Cyberonics reneged on its "Lifetime Reimbursement Guarantee". Click on the image to learn how you can help...

Monday, July 21, 2014

Study: Trying harder makes it more difficult to learn language

Study: Trying harder makes it more difficult to learn language

Tuesday, 22 July 2014

When it comes to learning languages, adults and children have different strengths. Adults excel at absorbing the vocabulary needed to navigate a grocery store or order food in a restaurant, but children have an uncanny ability to pick up on subtle nuances of language that often elude adults. Within months of living in a foreign country, a young child may speak a second language like a native speaker.

Brain structure plays an important role in this "sensitive period" for learning language, which is believed to end around adolescence. The young brain is equipped with neural circuits that can analyze sounds and build a coherent set of rules for constructing words and sentences out of those sounds. Once these language structures are established, it's difficult to build another one for a new language.

In a new study, a team of neuroscientists and psychologists led by Amy Finn, a postdoc at MIT's McGovern Institute for Brain Research, has found evidence for another factor that contributes to adults' language difficulties: When learning certain elements of language, adults' more highly developed cognitive skills actually get in the way. The researchers discovered that the harder adults tried to learn an artificial language, the worse they were at deciphering the language's morphology -- the structure and deployment of linguistic units such as root words, suffixes, and prefixes.


"We found that effort helps you in most situations, for things like figuring out what the units of language that you need to know are, and basic ordering of elements. But when trying to learn morphology, at least in this artificial language we created, it's actually worse when you try," Finn says.

The findings support a theory of language acquisition that suggests that some parts of language are learned through procedural memory, while others are learned through declarative memory. Under this theory, declarative memory, which stores knowledge and facts, would be more useful for learning vocabulary and certain rules of grammar. Procedural memory, which guides tasks we perform without conscious awareness of how we learned them, would be more useful for learning subtle rules related to language morphology.


"It's likely to be the procedural memory system that's really important for learning these difficult morphological aspects of language. In fact, when you use the declarative memory system, it doesn't help you, it harms you," Finn says.


Still unresolved is the question of whether adults can overcome this language-learning obstacle. Finn says she does not have a good answer yet but she is now testing the effects of "turning off" the adult prefrontal cortex using a technique called transcranial magnetic stimulation. Other interventions she plans to study include distracting the prefrontal cortex by forcing it to perform other tasks while language is heard, and treating subjects with drugs that impair activity in that brain region.

http://macedoniaonline.eu/content/view/25746/56/

Migraine treatment innovations still have ways to go

Migraine treatment innovations still have ways to go

Stephanie M. Lee
Published 3:02 pm, Saturday, July 19, 2014

 

Dr. Robert Cowan, head of the Stanford Headache Clinic helps migraine patient Nancy Mikhael, who is getting three rounds of Botox injections as part of her treatment. Photo: Leah Millis, The Chronicle

Dr. Robert Cowan, head of the Stanford Headache Clinic helps migraine patient Nancy Mikhael, who is getting three rounds of Botox injections as part of her treatment. Photo: Leah Millis, The Chronicle

Dr. Robert Cowan, head of the Stanford Headache Clinic, administers a Botox injection to migraine patient Nancy Mikhael, 31, of San Jose. Photo: Leah Millis, The Chronicle

Dr. Robert Cowan, head of the Stanford Headache Clinic, administers a Botox injection to migraine patient Nancy Mikhael, 31, of San Jose. Photo: Leah Millis, The Chronicle

 

Few sensations are as grating as a head-splitting, nausea-inducing migraine that just won't disappear.

When aspirin and Advil aren't strong enough, patients often turn to the class of drugs called triptans, the prescription medicine DHE or even opioids. But these treatments do not work well in everyone and may have dangerous side effects.

So biotechnology companies, including one in San Mateo, are developing alternatives in an attempt to treat some of the 36 million Americans who suffer migraines. Also on the market are two head devices that use magnets or electricity, one of them developed at facilities in Sunnyvale.

