G I V E

[TheWallnerus]

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"The truth of the matter is that you always know the right thing to do. The hard part is doing it."
- Gen. Norman Schwarzkopf

I gave $3000.

I don't believe ASTRO or any other society, or linac company, has yet joined the fight. Which is honestly inexplicable.

EviCore is not acting as an honest broker.

 

[Gfunk6]

For all the ****ting on “high-tax, libbed-out California” around here, this is one occasion when having regulators with teeth is rather useful. For state-regulated plans, a medical-necessity denial can go to DMHC/CDI independent medical review, and a favorable decision is binding on the insurer. eviCore’s policy manual is not the final word.

I use OA LDRT extensively. I’m not conceding my patients’ access because EvilCorp published a PDF. Writing a blanket denial policy and successfully defending individual denials before independent reviewers are two different things. Funny how “government interference” becomes considerably more attractive when it’s the insurance company being told no.

 

[SneakyBooger]

$3000

 

[SneakyBooger]

And I work for Evicore!

 

[WildRivers]

I'm going back and forth on this.

I do think it is important for individuals to help out with these types of situations and donate.

However, I've not seen one strongly worded statement from ASTRO - particularly when Keole said that this was his thing and the theme of ASTRO, etc.
Additionally, Varian has 510k approval for musculoskeletal conditions. They also should be speaking up/lawyering up.

Our group may contribute, but it would be much more meaningful if we had short videos of ASTRO board remembers saying "I donated X". We get all these emails to support ASTRO PAC or whatever, but they can't make some noise and do anything themselves?

 

[Gfunk6]

About one week ago, ASTRO two appeal letter templates that one can use for OA denials. You don't have to be a member to access.

 

[RickyScott]

I'm going back and forth on this.

I do think it is important for individuals to help out with these types of situations and donate.

However, I've not seen one strongly worded statement from ASTRO - particularly when Keole said that this was his thing and the theme of ASTRO, etc.
Additionally, Varian has 510k approval for musculoskeletal conditions. They also should be speaking up/lawyering up.

Our group may contribute, but it would be much more meaningful if we had short videos of ASTRO board remembers saying "I donated X". We get all these emails to support ASTRO PAC or whatever, but they can't make some noise and do anything themselves?

It’s baffling why Astro is silent.

 

[ramsesthenice]

I know patients can sue their insurance companies for denying coverage. Does anyone know if there is precedent for successfully suing PA companies? It seems to me that delays caused by needless denial of SOC treatments would be a liability.

 

[TheWallnerus]

I know patients can sue their insurance companies for denying coverage. Does anyone know if there is precedent for successfully suing PA companies? It seems to me that delays caused by needless denial of SOC treatments would be a liability.

There’s even more liability risk than normal imho because it’s not that they’re denying coverage, they’re denying coverage for something they’ve traditionally always historically covered (and the basis for reversal is a VA review paper).

Be that as it may it looks like that of the probably hundreds or maybe even thousands of individual rad oncs who know this is happening and know that there is a rad onc funded legal challenge perhaps three or four people have donated to the cause.

We can argue that ASTRO should help. They should. Varian should help. Elekta should help. All true.

But no one is coming to save you. No one truly cares if this is actually going to happen or not except those who are making an effort to stop it. The proof really always is in the pudding. You can say you care, but do you really if you’ve done literally nothing to show it.

“We really had it all didn’t we” - Leonardo DiCaprio in ‘Don’t Look Up’

 

[medgator]

For all the ****ting on “high-tax, libbed-out California” around here, this is one occasion when having regulators with teeth is rather useful. For state-regulated plans, a medical-necessity denial can go to DMHC/CDI independent medical review, and a favorable decision is binding on the insurer. eviCore’s policy manual is not the final word.

I use OA LDRT extensively. I’m not conceding my patients’ access because EvilCorp published a PDF. Writing a blanket denial policy and successfully defending individual denials before independent reviewers are two different things. Funny how “government interference” becomes considerably more attractive when it’s the insurance company being told no.

Same people that will **** all over the delays/rationing in universal healthcare but then turn around and say the current system is great (delays/rationing at UHC, Humana, etc to enrich shareholders).

 

[OTN]

It’s baffling why Astro is silent.

Is it, though? We're supposed to be surprised they're once again demonstrating they're the least-effective medical society on the planet?