a two-fer

This week started normally. Peggy and I recorded our “standard” weekly podcast, which focused on explaining the alphabet soup of organizations whose work directly and indirectly affects people with limb loss/difference. These include entities that certify the prosthetists who treat us, accredit the facilities in which we receive that care, and devote significant time to prosthetic research and legislative initiatives.

Straightforward, right?

Then, late Monday afternoon, House Republicans released The American Health Care Act, the first step in following through on their promise to “repeal and replace” The Affordable Care Act. We read through the 120+ pages and recorded a new “special alert” podcast Tuesday evening that went live immediately afterwards. In it, we explained what The American Health Care Act would do and how it would directly affect people with limb loss/difference. We also issued a new call-out to our amp’d Activists to again reach out to their legislators to express their thoughts about this new proposal and created updated model letters for amputees and their relatives/friends to personalize and send to their Congressional representatives.

Both podcasts address issues of importance to amputees. If you’re not already subscribed to our iTunes or other podcast feeds, you can visit www.ampdpod.com to listen to them and download our Podcast Summaries. (We’ve now embedded podcast players into the site so you can listen to us without having to leave ampdpod.com.) And whether you’re an amputee yourself or a family member/friend of one, please visit the Current Issues section of our website to directly engage with your elected officials. Your voices matter. A lot. So speak.

the ADA explained

 

In this week’s amp’d podcast, Peggy and I take on a law that affects every person with limb loss/difference every day: The Americans With Disabilities Act. The post arose out of questions sent to us by one of our listeners, a bilateral amputee who sometimes uses a wheelchair at college.

In this discussion, we provide a summary of how the ADA protects all people with disabilities (including amputees), take a close look at those portions of the law that have the biggest day-to-day impact on us, and share information about which governmental agencies you should contact if you believe an ADA violation has occurred.

Nearly as important, Peggy and I take a small step towards podcast professionalism with the inclusion of (gasp) intro and outro music on the podcast. The composer of this stunning piece is none other than Max McGill, whose creative juices are apparently in full flow coming off a week spent in early January recording his band’s new EP (stay tuned for more on that in the future). Enjoy!

i don’t know why you say goodbye i say hello

As I opened my computer this morning and typed in my password, I realized that I hadn’t authored a single less is more post since September. That realization upset me. Writing this blog has always been a passion project. Every post – whether I personally loved it or not after hitting “publish” – means something to me. But I sputtered and stalled in 2015. After writing 40-45 posts a year for several years in a row, I fell off the writing wagon for large portions of the last 12 months.

As we head into 2016, I hope to return to the older pattern, posting once a week for most of the year. In the interest of getting reacquainted in the meantime, allow me to revisit 2015 with the “less is more Top 10 of 2015.”

10. The Beatles hit Spotify

Technically, this hasn’t even happened yet. But as of December 24 at 12:01 AM, the entire Beatles catalog will find its way to Spotify and other music streaming services. For those of you who dismiss this as “old music for old people,” or ask, “what’s the big deal?” allow me to share the following story.

My son, Max, had serially shrugged off every suggestion I made about the importance of listening to The Beatles. Last Christmas, armed with a few hundred dollars of iTunes gift cards, he took the plunge and bought their entire catalog. In early January he pulled me aside.

“I listened to The Beatles, everything.” He paused. “[Expletive deleted.] You were right. They’re [expletive deleted] great.”

Score 1 for the old guy.

If, like Max before this year, you’ve never “gotten” The Beatles, you have to give it a shot now. Here are the 5 albums you must start with: Help; Rubber Soul; Revolution; Sgt. Pepper’s Lonely Hearts Club Band; and Abbey Road. You’ll thank me.

