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UPDATE: THIS FILE LAST EDITED 3-2006

Medicare

AT REPORT ONE

- AT = ASSISTIVE TECHNOLOGY

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A PUBLICATION FROM THE...

SIGHT LOSS

INFORMATION

DETECTIVE

.....ALL RIGHTS RESERVED

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SHOULD THE READER WANT TO SUGGEST ANY ADDITIONS OR CORRECTIONS FOR THIS BULLETIN, PLEASE SEND YOUR IDEAS - GO TO LINK, SEND A MESSAGE, NEAR THE TOP OF THIS WEBPAGE.

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NOTE: THIS INFORMATION IS NOT INTENDED AS AN ENDORSEMENT OR RECOMMENDATION, AND IS PRESENTED SIMPLY AS A CONVENIENCE TO THE READER. BECAUSE OF THE CHANGING AVAILABILITY OF PRODUCTS AND SERVICES, THE COMPLETENESS OF THIS LISTING IS NOT GUARANTEED.

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THE FOLLOWING ARTICLE WAS PUBLISHED MAY, 2000 IN THE DISABILITY JOURNAL - VISION ENHANCEMENT:

MEDICARE

APPEAL

VICTORY:

A National First

by XXXXX XXXXXX

Readers of this journal will recall a previous article (Spring 1999 issue) describing a talking scanner called VERA (Very Easy Reading Appliance) sold by Arkenstone.

Happily, I can report that in the Fall of 1999 a Medicare Administrative Law Judge ordered my HMO to provide me a VERA as treatment for my blindness.

Most vision loss consumers are aware that requesting Medicare coverage for an Assistive Technology (AT) device is a long-term project. Consequently, I want to share my success which marks the first time a vision related AT device has been judged to be both durable medical equipment and a prosthetic device.

For others who want to pursue a similar effort, a calendar of events for my Medicare appeal is detailed below. However, it is important for everyone to understand that I am sure I would not have won my appeal without the free legal representation was provided by the Oregon Advocacy Center.

Finally, to read the full text of my Medicare appeal victory, go to:

www.sightlosssolutions.org

- link #3, personal access,

assistive hardware AND medicare at hearings

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1. 11-24-1998: Submitted Request Letter & VERA Brochure To My Kaiser Permente Physician.

2. 11-24-1998: Physician Forwarded My VERA Request to the Kaiser Durable Medical Equipment (DME) Department.

3. 11-27-1998: Kaiser DME Department Denies My Request.

4. 12-2-1998: Submitted Appeal To Kaiser DME Department.

5. 1-21-1999: Kaiser Member Relations Department Denies My Appeal & Forwards My Appeal To the Medicare Center For Health Dispute Resolution. (CHDR).

6. 2-9-1999: CHDR Denies My Appeal.

7. 3-9-1999: Submitted Request For Medicare Administrative Law Judge (ALJ) Appeal Hearing.

8. 4-2-1999: CHDR Notification of To-Be-Scheduled ALJ Appeal Hearing.

9. 4-20-1999: Submitted Request For Legal Representation To Oregon Advocacy Center.*

10. 5-5-1999: Received Phone Notification From Oregon Advocacy Center They Will Accept My Case.

11. 8-31-1999: Medicare ALJ Appeal Hearing (XXXXXX vs. Kaiser).

12. 9-30-1999: Fully Favorable Decision Issued On Appeal Hearing (XXXXXX vs. Kaiser).

13. 11-2-1999: CHDR Sends Compliance Period Notification To Kaiser Permente.

14. 12-29-1999: Phone Notification From Kaiser DME Department That VERA Will Be Ordered.

15. 1-2-2000: CHDR Compliance Period Ends.

16. 1-11-2000: VERA Purchase Order From Kaiser Received By Arkenstone.

17. 1-28-2000: VERA Delivered To XXXXX XXXXXX By United Parcel Service.

18. Late 2000: Follow-up Article About Installation & Use of VERA.

*For referral to your region's agency who provides free legal services for disabled consumers, contact:

National Association of Protection and Advocacy Systems

900 Second Street, N.E., Suite 211

Washington, DC 20002

1-202-408-9514 - VOICE

1-202-408-9520 - FAX

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