Sound advocate pioneers new health care approach

Sheri Byrne-Haber has a winning streak any lawyer would envy. Since she launched a program in 2004 challenging health insurers' denials of a device that allows the deaf to hear, the East Palo Alto-based ...

[Greg M]

Thanks, Sheri! I think my boys were # 87 in the winning streak, so you're really on a roll!
GM

[Mark Hobratschk JD MPA]

What Sheri is doing is terrific, but it is hardly "unique" or pioneering. Back in 1994, I talked Cochlear Americas into sending me to administrative hearings to represent customers in their appeal of benefit denials and since then I and others have been representing cochlear implant candidates in thee battles nationwide, and almost always free of charge. I was able to not only win hearings in states like Arizona but get them to develop an entire coverage policy so that future cochlear implant claims would not be denied. Myself and another Cochlear employee created a private service in 1997 funded by Med El Corporation to appeal consumer denials and Sheri has just taken that idea and secured funding from Advanced Bionics to do the same thing. So while it is great to finally see manufacturers step up to the plate to fund these services, there is nothing novel or unique about this 12 year old concept.

[Caitlin Roberson - LTHF]

Hi, Mark. The Let Them Hear Foundation (LTHF) appreciates your commendation of our work, and thanks you for your readership of this article. I would like to clarify that LTHF is a 501(c)(3) non-profit, and receives funding outside of manufacturers from many generous private donors. LTHF is manufacturer-neutral, and is not focused solely on cochlear implantation. Our Insurance Advocacy Program performs appeals for a number of other hearing-related services, such as those for atresia and microtia. LTHF also seeks to assist the hard of hearing community through multiple other efforts that are not directly related to cochlear implantation. For example, we will work in collaboration with the California Department of Education per the effectivity of AB 2651, which requires all California newborns (over 400,000 annually) to receive hearing screening tests while in the hospital. For more information, please see the Oakland Tribune’s front page article from December 16, 2007 (http://www.insidebayarea.com/timesstar/localn... ).
Caitlin Roberson is the Public Relations Manager for the Let Them Hear Foundation, and can be reached at [e-mail].

[PAUL SHYKORA]

GREAT!! GOOD FOR YOU!! MERRY CHRISTMAS EVERYONE,TOO BOOT!!BUT,where is this ---palo alto ???

[Dr Laurie Naiman]

I'm the patient mentioned in the article. After a 6-month wait I underwent surgery at Stanford yesterday, and all went well. As a beneficiary of the Let Them Hear Foundation's advocacy program it's hard to find words to express my gratitude, not just for myself, but for patients and families everywhere who have benefited from its efforts. Their influence on discriminatory health insurance policies will be a wonderful legacy, when those who follow us can take things like this for granted instead of struggling like we have.

[Caitlin Roberson - LTHF]

Here is LTHF's address:
1900 University Avenue, Ste 101
East Palo Alto, CA 94303

Paul, LTHF has done appeals in Ontario, Nova Scotia and Newfoundland.

[Valerie Deleon]

Thank you Let Them Hear! They won my appeal against Blue Cross Blue Shield Tennessee in May of 2007. I am now a happy make that very happy with my Bilateral Cochlear Implants. They worked around a year to ensure that my insurance company provided my implants. Thank you Chris, Sheri and Amy for all you did for not only me, but others as well.

[Mark Hobratschk]

I understand that Cochlear Americas informed this reporter that LTHF's efforts were unique and pioneering solely because they were threatening class action lawsuits for CI exclusions. As I informed her, this really is not accurate. Cochlear and several advocacy groups discussed class action litigation over a decade ago. And in early 2000, a family in Ohio did bring an unsuccessful class action against Benicorp after it denied coverage for their daughter.(I got the American Speech Language Hearing Association to support this family's effort, as did the manufacturers.)

The problem remains that Federal courts have yet to take the EEOC's position that CI denials are illegal discrimination under the ADA because the consumer has no alternative but to remain deaf. So for now, the mere threat of a class action is not only far from unique or pioneering, but likely to yield spotty results, at best.

What is sorely needed are the appointment of Federal judges who support enforcement and strengthening of the ADA, and not the recent trend of appointees who continually seek to ignore or weaken the ADA. It would thus be very helpful for the CI community if the hearing loss associations would stop taking "no position" on these appointments and join in with the American Association for Persons with Disabilities and other disability groups in opposing these anti-ADA appointees.

[Mark Hobratschk JD MPA]

Thank you Caitlin for the detail on LTHF funding. I understand that there is non-manufacturer funding. However, I thought that the July 31, 2007 letter on your website about Cochlear withdrawing its funding indicated that Advanced Bionics and Med El were still funding the Insurance Advocacy program? Is that no longer the case? Is AB no longer the predominant manufacturer funding source?

[laura civitano]

I am having the same trouble, is there a contact for her?

[Sharon West Moscow TN]

Hi Mark,
My 25 year old was born profoundly deaf and we are trying to get her the cochlear implana surgery. She has a BSBS of TN private insurance policy that her and her husband pay a steep monthly premium. They denied her the surgery. We need went to Tenn Care and they are denying as well beacsue she is over the age of 21. She has already had her MRI and all Pre Op work completed because her surgery is scheduled for July 18th. Her Tenn Care coverage is with TLC and I went to their website and the implant is nor listed under the non covered services. Can you please give me some advice?
Thanks

[PAUL SHYKORA]

I'am ''all''for helping the disabled-Persons in any way that would HELP in their....Lives..tooooo booot!!!Thankyou!!GOD Bless......eh....