Monday, 3 January 2011

No Military Insurance Coverage for New Brain Injury Treatment

A move by the U.S. military's health insurer to deny insurance coverage for a promising new brain injury treatment is being criticized by California brain injury lawyers, veterans groups and advocates for military families. Tricare, the U.S. military’s health insurer, is refusing to cover the costs of cognitive rehabilitation, a proven brain injury treatment that has received widespread support from doctors and lawmakers.

A Tricare management study claims the treatment is far too expensive and time-consuming. According to Tricare, the treatment requires intensive one-on-one help for patients who have suffered a brain injury in order to help them relearn basic skills. The cost of a treatment program can be up to $50,000 for a four-month program. According to Tricare, cognitive rehabilitation therapy can be covered when it is included in other treatment programs, but not when it is billed as a separate and distinct treatment program.

In 2008, several legislators sent a letter to Defense Secretary Robert Gates, encouraging Tricare to provide coverage for cognitive rehabilitation therapy. In fact, the therapy has strong support on Capitol Hill, and there is a special congressional Brain Injury Task Force, which has strongly supported the therapy. The treatment has also received widespread support from military doctors, who have also recommended to the Defense Department that the insurer cover cognitive rehabilitation therapy as a separate and distinct treatment method for brain injury patients. However Tricare insists that the treatment is scientifically unproven.

To many doctors and California brain injury lawyers, this seems like an effort by the military insurer to control costs, rather than an accurate statement on the scientific validity of this therapy to improve cognitive abilities and encourage independent functioning. The specific benefits of this treatment includes advanced problem-solving abilities, better attention span, increased memory and better grasp of visual spatial relations. The therapy has proved to be especially useful in teaching vets with a brain injury to relearn basic functions.

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