December 2019 Newsletter


Welcome to our #MEAction Colorado newsletter.  We hope you find some valuable information in these newsletters.  If you want to contribute to our next newsletter or have comments and suggestions, please let us know. 

Our next newsletter will be February 2020.  We are taking January off.
 
Sincerely,

Lara Heisler, Editor   heisler.lara@gmail.com
Jim Lutey, Editor   jimlutey@gmail.com

  

MEAction of CO Meets with Colorado Department of Health


Last week I had a chance to meet with leaders from the Colorado Department of Health Care Policy & Financing.  The meeting was set up by a friend in the Colorado Don't Punish Pain group, who had caught the Department's attention.  We met with several people in the Department for over an hour and discussed our concerns related to the difficulties that people with chronic pain and/or chronic illnesses face with regards to getting care in Colorado.  The discussions had both ME-specific and pain-specific elements as well as general discussions of how the system so often fails people with chronic illnesses.  The people from the Department were very interested, listened intently and asked a lot of questions.

They will be including an article on ME in their newsletter.  The newsletter will call medical providers' attention to ME and ask them to use it as a differential diagnosis when considering people with the key symptoms.  They have a copy of the New York Department of Health's letter as an example to go from.

John Kelty, #MEAction, Colorado State Chair

 
My Patient Rights.org (mypatientrights.org) is a website inspired by actual patients who have experienced denials, delays, high out-of-pocket costs, out-of-network charges and other barriers to quality, affordable health care. The website can help patients with M.E.
 
STEP ONE-Notify Your Health Plan-file a formal complaint with your health plan.  
 
Here is an outline of the health plan review process and timelines:
*Filing a formal complaint over phone, letter, email or online through your health plan's website.
*If you disagree with your Health Plan's decision, you have the right to file an appeal within 180 days.
*A physician not involved in the original denial of care must review your appeal of denial. You must receive a decision in writing or electronically within 30 days.
*A second review is required if your first appeal is denied-with a meeting scheduled within 60 days. Your health plan must give a decision 7 days after that.
*Regulators allow an external appeal if the health plan denies your appeal a second time. The health plan must make a decision on external appeals within 45 days of the request's filing.
(Links to complaint forms for Colorado's top health plans are listed on the website)
 
STEP TWO-File a Complaint
 
You have the right to file a complaint with the Colorado Division of Insurance (DOI) if you have a problem getting the services you need, including quality and affordable health care. To file a complaint, you must first file an appeal with your health plan.
*File a complaint with the DOI
*Call the DOI helpline (800)930-3745
***The Chronic Care Collaborative-main purpose is to advocate, inform, and educate regarding health policy issues that affect people living with a chronic disease.  
 
In addition to filing a complaint with the Colorado Division of Insurance, we encourage you to share your story (mypatientrights.org). Sharing your story will help highlight recurring health care barriers that place other patients like you at risk. Both actions will help the CCC advocate to improve access to health care for all people in Colorado, especially the one in four Coloradans living with a chronic condition.
 
MEAction CO will help people through the process if they need.  Contact Pam Lutey at plutey@aol.com.  She will research your request and try to help.

     
 
The following information is quoted from the Colorado Consumer Health Initiative (CCHI) and is written from their point of view. 
 
The CCHI is a nonprofit, consumer-oriented, membership-based health advocacy organization that serves Coloradans whose access to health care and financial security are compromised by structural barriers, affordability, poor benefits, or unfair business practices of the health care industry.
 
Coloradans should not face financial hardship because they need access to health care or because they have received health care services. CCHI works to protect consumers from health care industry practices that jeopardize the health and financial security of Colorado families.
 
All Coloradans should have access to the health care they need, when they need it, and be able to afford it. While the Affordable Care Act has helped many Coloradans obtain health insurance, we know there are many that still struggle to access and afford the care they need because they cannot find a doctor or because the out-of-pocket costs are too high.
 
Structural barriers based on race, ethnicity, income, LGBTQ status, and age among others, prevent individuals from getting the health care they need and deserve. We work toward health equity by addressing systems of oppression and barriers that lead to disparate health outcomes.
 
CCHI's Consumer Assistance Program helps Coloradans who experience issues with their health coverage. We can help you navigate hospital financial assistance programs, surprise medical bills, health care denials, claims issues, and negotiating payment plans with doctors, clinics, hospitals and collections agencies. We can also refer you to health coverage enrollment assistance and to other basic needs programs like food and energy assistance. You can complete this inquiry form by clicking HERE and we will contact you.  
 
Check out CCHI's website HERE.  
 
MEAction CO will help people through the process if they need.  Contact Pam Lutey at plutey@aol.com.  She will research your request and try to help. 


ME International

 
 
ME International has updated their website.  Check it out  HERE.  
 
We would love for you to sign up as a member if you haven't already.  HERE is a link to the application.  There is no charge. 



Colorado advocates for people with Myalgic Encephalomyelitis, their caregivers and allies. Join our FB group MEACTIONCO.  Follow us on Twitter and Instagram @MeactionCO
  
 
 #MEAction Colorado
 
Disclaimer:  
 
Newsletter volunteers are NOT medical professionals; we are patients, allies and caregivers sharing our own experiences. What you do with the information offered is at your own risk and is your responsibility. Always try to work with a good doctor and/or medical professional and please consult him/her for your personal medical decisions. Please note that none of the information on this site has been evaluated by the FDA. It is shared for support and educational purposes only and is not intended to diagnose, treat, cure or prevent any disease or illness. Please do not make major changes in diet or exercise without discussing them with your physician and/or medical professional. Never begin taking any supplement without discussing it with your physician and/or medical professional, and never stop taking any prescription medications unless directed to do so by your physician and/or medical professional. The opinions expressed in this newsletter are those of the submitter and not of the newsletter volunteers or MEAction.