9. i can still get nervous before speaking in public

MAC Public Hearing

Peggy Chenoweth and Your Humble Author at the Public Hearing

I spend so much of my professional life speaking to audiences of varying sizes that I’m largely immune to nerves. But that wasn’t the case this past August when I spoke for 6 minutes at a public hearing focusing on proposed changes to coverage, coding, and clinical care for Medicare beneficiaries. (See also, #1, below.) I haven’t been that nervous in years. Why? Because that speech, more than almost anything I’ve ever delivered, felt like it mattered.

8. college looms

The fact that in 2015 Max received his driver’s license and now has submitted applications to college is one of the great mind-benders of my adult life. The fact that 17 years have passed and he’s on the verge of starting a new phase of his life is something I still can’t fully comprehend. I can’t even write about it in a coherent way.

Anyway, it’s bizarre. And I’m happy for him but completely freaked out.

7. Amp’d ramps up

Peggy Chenoweth, my partner in crime and co-host of the Amp’d podcast, texted me two months ago. “Do you know how many people listen to our podcast?” As a proud web analytics agnostic, I quickly responded, “Nope.” When she gave me the number I couldn’t respond for a moment. The fact that for a given topic we have more than 11,000 people listening to us ramble is simultaneously thrilling and daunting.

Peggy and I have made a commitment that we’re going to try to increase our podcasts to a weekly (or near-weekly) frequency moving forward. Let me in advance apologize for the times we don’t meet this goal, because it’ll be entirely my fault and likely due to my travel schedule. But much more Amp’d to come in 2016! (In this case, more is more.)

6. Cheap Shots releases its first EP

Cheap Shots EP

Cheap Shots EP

Just as important as The Beatles catalog becoming available to streaming services was Cheap Shots’ release of its first EP in October. After losing his lead guitarist and bassist to college at the end of this summer, Max formed this new group. (He and I spent the better part of two weeks in Aruba tossing potential new band names around. Discarded names included Illysium and Kooster’s Last Stand, among roughly 830 others.)

Cheap Shots has played regularly through the fall and into the early winter, including a stellar gig at Webster Hall in New York City right before Halloween. The EP, The Things That Keep Me Up Late, is a blistering set of melodic pop-punk/rock tunes with a gorgeous acoustic ballad (“One More May”) thrown in for good measure. If you’re unwilling to submerge yourself in the Beatles discography, then commit to Cheap Shots instead. Actually – commit to them either way. If you want to hear soaring melodies and poignant lyrics that come right from Max’s heart, you’ll love Cheap Shots.

5. everything is impermanent

Back in March I wrote about the unexpected death of Phil Kreuter, my friend and the physical therapist who trained me to walk again after I lost my leg. Phil wasn’t old – only in his mid-50’s – but suffered a massive stroke that led to his death shortly thereafter. It shouldn’t take the passing of important people in my life or the near-misses in my own to remind me just how important it is to respect the time we do have on this planet with the people around us. But invariably, it does.

Be aware. Don’t sleepwalk through everything. We only get to climb on this roller coaster once, so enjoy the ride.

4. i have 3 amazing kids

In July, Cara unexpectedly wound up in the hospital for a week while we were in Aruba. It was a serious situation – she was admitted to the ICU, initially – and I suddenly had to spend the majority of my time in a foreign hospital. While she responded to treatment quickly and got out with enough time to enjoy the second week of our vacation, I had to depend on all of my kids in ways none of us could have planned for.

They were all, in their own ways, amazing. When everything around them was going to hell, they supported each other, me and Cara. I couldn’t have gotten through that week without them there. I don’t remember a lot of what happened over those 5 days, but I distinctly recall sitting with my kids around a dinner table and telling them how proud I was. “When the chips are down, families are supposed to pull together and look out for each other, no matter what,” I said. They did that and then some. Thanks Max, Jackson and Caroline!

3. your humble author cries

Eastman Theater

Eastman Theater

I’m not particularly emotional. But earlier this month, Max performed as a member of New York’s All-State Chorus. This is an honor afforded to less than 300 students in the entire state, all of whom qualify based on a formal vocal audition. As I sat in the packed Eastman Theater in Rochester and listened to the songs, I began to quietly cry.

