On the recordJune 18, 2015
Let me take a couple of minutes to explain why Americans fear the Independent Payment Advisory Board, as it meddles with their health care. As I stand here today, I will tell you that I am a physician, and I can tell you what is already taking place within private insurance with these peer reviews when you recommend something. I recommended an MRI to a patient. That afternoon, I get on the phone. The woman says: I have had a problem for 10 years. I have had cortisone injections, physical therapy, blah, blah, blah. I said: You need an MRI. I am being denied the MRI by the insurance company because I have only seen her once. And I said to the gentleman, the doctor on the phone: How many times have you seen her? None. I said: What State do you have a license to practice in? Not Ohio, which is where we were. And so I said: Tell me your specialty. My specialty is foot and ankle. This woman was in for a foot problem. He said: I am an emergency room doctor. I said: Well, then you would refer her to a specialist, which is where she is today. He said: Well, I am not going to let you get that MRI. I said: I hope this call is monitored for quality assurance, because I want someone to hear what you said to me today. And then I asked the patient if she would go to her HR director and call the insurance company and say: We are going to drop the insurance because you are not letting the patients get the care their doctor recommends. And then we got it.…
Source
govinfo.gov




