JustRalph
08-21-2004, 03:14 AM
This sucks..........in an industry with so much money flowing through it.........why does this still happen?
Injured Jockey Birzer Struggles With Rehabilitation Costs
by The Associated Press
Date Posted: 8/20/2004 12:56:41 PM
Last Updated: 8/20/2004 12:56:41 PM
A former jockey paralyzed in a racing accident at West Virginia's Mountaineer Racetrack & Gaming Resort is now struggling with how to pay for rehabilitative services.
Gary Birzer's spinal cord was severed on July 20 when his horse tripped and another horse fell on top of him. He is now a quadriplegic.
Since the accident, West Virginia Delegate Joe DeLong (D-Hancock) has been trying to help the 28-year-old Hancock County resident obtain Medicaid coverage for his rehabilitation costs. Acute rehabilitation services are not covered by Medicaid for anyone over the age of 21 in West Virginia as they are in neighboring Ohio and Pennsylvania.
"If he lived five minutes away across the border, he wouldn't be having this problem,'' DeLong said. "West Virginia is the only state around us that does not recognize acute rehabilitative services.''
West Virginia's Medicaid plan only covers services reimbursed by the federal government on a 3-to-1 basis. The state receives $3 in federal money for every $1 it spends, said John Law, a spokesman for the state Department of Health and Human Resources.
"If we paid for it, not being in our state plan, it would be all state dollars,'' Law said.
Law said the current state Medicaid budget is about $1.5 billion. It covers about 400,000 people on average.
"We have made $30 million worth of cuts, and it still grows every year,'' Law said.
Since his accident, Birzer has been receiving medical care at the University of Pittsburgh Medical Center. Kelly Cahill, a clinical social worker at the hospital, has been Birzer's case worker.
Cahill said Birzer was moved Wednesday to the hospital's rehabilitation complex to receive four weeks of inpatient acute rehabilitation. She said the hospital is providing the services even though they may never be covered by Medicaid.
"If this accident had occurred in Pennsylvania, we would not be going through this conversation because Medical Assistance of Pennsylvania covers rehabilitation services,'' Cahill said. "West Virginia works by the minimum standards. They only provide the minimum of what they can get away with.''
DeLong said he has asked Gov. Bob Wise to try to get an exemption for Birzer.
While DeLong said at least three exemptions have been awarded in the past, Law said he had no knowledge of that ever being done.
Birzer could qualify for a more limited form of rehabilitation in a nursing home under West Virginia Medicaid guidelines, but even that has a catch. He would have to divest himself of most of his family's assets to reduce them to a value of $2,000 before Medicaid would provide such coverage.
Birzer has a wife and a 2-year-old daughter. They live in a mobile home and have assets worth about $23,000, DeLong said.
"You end up with a family that is forced to be down-and-out and dependent on government programs,'' DeLong said.
Injured Jockey Birzer Struggles With Rehabilitation Costs
by The Associated Press
Date Posted: 8/20/2004 12:56:41 PM
Last Updated: 8/20/2004 12:56:41 PM
A former jockey paralyzed in a racing accident at West Virginia's Mountaineer Racetrack & Gaming Resort is now struggling with how to pay for rehabilitative services.
Gary Birzer's spinal cord was severed on July 20 when his horse tripped and another horse fell on top of him. He is now a quadriplegic.
Since the accident, West Virginia Delegate Joe DeLong (D-Hancock) has been trying to help the 28-year-old Hancock County resident obtain Medicaid coverage for his rehabilitation costs. Acute rehabilitation services are not covered by Medicaid for anyone over the age of 21 in West Virginia as they are in neighboring Ohio and Pennsylvania.
"If he lived five minutes away across the border, he wouldn't be having this problem,'' DeLong said. "West Virginia is the only state around us that does not recognize acute rehabilitative services.''
West Virginia's Medicaid plan only covers services reimbursed by the federal government on a 3-to-1 basis. The state receives $3 in federal money for every $1 it spends, said John Law, a spokesman for the state Department of Health and Human Resources.
"If we paid for it, not being in our state plan, it would be all state dollars,'' Law said.
Law said the current state Medicaid budget is about $1.5 billion. It covers about 400,000 people on average.
"We have made $30 million worth of cuts, and it still grows every year,'' Law said.
Since his accident, Birzer has been receiving medical care at the University of Pittsburgh Medical Center. Kelly Cahill, a clinical social worker at the hospital, has been Birzer's case worker.
Cahill said Birzer was moved Wednesday to the hospital's rehabilitation complex to receive four weeks of inpatient acute rehabilitation. She said the hospital is providing the services even though they may never be covered by Medicaid.
"If this accident had occurred in Pennsylvania, we would not be going through this conversation because Medical Assistance of Pennsylvania covers rehabilitation services,'' Cahill said. "West Virginia works by the minimum standards. They only provide the minimum of what they can get away with.''
DeLong said he has asked Gov. Bob Wise to try to get an exemption for Birzer.
While DeLong said at least three exemptions have been awarded in the past, Law said he had no knowledge of that ever being done.
Birzer could qualify for a more limited form of rehabilitation in a nursing home under West Virginia Medicaid guidelines, but even that has a catch. He would have to divest himself of most of his family's assets to reduce them to a value of $2,000 before Medicaid would provide such coverage.
Birzer has a wife and a 2-year-old daughter. They live in a mobile home and have assets worth about $23,000, DeLong said.
"You end up with a family that is forced to be down-and-out and dependent on government programs,'' DeLong said.