It hit me that Max was moving on (see #8, above) to new opportunities in less than a year. I realized that while I’ll still be his father and always part of his life, I’ll be losing him, to some extent. The thought of 2:30 PM rolling around and Max not walking through the door to shoot the breeze with me about his day at school and the music he’s working on or listening to hit me hard.

In that moment I was filled with equal parts pride and sadness. Prediction: I’ll be a total mess when he leaves for college. Thank god for Skype.

2. New York’s one-limb-per-life restriction overturned for 2016

As an amputee living in New York, I found it particularly galling that amputees paying premiums for plans purchased through the state’s insurance exchange were subject to a 1-prosthesis-per-limb-per-lifetime restriction. As President of the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), I helped support an effort driven largely by a friend and fellow amputee, Dan Bastian, to get that restriction changed.

First the good news: the Director of NY’s exchange added language that requires insurers to additionally cover prosthetic repairs and replacements beginning January 1, 2016. Now the bad news: it’s not clear that this language will carry over into 2017. Additionally, even though the NY House of Representatives unanimously supported a permanent legislative fix that would cover prosthetic devices whenever medically necessary, the Senate refused to bring that bill to the floor for a vote.

So there’s still work to do in NY in 2016, but at least amputees in my home state requiring prosthetic repairs or replacements during the next 12 months will get them.

1. amputees successfully thwart proposed national coverage changes

We the People Petition

We the People Petition

I won’t belabor the point since this was the subject of virtually all of my posts and Amp’d podcasts from August of this year on. Medicare’s contractors published a draft local coverage determination that would have fundamentally changed prosthetic clinical care, coding, and costs if implemented. NAAOP launched a successful campaign that led to 110,000 signatures in 30 days on a petition requesting that the White House instruct Medicare to rescind the draft document.

In October, the White House and Medicare issued joint statements saying that the proposal would be shelved for now in favor of a federal workgroup tasked with analyzing current prosthetic best practices. While we will continue to need to fight over the coming year to make sure that the workgroup possesses complete and accurate information, the decision not to implement a policy that would have returned prosthetics to an average standard of care worse than what I experienced as a new amputee in 1996 was a huge win for amputees across the United States.

It shows how powerful we can be when we speak together with one voice. Here’s hoping there’s much more of that to come in 2016.

big changes loom: what you can do!

It’s a big week for lower limb amputees. The Medicare contractors who published the draft rule affecting (1 ) how amputees receive clinical care, (2) which prosthetic components Medicare will cover, and (3) coding of different prosthetic devices are holding a public hearing tomorrow. In addition, comments in response to this proposed rule are due on Monday, August 31st. If you’re reading this saying, “I’m not on Medicare, so this doesn’t affect me,” think again. Medicare’s coverage requirements form the basis of every major private insurance company’s approach to coverage, so if these changes get implemented, your insurance company will likely adopt them within 12 months!

For the lowdown on what the amputee community has accomplished so far, what’s happening over the next 6 days, and what you can do to make your voice heard, listen to our new Amp’d podcast, fresh off the aural press.

what if … you couldn’t get a prosthesis?

less is more 05.01.15

What if you lost your arm or leg and required a prosthesis? What if you had insurance when that happened? What if that insurance covered the cost of your amputation surgery? What if you left the hospital and looked forward to reclaiming your life with the help of a prosthesis? What if you visited a prosthetist 4-6 after becoming an amputee and were told that your insurance would cover only your initial prosthesis … or no prosthesis at all?

Several states – New York, Alaska, Nevada – either restrict prosthetic coverage to one prosthesis per limb per lifetime (NY) or don’t offer it at all (AK, NV) in plans available on their insurance exchanges. In this month’s Amp’d, The Amputee Mommy and I discuss the advocacy efforts underway in NY. We explain the underlying issues and what amputees can do to make their voices heard.