The migraine market in developed countries will grow to nearly $5.4 billion in 2022, predicts the Decision Resources Group. "The unmet need is pretty strong," said Bethany Kiernan, a senior director for the health care market analysis firm. "Having a therapy that can either work to a greater extent in a larger percentage of the population, or that can better serve those patients that are currently underserved, has a real advantage in this market."

Universal relief may be a long way off, however. This month, a panel of California clinicians voiced support for Botox, the wrinkle-smoothing shots that are also approved to treat chronic migraines, defined as severe headaches at least 15 times per month.

At the same time, the doctors were skeptical about the two new head devices.

"These are all promising things, but we still know so little about what's actually going on," said Dr. Robert Cowan, director of Stanford University's Headache Clinic. "How come two different people get hit in the head the same way, one of them gets a lump in the head that goes away in few days or a week, and the other gets chronic headaches that never go away for the rest of their life?"

Seeking cause

Scientists are still trying to understand the exact causes of migraines. Labrys Biologics in San Mateo has been developing a drug that tries to prevent chronic and episodic headaches by binding a protein to a neuropeptide thought to play a role in migraines. In June, Israeli drug giant Teva Pharmaceutical Industries said it would acquire the company for up to $825 million.

But the field has seen some high-profile flops. Last year, Allergan spent nearly $1 billion to acquire a new, inhalable migraine drug, only for the Food and Drug Administration to reject it out of safety concerns.

Allergan also owns Botox. In 2010, the cosmetic injections won approval to treat adults with chronic migraines. Current therapy recommendations call for injections every three months.

Compared to no treatment at all, Botox seems to have small benefits in some patients, the California Technology Assessment Forum agreed this month. The panel of physicians reviews medical issues three times a year.

The group was not as convinced of the merits of SpringTMS, a handheld device that delivers a brief pulse of energy, or transcranial magnetic stimulation, to the back of the head. It is supposed to generate magnetic fields that interrupt abnormal electrical activity associated with migraines.

The device won federal approval in May and is made by eNeura Therapeutics, whose headquarters are in Baltimore and whose research and development facilities are in Sunnyvale. CEO David Rosen said the product may appeal to the estimated 10 to 15 percent of migraine patients who are not eligible for drugs or other treatments.

"It would make sense for a specialist to consider use of the device and prescribe use of the device for patients who don't have any other treatment option," he said. "What are you going to do for these people besides say, 'I don't have a treatment option for you?' "

But the panel decided there was inconclusive evidence to demonstrate the SpringTMS was better than standard treatments. Patients in one study reported some relief after using the device, but other measures, such as whether patients became less sensitive to light and sound, did not significantly differ from the placebo users.

"There really was no difference between the device and a sham stimulator," said Dr. Rita Redberg, a cardiologist at UCSF, who sided with the majority of the panel. It was "just putting something on your head and thinking you were being treated for migraines."

The panel was similarly skeptical of Cefaly, a $449 headband designed to deliver electrical impulses to nerves that transmit migraine pain. Approved in March, it is supposed to be worn for 20 minutes each day to reduce the frequency of migraines - but the panel found the supporting evidence inconclusive.

Few options

At the same time, the group acknowledged that many patients lack viable options. The popular migraine drugs known as triptans, for example, temporarily narrow blood vessels, an effect that makes them off-limits for people with coronary artery disease and other vascular conditions.

Frustrated patients often seek out opioids in the emergency room, but opioids can be dangerous. In a year, the panel estimated, 20,000 patients in California develop chronic migraines because of opioid overuse, and 3,000 become addicted. So the demand for safe and effective alternatives is urgent.

"Headache care is 50 years behind things like diabetes and cancer," said Cowan, the Stanford doctor, who was an adviser to the panel. "It just hasn't had the attention, hasn't had the funding, in order to get to the answers we need."

Stephanie M. Lee is a San Francisco Chronicle staff writer. E-mail: slee@sfchronicle.comTwitter: @stephaniemlee

http://www.sfgate.com/health/article/Migraine-treatment-innovations-still-have-ways-to-5633145.php#photo-6614679

Friday, July 11, 2014

"Compassionate Use" for VNS Therapy Depression Patients...

