From Fox News:
Brain Injury Patients Face Double Injustice
As many as 1.7 million people suffer traumatic brain injury each year in the U.S., and tens of thousands die. Those who survive are often left facing years of physical, occupational and speech therapy, mountains of bills and limited insurance options.
Nine months ago, Marie Beattie was awakened at 3 a.m. by a phone call that changed her life.
Her 18-year-old daughter, Corey, suffered a traumatic brain injury, or TBI, when a truck broadsided the car she was riding in.
With her body twisted and broken, it took two hours for rescuers to untangle Corey from the wreckage. She had a broken neck, multiple fractures and, Beattie says, “The brain not only was hit within the impact, it spun within her frame of her skull.”
Doctors say Corey's best chance for maximum recovery is 12 months of intense inpatient rehabilitation. But she was released after only 6 1/2 months.
According to Beattie, her family's health insurance, Independence Blue Cross of Pennsylvania, sent her daughter home too early.
But medical opinions differ over the best treatment for TBI.
In a statement to Fox News, Karen Godlewski, a spokesperson for the insurance company, defended the decision to release Corey: "Corey's transition to home was consistent with the recommendations of the professionals at Bryn Mawr rehab hospital who noted that ongoing therapy could be provided in a less intensive setting."
But Corey's surgeon, Dr. Kennedy Yalamanchili, says 12 months is the best window of opportunity for brain trauma patients. "We try to provide the maximum benefit during the period of time that brain's ability to rehabilitate and regenerate exists."
Corey's battle is just one example of the millions of families left heartbroken and buried in bills.
“This is one month's worth of medical bills,” Beattie says, referring to a 6-inch stack of envelopes and papers sitting on a table in her living room.
She hopes Congress will intervene.
New Jersey Rep. Bill Pascrell, co-founder of the Congressional Brain Injury Task Force, [Emphasis mine. - F.G.] is asking the Department Health and Human Services to make treatment of TBI an essential benefit under the Patient Protection and Affordable Care Act.
Pascrell says, “[HHS] will define those guidelines. So that brain injured people can feel assured that they're going to get proper care.”
Staff members for Rep. Gabrielle Giffords, who suffered a traumatic brain injury when she was shot in Tucson this year, have also appealed to HHS on behalf of traumatic brain injury victims.
In a statement to Fox News, HHS spokesman Chris Stenrud, wrote, “We greatly appreciate the thoughtful ideas provided by Congresswoman Giffords’ staff and will certainly take them into account as we work to develop rules describing an essential benefits package. HHS will be engaging in a public process later this year to get broad input for the process of establishing essential benefits.”
Until then, families like the Beatties continue to fight. A sometimes-overwhelming task according to Marie Beattie, “This is an exhausting process ... I can't tell you how many times in the middle of the night I want to throw my hands up and say forget it, fine, I'm done, you win, I'm done, you are bigger than me. Then I look at Corey and think, uh no, I can't look at my child without knowing that I have done everything possible.”
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