I was lucky enough to directly participate in some of those efforts in my capacity as President of the National Association for the Advancement of Orthotics and Prosthetics. (For more information about NAAOP generally and how to become a member/support the organization, please click on the link under the heading “Blogroll” on the upper left-hand portion of this webpage. NAAOP needs your support to engage in these kinds of efforts!) And, because like all advocacy efforts, things change fast, I’m happy to have a bit of an Amp’d spoiler alert.

The head of the New York State Senate’s Health Committee, Kemp Hannon, authored a letter just two days ago to the Executive Director of the New York health insurance exchange requesting that she eliminate the one prosthesis per limb per life restriction in that state’s benchmark plan. (When Peggy and I recorded our podcast, this had not yet happened. Click on the following link to read Senator Hannon’s letter: Hannon 1L4L Letter 04.28.15.) Special thanks to Senators John Bonacic, Andrew Lanza, Kenneth LaValle, Jack Martins, Mark Panepinto, and Michael Venditto as well, all of whom joined with Senator Hannon’s call for eliminating the one prosthesis per life restriction.

It’s an important step in the New York State advocacy effort, but it’s only the first step. We have just learned that the deadline for NY to make changes to the benchmark plan is only 30 days away, so much work remains to be done if we are to give NY amputees access to prosthetic devices in 2016.

If you haven’t already signed the petition requesting that NYS legislators take action regarding this issue, join the more-than 13,800 people who have already done so.

Access to qualified prosthetic care is a basic health care right for amputees. For many, it is the difference between living independently or requiring full-time assistance; between living an unhealthy, sedentary lifestyle or a healthy, active one; or between being forced to sit at home and depend on the government for support or rejoining the workforce.

In this month’s Amp’d, learn the dangers of taking this right for granted and how to make sure every amputee has the same opportunity to live a productive, active, healthy life.

P.S. The Amputee Mommy is getting in on the advocacy action as well, as she testifies in Washington D.C. today! Click here to read her pre-testimony post on the subject.

the second age

the second age 1.29.15

Lo, many fortnights ago, The Amputee Mommy and the Bionic Blogger uttered words of humor and power, speaking towards electronic sheafs lit with the glow of 10 incandescent moons. They spoke of bygone months, an epoch that saw the accumulated wisdom of an oral history bearing the name Amp’d slide into the mists of time until those who once knew of it remembered only its wisps and tendrils.

Verily, The Amputee Mommy uttered words of childbirth and disease, while the Bionic Blogger offered soliloquies about payment for services provided by the followers of Hippocrates and his travails upon a lighted stage with 6 and 5-stringed instruments. And then … this record too, slipped into the past, forgotten on these pages as if it had never existed. The cold nights of autumn receded as the harsh chill of winter and the icy accumulations of its residue cloaked the northern regions.

When suddenly, breaking through the hoar-frost like a spear through the finest silk, The Bionic Blogger received a magical link from The Amputee Mommy, a divine tool that brought back those words from the month derived from the Latin, “novem,” restoring them to their full glory of two moon cycles past. The Bionic Blogger fell to his knees and wept. That which he had thought lost now was found, and with it, the purpose that had dimmed to a flicker in his heart surged out of him like a thousand suns, and mortal men averted their gaze he shone so brightly.

He lifted his hands and his fingers gently alit over the backlit runes known as QWERTY, so that all people of the world could hear The Words, and pass their message down through the generations.

The Second Age of Amp’d had begun. (Click here.)

what if … you could win an insurance appeal?

less is more 02.18.14

What if your insurance company denied your claim for a new prosthesis? What if that happened and you happened to co-host a podcast about issues facing amputees? What if the denied claim discussed in this podcast included a request from the insurance company that was so inappropriate that even I was taken aback?

Well, with that background in place, this podcast is a must-listen for everyone. In the first of a multi-part series, the Amputee Mommy and I discuss her recent claim denial and strategies for overcoming it. Click here, and enjoy!