From: Herbert Stein [mailto:fabrik@bellsouth.net]
Sent: Friday, July 11, 2014 2:02 PM
To: Madam Secretary Sylvia Matthews Burwell, United States Secretary of Health and Human Services
Subject: "Compassionate Use" for VNS Therapy Depression Patients...

Dear Madam Secretary Burwell,

clip_image001

Do you happen to know what kind of cake this is?  If by chance you don’t it is a Seven Layer Cake somewhat reminiscent of the bureaucracy I’ve encountered these past seven years since one of the agency’s, CMS now under your stewardship, through their ignorance, intellectual arrogance, stupidity or downright forgetfulness denied medical insurance coverage to volunteer study subjects and patients implanted with a medical prosthesis after the FDA approved the device, another agency now under your stewardship.

Pick the appropriate word for what the brain-trust at CMS committed; immoral, egregious, unconscionable, unfathomable, half-assed, incomplete, thoughtless, negligent, criminal and/or plain stupid.

One or all terms might be apropos but what we have after 7 years since the decision to deny was rendered is additional negligence and the seven layer cake.  This negligence and layers of bureaucracy could quickly and simply be remedied by the stroke of your pen.  A document issued and signed by you for “Compassionate Use” eliminates the current band-aide attempt to remedy what should have been considered and included in the decision of May 4, 2007.

You might be too young to know of the sign on former President Harry Truman’s desk read, “The Buck Stops Here.”  Isn’t it time for the same? 

I shall quote your message to me, once again:

“Thank you very much for your e-mail.  Our ability to deliver impact depends on your input.  I very much appreciate that you’ve taken the time to write, and will be sure to share your message with the most appropriate member of my team for review. 

This Department belongs to the American people, and what you have to say matters to all of us.   As we advance our mission of providing Americans with the building blocks of healthy and productive lives, we never lose site of the fact that ultimately, you are “the boss” – and everything we do is on behalf of everyday Americans who work hard, take responsibility and rely upon the outcomes and services this Department provides.

To deliver impact and move our mission forward, we are guided by three central tenets: delivering results for the American people on a wide range of important issues; strengthening the relationships that drive progress; and building strong teams with the talent and focus that our challenges call for, and our fellow Americans deserve.

Working together, we can strengthen the foundation of a stronger middle class, a more prosperous economy, and healthier communities.

Thank you again for your message.

Sylvia Burwell

Secretary”

I hope your message was truly meaningful of your sincere thoughts and not simply public relations speak.  You are “the boss” of your agencies.  After 7 years of inexcusable inaction exercise your executive authority and make the decision to do the right thing for this small American group of patients.  Don’t waste time by sharing my “message with the most appropriate member of my team for review” as you stated.  Instead take action and stop fostering the “Seven Layer Cake Syndrome”. 

U.S. Administrative Law Judge Troy Smith saw the injustice by ruling for one patient.  Now you too can remedy the issue for all these patients.  Take action!

Sign the document now for “Compassionate Use” and give these Americans “the building blocks of healthy and productive lives” that you are espousing.

Sincerely,

Herb

Joyce and Herbert Stein

1008 Trailmore Lane

Weston, FL 33326-2816

(954) 349-8733

vnsdepression@gmail.com

http://www.vnstherapy-herb.blogspot.com

http://www.vnstherapy.wordpress.com

---------------------------------------------------------------

NOTICE OF CONFIDENTIALITY / Disclaimer

---------------------------------------------------------------

Disclaimer: This E-Mail is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521 and is legally privileged. The information contained in this E-Mail is intended only for use of the individual or entity named above. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you receive this E-Mail in error, please notify the sender immediately at the email address and/or phone number above and delete the information from your computer. Please do not copy or use it for any purpose nor disclose its contents to any other person.

CONFIDENTIALITY NOTICE: This e-mail message including attachments, if any, is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail, destroy all copies of the original message, and do not disseminate it further. If you are the intended recipient but do not wish to receive communications through this medium, please advise the sender immediately.

