posted
HUGE NEWS FOR THE LYME COMMUNITY!!! LDUC has announced that a precedent has FINALLY been set to force INSURANCE COMPANIES to cover LYME DISEASE Treatment!!! Read More...
CASE #09-CV-1039MCA GLIBOWSKI VS. U.S. OFFICE OF PERSONNEL MGMT.
History was made, and has set a precedent, for all Lyme disease patients in a lawsuit, in which attorney, William L'Esperance, a longtime part of the Lyme Disease United Coalition, has won a case where the Office of Professional Management (OPM), on the side of the insurance company, has been overruled.
The Lyme disease patient, in the lawsuit, submitted bills for hundreds of medical services, treatments, and tests. The court ruled that the Lyme disease patient wins the case without regard to the medical necessity of the patient; or whether the medical treatments or tests were medically necessary or experimental or investigative. The case is GLIBOWSKI VS. US OFFICE OF PERSONNEL MGMT., 09-CV-1039MCA (US DISTRICT COURT, DISTRICT OF NEW MEXICO).
The case is sealed. However, attorney William L'Esperance has filed the case and outcome with the United States Federal Courts to set precedence to aid all Lyme disease patients in lawsuits against their insurance companies, and OPM, for not covering the ILADS guidelines or Dr. Burrascano's guidelines in treatment of Lyme disease.
What does this mean to each of us?
1.The door has opened for Lyme-treating doctors to accept insurance -- once all is established in U.S. Federal Court.
2. You may now sue your insurance company for past bills not covered or reimbursed by insurance. The OPM cannot hold you back -- in other words, the IDSA's guidelines are no longer accepted.
To contact our hero, attorney Bill L'Esperance, e-mail: [email protected]
William L'Esperance, Counselor at Law P.O. Box 90668 Albuquerque, NM 87199
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William L'Esperance does not want to take on new clients. He is willing to be a resource for out-or-state attorneys handling similar cases.
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Please send notes of thanks to our hero, Bill L'Esperance.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96223 | From Texas | Registered: Feb 2001
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map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
Lord, let this be the truth for us. Help us to continue our fight with the powers that be that have lied, cheated and tried to destroy the Lyme ill community name/image of millions of ill folks for far to long.
Ours is the truth. Truth always comes out in the end.
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6478 | From Louisville, Ky | Registered: Jan 2002
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lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
Ditto what tutu said
I want tobe positive but when you've been here for awhile you learn that all new news doesnt end up being good...lets hope thistime it is
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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Ann-OH
Frequent Contributor (5K+ posts)
Member # 2020
posted
Since the case is sealed, it is nearly impossible to find more information about it. I hope it can be used as a precedent in other cases.
BTW the OPM is the Office of Personnel Management of the Federal Government. It does look like the judgement was not specific to Lyme disease.
" The court ruled that the Lyme disease patient wins the case without regard to the medical necessity of the patient; or whether the medical treatments or tests were medically necessary or experimental or investigative."
I hope some good journalist looks into this and writes an article.....
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Congrats to the patient who hung in there and had a victory! Must be a huge relief! Three thumbs up!
And to the attorney, my sincere appreciation!
We do need to be careful though with how we interpret this victory. The notice said...
"You may now sue your insurance company for past bills not covered or reimbursed by insurance. The OPM cannot hold you back -- in other words, the IDSA's guidelines are no longer accepted."
1. Ok. You can try to sue if you can find an attorney to take the case. There are, however, no assurances you will win. This is a New Mexico case which is sealed. Cases out of state (the courts) may consider the action and results if presented in a brief once it is filed in federal court, but it doesn't mean the State will consider it or base any rulings on it.
2. The OPM, as Ann-OH mentioned, can basically do what they want at any given time. Just as you or I can reference the ruling, so can they. They can keep fighting this one case at a time.
3. As far as the IDSA guidelines being "no longer accepted", well, actually they are. They are endorsed by HHS, CDC and other agencies as "the" guidelines. They can be referenced by insurers, doctors, hospitals, etc. and used against us as always. It would then be up to each person to make a case against them.
This ruling, if filed in the federal courts (few are accepted), will go a long way to assist us in the process.
And again, my sincere appreciation to those who helped with this case. It is a winner. Kudos!!!
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