This is personal for Newt Gingrich.
The former House Speaker headlines this in Real Clear Wire: https://realclearwire.com/
Medicare’s Private Contractors Are Gaslighting Transplant Patients
Gingrich reveals:
“Once again, the government is getting between patients and their doctors to ration care – and it’s endangering my own family.
Due to rare a lung disease that runs in the McPherson side of my family, two of my siblings have had lung transplants. Further, my sister-in-law has had a liver transplant. When my brother Randy received his transplant four years ago at our local hospital, INOVA, he stayed at our house for months while he recovered. I have personally witnessed the physical and emotional journey of a loved one who needs a transplant – and the relief and joy of being given a second chance through the gift of a donated organ.
Randy’s lung transplant was successful, but we quickly learned it was just the beginning of his journey as a transplant recipient. The complexity and precision needed to keep his newly transplanted organ healthy was intense. Estimates indicate that more than 40% of lung transplants will fail within five years. This is most often due to organ rejection by the recipient’s immune system. Doctors must find a precise balance of immunosuppressive drugs to keep the body from attacking itself.
Fortunately, there are advances in molecular diagnostics that give doctors the ability to monitor the health of organs more effectively. This largely replaced the previous surveillance method, which includes costly, painful biopsies. Biopsies are invasive procedures that require recovery time and have complication risks. Before the non-invasive molecular tests were available, Randy might have had to endure eight to 16 invasive biopsies in his first year post-transplant. Now, he just has his blood drawn. Access to these non-invasive surveillance tests is vital for identifying organ injury or rejection. Rejection can occur without signs or symptoms, and detecting it early can help prevent irreversible damage. So, when I heard that coverage for these tests was being dramatically curtailed, I suspected a faceless, unaccountable bureaucracy was the culprit. I was right.
Earlier this year, one of Medicare’s private contractors dramatically limited coverage for these tests without any opportunity for public comment, which violated the Medicare statute. The decision was made by Palmetto, a private contractor that operates Medicare’s Molecular Diagnostic Services Program (MolDX), with opaque accountability and oversight from the Centers for Medicare and Medicaid Services (CMS).
Doctors were given 30 days’ notice that they would be left without this critical surveillance tool to help manage organ rejection. Patients, such as my brother Randy, are left wondering if they will be able to protect their transplanted organ.
The Honor the Gift coalition, comprising 13 patient organizations such as the Lung Transplant Foundation, Transplant Life Foundation, and Transplant Recipients International Organization, alongside physician organizations like theAmerican Society of Transplant Surgeons, American Society of Transplantation, International Society for Heart and Lung Transplantation, have written to the government to advocate for this cause. Regrettably, their appeals have been met with silence. They have had to turn to the public and Congress for assistance.”
If there is anybody Medicare’s private contractors should not want to tangle with it would seem the former Speaker would be that person.
Stay tuned.