Wednesday, July 9, 2014

Important information…

From: Herbert Stein [mailto:fabrik@bellsouth.net]
Sent: Tuesday, July 08, 2014 10:59 PM
Subject: Important Information...

To the VNS patients and their attending physicians,

1:00 PM today I participated in a teleconference with CMS.  The discussion I was told is “off-the-record” although I could share one particular very important piece of information and then I’ll share my thoughts and opinions of the teleconference.

As you already know Kathleen Sebelius and Jonathan Blum had resigned their positions with their respective agencies.  Ms. Amy Larrick has been moved to a higher position within CMS and will no longer be the contact person at CMS for the VNS patients so please delete any information pertaining to Amy Larrick. The first step to obtaining replacement is described in my posting link entitled:

Expediting the VNS replacement surgery for the depression patient. 

Kindly substitute Courtney Turner’s name anywhere you read “Amy Larrick”.  Should one encounter any obstacles then read the below listed information.

The new contact at CMS, so please mark your records accordingly, for any VNS patients for Depression initially implanted prior to May 4, 2007 is:  

Ms. Courtney Turner

Telephone: 410-786-4593  

Any implanted depression patient needing assistance must be prepared to supply the following information when contacting Ms. Courtney Turner:

One’s Full Name  

Telephone number

State of residence

 Be prepared to share any other pertinent information relating to one’s case, if requested.

I have been advised that Ms. Turner will make every effort to expedite each case on a case by case basis although some patience on the part of the applicant will also be required as Ms. Turner is apparently the sole staffer assigned to this undertaking.

I more or less firmly expressed my frustration and exasperation during the conference as to why after all this time a written or “Compassionate Use” document could not be issued, once and for all. 

What I came away with is my continued belief and impression that the government is inundated with bureaucracy, upon bureaucracy, department upon department, committee upon committee and the wonderment in my mind that anything can ever be accomplished.  If the government were a private enterprise in my opinion; they’d be bankrupt by now through their inefficiencies, convoluted organizational management and questionable qualification of their so called medical experts.

I also indicated during the conference call that I shall not let up in my advocacy and campaign to formally right this egregious wrong as I direct my emails to Madam Secretary Burwell in the hope she gets completely fed up with me and whether she personally signs or directs one of her subordinates to sign a formal directive to cover the health insurance for these patients.

In any event and under the circumstances I was left with the impression despite all the negatives in my mind they are making their best efforts, under the circumstances, to accommodate the medical insurance needs of the VNS Depression patients.

Sincerely,
Herb

Joyce and Herbert Stein
1008 Trailmore Lane
Weston, FL 33326-2816
(954) 349-8733
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com
http://www.vnstherapy.wordpress.com

Tuesday, July 8, 2014

The real-time resulting benefits of VNS Therapy for Depression.

From: Herbert Stein [mailto:fabrik@bellsouth.net]
Sent: Tuesday, July 08, 2014 11:22 PM
To: Madam Secretary Sylvia Matthews Burwell, United States Secretary of Health and Human Services
Subject: The real-time resulting benefits of VNS Therapy for Depression.

Dear Madam Secretary Burwell,

I take this opportunity to share with you as I have done in the past with former Madam Secretary Sebelius and Mr. Jonathan Blum of CMS letters I receive from existing VNS Therapy Depression patients.  The letters I shared in the past were gut wrenching narratives begging to obtain replacement pulse generators to once against lift these souls out of the depths of anguish and despair and the “Black Hole” of depression.

With permission from Julie I’d like to share with Amy, you and others her recent communications with me that is a self-explanatory:

-----Original Message-----
From: Julie Ottaviani [mailto:julieottaviani@aol.com]

Sent: Tuesday, July 08, 2014 7:33 AM
To: Herbert Stein
Subject: Re: U.S. Administrative Law Judge sides with VNS Depression Patient

Congratulations to Amy.  I hope the action will bring forth a written document clearly explaining the COMPASSIONATE USE coverage of all of us who benefit from VNS.  As always thank you for cheering up my day Herb.

