This is a super proud advocacy moment for me!
Many of you that know me, know that I spend much of my time battling health insurance companies and helping individuals get the medically necessary durable medical equipment they need to not only survive in life but to thrive. Over the last two years I’ve taken my mission one step further to focus on having adaptive exercise equipment for long-term wheelchair users put under a “Medical Necessity” Review under Durable Medical equipment.
Today as it stands, under Medicare and private health insurance companies, any type of exercise equipment is considered a non-covered benefit item. This means it does not have a code and will not get approved. Unless you have specific laws in your state, are part of the VA, or have an “in,” you’re not going to have much luck in getting approval. I know … I’ve been fighting for an adaptive rowing machine called the Vitaglide for 2 years — With no luck I might add. Even after writing a 35 page Letter of Medical Necessity backed up by over 130 peer reviewed journal articles, which took me 4 months to research & write, I was treading water.
Despite my 24 month herculean effort I still failed.
I then decided to take my mission to Blue Cross and Blue Shield directly. Through a series of internal contacts and help from the North Carolina Department of Insurance I started working with multiple policy directors. I gave speeches, had zoom calls, created videos, and more. This was a four tedious process trying to make a financial and medical argument for preventative healthcare for adaptive exercise equipment for long-term wheelchair users to be reclassified. Honestly, this epically failed and several months ago I received a beautiful blow-off letter from Blue Cross and Blue Shield. No bites. You can see the attached letter yourself.
Have no fear. I was working behind the scenes with my North Carolina State Senator Jay Chauduri on this very issue. In May 2020 we finally introduced legislation trying to mandate health insurance companies to put adaptive exercise equipment for long-term wheelchair users under a medical necessity review. Very proud of this accomplishment. However, I’m acutely and painfully aware, I might add, the success of this bill is slim to none. However, this creates a beginning legislative track record for me. I am now working on different plans over the next nine months to introduce more legislation.
It’s going to be a very long road, I’ve heaved advice from so many around the country, but I’m also kind of a one woman show on this front. I just keep pushing and pushing and pushing. I’m ridiculously determined, pleasantly persistent, and will continue down this road is long as there is someone to listen to me.
I simply won’t stop. I don’t know how to give up. I never have. As Winston Churchill famously quoted “The Definition of Success is Moving from Failure to Failure without Lack of Enthusiasm.” I live by this quote on a daily basis living with a long-term severe physical disability.
Change can start with one person. You may not be able to affect national change by yourself, but you can ignite that spark in others, create a movement, and while you may not accomplish what you would like to in a year or two or 10 — I have no doubt I will ignite a spark in the younger generations to continue my work for many years to come!