache.
Moreover, for the payers and homecare providers that do cover or accept home oxygen therapy for the cluster headache, too many of them frequently confuse my prescriptions as being for supplemental oxygen for COPD sufferers and not as an abortive for the cluster headache. As a result, some of my patients must endure needless delays and the additional expense of blood gas analysis or pulse oximetry for oxygen concentration when their oxygen saturation values are very normal and the diagnosis listed on the prescription is clearly cluster headache.
In short, the prescriptions I write for home oxygen therapy for my cluster headache patients represent clear statements of need, written in accordance with my experience as a physician in treating this disorder and the latest standards of care for the treatment of the acute cluster headache, episodic or chronic.
2. My patients and I have also found that an oxygen flow rate of 15 liters/minute with a non-rebreathing oxygen mask appears to be the minimum flow rate and that higher oxygen flow rates appear to provide even greater efficacy with significantly shorter abort times without increasing the volume of oxygen consumed with each abort. I also have patients who use an oxygen demand valve method of aborting their cluster headache with excellent results so would suggest this method be examined during this CSA.
3. Finally, as a cost consideration, I've found that oxygen therapy costs are far less per abort if prescribed with the larger home use stationary M-sized oxygen cylinders than the smaller portable E-size cylinders. Many of my patients who suffer an average of three cluster headaches a day require three of the M-size oxygen cylinders as a one-month's supply. For my patients who work or have frequent requirements for local travel, I also prescribe the smaller E-size oxygen cylinders. I've also found that successful oxygen therapy users require less of the more expensive triptan based abortives that I also prescribe as a bailout or rescue abortive when oxygen therapy is not available or permitted such as during airline travel.
For all you members and guests who use oxygen therapy and reside here in the US and its Territories, we have a golden opportunity to help ourselves and all the other CH'ers here in the US in a very big way.
Dr. Fred Sheftell, MD, President, American Headache Society and Dr. Robert C. Griggs, MD, FAAN, President, American Academy of Neurology have submitted a Formal Request to the Centers for Medicare & Medicaid Services (CMS) for a National Coverage Assessment and Determination on the use of home oxygen therapy for the cluster headache.
For those of you unaware of the CMS role in obtaining a prescription for oxygen therapy, they do not cover home oxygen therapy for Medicare beneficiaries suffering from cluster headache.
That's right… the biggest health insurance company in the world and the centerpiece for Obamacare, the US Government, will not cover the expense of oxygen therapy for your cluster headaches when you turn 65 and become a Medicare beneficiary… This CMS policy also impacts many with Medicaid or private health insurance regardless of age as too many of these payers tend to follow CMS policy.
You may not be 65 at this point, but if you stick around long enough… it will happen.
Wouldn't it be nice to see some that payroll tax you pay into social security each month come back to you in Medicare coverage for oxygen therapy for your cluster headaches when you turn 65?
Perhaps you'd prefer to pay for your oxygen therapy out of your pocket and have your payroll tax payments go to illegal aliens who will be granted amnesty and instant citizenship by a rogue congress and a president out to redistribute your wealth.
Here's the deal. Opportunities like this, to really help yourself and others, don't come around all that often…
You need to contact your Primary Care Physician and/or the neurologist who gave you the prescription for oxygen therapy as soon as possible this week and give them the following link:
START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!! You need to
or END PRINTPAGE Then ask them make a public comment to CMS strongly encouraging a coverage determination that covers the use of home oxygen therapy as a safe and effective method of intervention for your cluster headaches.
The comment period for this National Coverage Assessment and Determination review is 4/9/2010 through 5/9/2010… That's less than 30 days, so notify your PCP and/or neurologist about this matter at the soonest and for sure not later than this coming Friday to give them ample time to respond. I've already notified my doctor and I've provided a sample public comment below.
Please feel free to ask questions about this post if you have any… Otherwise, a simple "Done" will do. That way I can have a rough count until CMS publishes the public comments.
The action is over to all of you oxygen therapy users here in the US and its Territories… please don't waste this opportunity to help yourself and other cluster headache sufferers.
Take care,
V/R, Batch
The CMS representative at CMS/OCSQ responsible for fielding these public comments is listed below:
Jean Stiller, MA
jean.stiller@cms.hhs.gov
1-410-786-0708
The format for the public comment to CMS follows:
Commenter: Last Name, MD, First Name
Title:
Organization:
Date: 04/--/2010
Comment: (Note. It's best if your PCP/neurologist uses his or her own words in preparing the public comment to CMS on this CSA. Having said that, the following example provides some of the key points that need to be made so I suggest you send this along with your request for their public comment if you have their email address. Call or fax them with this message if they don't have an email address.)
1. Thank your for the opportunity to provide a public comment on this important NCA for home oxygen therapy as an abortive for the cluster headache.
As a primary care physician / neurologist with N + years experience in treating patients with episodic or chronic cluster headaches, I frequently see many instances where oxygen therapy is clearly indicated as a safe and effective method of intervention for this very painful disorder. However, all too often home oxygen therapy is unavailable to these cluster headache sufferers as a result of the current CMS non-coverage determination for Medicare beneficiaries. Coverage for home oxygen therapy is also frequently denied due to guideline criteria for the cluster headache used by too many medical insurance companies/payers that subscribe to same CMS policy on non-coverage for the cluster headache.
Moreover, for the payers and homecare providers that do cover or accept home oxygen therapy for the cluster headache, too many of them frequently confuse my prescriptions as being for supplemental oxygen for COPD sufferers and not as an abortive for the cluster headache. As a result, some of my patients must endure needless delays and the additional expense of blood gas analysis or pulse oximetry for oxygen concentration when their oxygen saturation values are very normal and the diagnosis listed on the prescription is clearly cluster headache.
In short, the prescriptions I write for home oxygen therapy for my cluster headache patients represent clear statements of need, written in accordance with my experience as a physician in treating this disorder and the latest standards of care for the treatment of the acute cluster headache, episodic or chronic.
2. My patients and I have also found that an oxygen flow rate of 15 liters/minute with a non-rebreathing oxygen mask appears to be the minimum flow rate and that higher oxygen flow rates appear to provide even greater efficacy with significantly shorter abort times without increasing the volume of oxygen consumed with each abort. I also have patients who use an oxygen demand valve method of aborting their cluster headache with excellent results so would suggest this method be examined during this CSA.
3. Finally, as a cost consideration, I've found that oxygen therapy costs are far less per abort if prescribed with the larger home use stationary M-sized oxygen cylinders than the smaller portable E-size cylinders. Many of my patients who suffer an average of three cluster headaches a day require three of the M-size oxygen cylinders as a one-month's supply. For my patients who work or have frequent requirements for local travel, I also prescribe the smaller E-size oxygen cylinders. I've also found that successful oxygen therapy users require less of the more expensive triptan based abortives that I also prescribe as a bailout or rescue abortive when oxygen therapy is not available or permitted such as during airline travel.