Sincerely

Julie Ottaviani

Sent from my Verizon Wireless Phone

 

 

-----Original Message-----
From: Herbert Stein [mailto:fabrik@bellsouth.net]

Sent: Tuesday, July 08, 2014 8:39 AM
To: 'Julie Ottaviani'
Subject: RE: U.S. Administrative Law Judge sides with VNS Depression Patient

Julie,

May I share your response publicly and with Amy?

Most importantly, how are you doing?

Sincerely,

Herb

Joyce and Herbert Stein

1008 Trailmore Lane

Weston, FL 33326-2816

(954) 349-8733

vnsdepression@gmail.com

http://www.vnstherapy-herb.blogspot.com

http://www.vnstherapy.wordpress.com

 

 

 

From: Julie Ottaviani [mailto:julieottaviani@aol.com]

Sent: Tuesday, July 08, 2014 8:59 PM
To: fabrik@bellsouth.net
Subject: Re: U.S. Administrative Law Judge sides with VNS Depression Patient

No bother Herb sorry it took so long I just got back on the computer after a long stormy day in Pa.  Of course you have my permission to use any and all my correspondence to you.  I am doing well after the replacement of my VNS battery.  My greatest regards to Amy for her dedication and persistence in obtaining a judicial ruling in favor of coverage of the forgotten  Cyberonics Vns Depression Implant patients.  Maybe now there will be a Compassionate Use coverage by medicare and an order to the private insurance companies also " IN WRITING".  Thank you Amy.  And thank you Herb for all your hard work.
Julie Ottaviani
julieottaviani@aol.com

Sincerely,

Herb

Joyce and Herbert Stein

1008 Trailmore Lane

Weston, FL 33326-2816

(954) 349-8733

vnsdepression@gmail.com

http://www.vnstherapy-herb.blogspot.com

http://www.vnstherapy.wordpress.com

In my previous email I inadvertently omitted a key word; “not” in my sentence.

From: Herbert Stein [mailto:fabrik@bellsouth.net]
Sent: Tuesday, July 08, 2014 11:56 AM
To: Madam Secretary Sylvia Matthews Burwell, United States Secretary of Health and Human Services
Cc: 'Amy Larrick, Senior Advisor to the Principal Deputy Administrator Centers for Medicare & Medicaid'; 'Chet Burrell, President & CEO CareFirst BlueCross BlueShield'; 'Courtney Turner'; 'Daniel Moore, CEO - Cyberonics'; 'Daniel Schreiner, Acting Deputy Director - Office of Public Engagement'; 'Dr. Jeffrey A. Kelman (CMS/CM)'; 'Dr. Mark Bunker'; 'Lynda M. Gyles, Executive Assistant to the Secretary - HHS'; 'Marilyn Tavenner, Administrator - CMS'; 'Stephen J. Hemsley - CEO, United Healthcare'; 'Teresa Niño, Director - Office of Public Engagement'; Bryan Olin, Ph.d
Subject: U.S. Administrative Law Judge Troy Smith finally has gotten it right...

Dear Madam Secretary Burwell,

In my previous email I inadvertently omitted a key word; “not” in my sentence.  The sentence should have correctly read:

Now I’m about to tell you once again about your “fakakta (<Yiddish origin> A person or thing who is completely crazy/fucked up)” organization, CMS, which in my opinion has perpetrated criminal and immoral acts against volunteer study subjects and patients implanted with VNS Therapy for Depression by not grandfathering care.

I too make mistakes.  It is one of the shortcomings of being human but more importantly I have the capacity to learn and understand and correct my errors and move forward.

It has now taken a little more than 7 years for someone in government to formally recognize the egregious and serious errors perpetrated, whether purposely or otherwise, against this unique population of VNS Therapy for Depression patients by not grandfathering and providing for their care when CMS rendered their decision May 4, 2007.  In doing so, CMS put the lives of patients at risk contrary to their mandates.

