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ask.heather@mail.house.gov
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In Washington DC
442 Cannon House
Office Building
Washington, DC
20515
202-225-6316 Phone
202-225-4975 Fax |
In Albuquerque
20 First Plaza NW
Suite 603
Albuquerque, NM
87102
505-346-6781 Phone
505-346-6723 Fax |  |
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Congresswoman Heather Wilson, First Congressional District of New Mexico
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| Health Care Reform |
March 13, 2001 |
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A PRICKLY TEST: Heather`s blood sugar is tested at a recent Health Fair she hosted for seniors. There are 7 million diabetics in America -- many of them children -- who prick their fingers several times a day to test their blood sugar levels.
Dear Friends,
I recently had a meeting in Albuquerque with health care providers. We talked mostly about Medicaid, but, as they were leaving, I casually mentioned that we would be holding our first hearing on reforming the Health Care Financing Administration (HCFA) the following week in Washington. I thought they would break into cheers.
HCFA is a little known federal agency that has tremendous power over health care in America. They manage -- and I use the word loosely -- Medicaid and Medicare as well as other things like the organ transplant program. Since most Americans don`t have to deal with them directly, you may have never heard of them. So just imagine how you feel about the IRS. . . . That`s pretty close.
We had our first HCFA hearing just highlighting one problem area -- getting billing approval for new medical devices. Since the Food and Drug Administration was reformed, many of the delays have ended to get a medicine or device declared "safe and effective" by that agency. The next step is to get HCFA and insurance companies to approve the device for payment under insurance.
We learned at our hearing that most of the big insurance companies use the same testing contractor to decide whether they will cover new devices under their insurance plans. It`s the same testing contractor HCFA uses too. But private insurance companies take about 18 months to get a new device approved for payment by insurance. HCFA, using the exact same product tests and data, can take 5 or 6 years to get a billing code for Medicare or Medicaid.
What does that mean and why does it matter? I explained it this way.
WHY IT MATTERS
There are 7 million diabetics in America -- many of them children -- who prick their fingers several times a day to test their blood sugar levels. Hispanics and Indians have disproportionately high rates of diabetes. New Mexico is hit hard by this disease.
In Albuquerque, Rio Grande Medical Devices has built a way to test blood sugar by shining light through the web of your hand. No more pricks. No more trying to find a place on a child`s tiny fingers that doesn`t hurt already. If HCFA doesn`t give them the billing code, they can`t widely sell their devices.
Imagine having to prick your child`s fingers two or three times a day to make them bleed because a federal bureaucracy doesn`t work fast enough or well enough. Imagine doing it every day for the next five years. That`s why reforming HCFA matters.
Wish you were here,
Heather |
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