Migraine Remains a
Reimbursable Medical Condition

Medical News / Health Line

WESTPORT, Sep 05 (Reuters) - Severe pain, including acute migraine, is included as an "emergency medical condition" in the Balanced Budget Act of 1997. Thus, emergency department visits for migraine by Medicare and Medicaid beneficiaries remain reimbursable events, Michael John Coleman, Executive Director, and founder of the Migraine Awareness Group: A National Understanding for Migraineurs (MAGNUM Inc.), told Reuters Health.

The nonprofit educational group, based in Alexandria, Virginia, worked with House and Senate Offices and organizations such as the AMA and AASH to convince legislators not to delete the "severe pain" definition from the Balanced Budget Act, which was recently signed into law. "If they didn't retain 'severe pain' in the prudent layperson definition of an emergency condition," Coleman said, "it would have created a loophole for health plans to deny coverage to Medicare and Medicaid beneficiaries who, in severe or profound pain, take a reasonable decision to seek emergency medical care."

MAGNUM recently drafted legislation to have migraine added to the federal list of impairments, thus facilitating the settlement of disability claims for intractable migraine, Coleman told Reuters Health. In most states, it takes up to two years to settle this type of case, he explained, because state review boards look to the federal list for conditions not included in state laws. If the condition is not listed, "people have to go through a 5-tier system of courts and judges" before a decision is made--a costly and time-consuming process. To get around the problem, "we've shown that migraine and epilepsy are related, and on that basis, the disability cases go through."

The group also intends to increase migraine awareness among physicians and consumers through presentations of migraine art (Coleman is an artist) and other educational projects. The group has received grants from various pharmaceutical companies, including Zeneca, Merck, Glaxo Wellcome, Bristol-Myers Squibb, Novartis Pharmaceuticals, and Carnrick Labs, and from local Businesses.

For more information, contact MAGNUM at (703) 349-1929, or visit their web site: http://www.migraines.org. -Westport Newsroom 203 319 2700

REUTERS

Copyright ~ 1997 Reuters Limited.

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