7 years later Judge Troy Smith finally sets the record straight.

All the volunteer study subjects and patients implanted with VNS Therapy for Depression prior to May 4, 2007 CMS decision who wish to continue with the therapy are entitled to health insurance coverage.

Madam Secretary, I quote once again your statement to me:

“Thank you very much for your e-mail.  Our ability to deliver impact depends on your input.  I very much appreciate that you’ve taken the time to write, and will be sure to share your message with the most appropriate member of my team for review. 

This Department belongs to the American people, and what you have to say matters to all of us.   As we advance our mission of providing Americans with the building blocks of healthy and productive lives, we never lose site of the fact that ultimately, you are “the boss” – and everything we do is on behalf of everyday Americans who work hard, take responsibility and rely upon the outcomes and services this Department provides.

To deliver impact and move our mission forward, we are guided by three central tenets: delivering results for the American people on a wide range of important issues; strengthening the relationships that drive progress; and building strong teams with the talent and focus that our challenges call for, and our fellow Americans deserve.

Working together, we can strengthen the foundation of a stronger middle class, a more prosperous economy, and healthier communities.

Thank you again for your message.

Sylvia Burwell

Secretary”

I am not interested in being “the boss” but rather prompting your department by “delivering results for the American people…”

Issue a formal document of “Compassionate Use” for these patients now, so these patients do not have to continue battling for their rights each and every time they need care.

Lastly and to Amy Lasko, on my behalf and all your fellow patients, I’d like to thank you once again for your courage and perseverance in obtaining this most important decision.

Sincerely,

Herb

Joyce and Herbert Stein

1008 Trailmore Lane

Weston, FL 33326-2816

(954) 349-8733

vnsdepression@gmail.com

http://www.vnstherapy-herb.blogspot.com

http://www.vnstherapy.wordpress.com

Monday, July 7, 2014

U.S. Administrative Law Judge sides with VNS Depression Patient

From: Herbert Stein [mailto:fabrik@bellsouth.net]
Sent: Monday, July 07, 2014 11:59 PM
To: Madam Secretary Sylvia Matthews Burwell, United States Secretary of Health and Human Services
Cc: 'Amy Larrick, Senior Advisor to the Principal Deputy Administrator Centers for Medicare & Medicaid'; 'Chet Burrell, President & CEO CareFirst BlueCross BlueShield'; 'Courtney Turner'; 'Daniel Moore, CEO - Cyberonics'; 'Daniel Schreiner, Acting Deputy Director - Office of Public Engagement'; 'Dr. Jeffrey A. Kelman (CMS/CM)'; 'Dr. Mark Bunker'; 'Lynda M. Gyles, Executive Assistant to the Secretary - HHS'; 'Marilyn Tavenner, Administrator - CMS'; 'Stephen J. Hemsley - CEO, United Healthcare'; 'Teresa Niño, Director - Office of Public Engagement'; Bryan Olin, Ph.d
Subject: U.S. Administrative Law Judge sides with VNS Depression Patient

Dear Madam Secretary Burwell,

Today is somewhat of an auspicious day for me.  First, I earlier in the day quickly introduced myself to you and my purpose for hounding and asserting myself upon you and your voluminous staff.  Now I’m about to tell you once again about your “fakakta (<Yiddish origin> A person or thing who is completely crazy/fucked up” organization, CMS, which in my opinion has perpetrated criminal and immoral acts against volunteer study subjects and patients implanted with VNS Therapy for Depression by grandfathering care.

To quickly recap for you and to put this matter into perspective:

1- Numerous volunteer study subjects were enrolled in studies and implanted with a VNS pulse generator.  Leads were then run from the generator and are connected to the left vagus nerve (starting in early 1999).

2- FDA approves VNS Therapy for Depression (July 15, 2005).

3- Upon FDA approval, the sponsor of the VNS Therapy, Cyberonics is no longer responsible for patient care.

4- Additional patients obtain VNS Therapy for Depression through Medicare/Medicaid and private insurance carriers upon the FDA approval from July 15, 2005 until May 4, 2007.

5- The then CEO of Cyberonics, Skip Cummins, issues a public statement of a “Lifetime Reimbursement Guarantee” at my request and insistence after I realized the potential loophole or Catch-22 in medical coverage for the study subjects (January 18, 2006).

6- CMS issues a NCD denying coverage for VNS Therapy for Depression (May 4, 2007).

7- Cyberonics changes their position, denies care and reneges on their “Lifetime Reimbursement Guarantee” citing kickback laws which in my opinion is bull-turd.

8- Cyberonics is shown the door by CMS and denied reconsideration for the Depression indication a second time (May 30, 2013).

9- I immediately begin my advocacy to obtain medical coverage for the volunteer study subjects and patients who wish to continue with their VNS Therapy for Depression (June 3, 2013).

10-I finally obtain some reasonable results after 4 month, 24/7 at my computer writing to anyone and everyone who would listen.  I receive a number of responses from individuals within your organization and then I hear from and speak with Mr. Jonathan Blum and Ms. Amy Larrick.  I am informally assured that Ms. Larrick would handle the matter directly with any Medicare/Medicaid patients needing assistance.  The informal system benefits a number of patients but leaves a lot to be desired.

11-In the meantime, Jonathan in an off-the-record telephone conversation where I requested formal documentation assures me they are working on something.

12-Ms. Kathleen Sebelius and Mr. Jonathan Blum resign and Ms. Amy Larrick is not heard from.

13-Now I’m hounding you Madam Secretary Burwell for results; nothing but results.

So just where does this leave me today.  Well, to tell you the truth I’m chuckling and appreciative of the information, input and support I’ve received from patients and their attending physicians who I blind copy on these emails.  Today I would like to cite one such instance of the outstanding courage of Ms. Amy Lasko who despite her debilitating depressive illness and personal challenges went to bat and advocated for herself and in doing so I believe will also benefit others as she shared the following information with me.

14-Amy Lasko wins an Administrative Law Judge Appeal.

I am not an attorney but I still am capable of reading English and if one carefully reads the decision rendered by Troy Smith, U.S. Administrative Law Judge he clearly indicates the CMS decision of May 4, 2007 applies to patients seeking VNS Therapy for Depression on or after May 4, 2007.  Therefore all the volunteer study subjects and patients implanted prior to May 4, 2007 should rightfully be covered by Medicare/Medicaid and/or private health insurance carriers.

I do not know the internal workings of your bureaucracy nor the various terminologies you may use.  I am once again asking for a written document for “Compassionate Use” for all those volunteer study subjects and patients who wish to continue with VNS Therapy for Depression and who were initially implanted prior to May 4, 2007.  I would like to read written directives sent to your various state agencies as well as communications sent to the various private health insurance carriers.  Based upon Judge Smith’s ruling all those private health insurance carriers such as United Healthcare are in violation of his ruling as United Healthcare and others have denied coverage to patients implanted prior to May 4, 2007.

To the patients and physicians reading my missive you might now have something to hang your hats upon to advocate for the health of your patients.

Sincerely,

Herb

Joyce and Herbert Stein

1008 Trailmore Lane

Weston, FL 33326-2816

(954) 349-8733

vnsdepression@gmail.com

http://www.vnstherapy-herb.blogspot.com

http://www.vnstherapy.wordpress.com

---------------------------------------------------------------

NOTICE OF CONFIDENTIALITY / Disclaimer

---------------------------------------------------------------

Disclaimer: This E-Mail is covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521 and is legally privileged. The information contained in this E-Mail is intended only for use of the individual or entity named above. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you receive this E-Mail in error, please notify the sender immediately at the email address and/or phone number above and delete the information from your computer. Please do not copy or use it for any purpose nor disclose its contents to any other person.

CONFIDENTIALITY NOTICE: This e-mail message including attachments, if any, is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail, destroy all copies of the original message, and do not disseminate it further. If you are the intended recipient but do not wish to receive communications through this medium, please advise the sender immediately.