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Posted on 4. January 2018

Is Autoimmune Disease a Disability?

By Holly Bertone

Is autoimmune disease (AI) a disability? This is the million-dollar question.

The short answer is if your AI is protected by certain conditions under the Americans with Disability Act (ADA) then you are protected under the law. The long answer is it's a lot more complicated. First, I can't tell you how many individuals I've spoken with who have AI who do not view having one as a disability. Some of these people are able to manage their conditions and live productive lives without any issues, while others are too proud to consider themselves disabled.

It's a double-edged sword. The word “disability” sometimes has negative connotations in our society of someone who is not able to perform or function. One of the challenges of having AI is the common occurrence of people saying, “But you don't look sick.” If you are able to work full time but still need accommodations, your manager or company may not understand the connection. Or, you may not view yourself as having a disability, especially compared with someone with a more visible disability. It's a change in mindset and education.

Back to the law: The ADA was amended in 2008, and went into effect Jan. 1, 2009. If AI was ever blurry under the law, this amendment added a new category of major life activities called “major bodily functions,” which specifically includes the endocrine and immune systems.

According to section 4, part 2b, of the amendment titled Disability Defined and Rules of Construction, “a major life activity also includes the operation of a major bodily function, including but not limited to functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions.”

It doesn't matter how you feel about being considered disabled. It certainly doesn't matter if your employer wants to acknowledge your disability. The language of the law is crystal clear: If you meet the required conditions under the ADA, you are legally protected by it. According to www.ada.gov, “If you have a disability and are qualified to do a job, the ADA protects you from job discrimination on the basis of your disability.”

This article is shared by Holly Bertone, CNHP, PMP, president of Pink Fortitude, a health and wellness site, and author of the No. 1 Amazon bestselling book Thriving in the Workplace with Autoimmune Disease: Know Your Rights, Resolve Conflict, and Reduce Stress. Bertone, a breast cancer and Hashimoto's survivor, turned these two significant health challenges into a passion to help others. She inspires others with her quick wit, brutal honesty and simple ways to be healthy in real life.

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IG Living Blog | A National Increase in the Demand of Immune Globulin: A Statement from IG Living Magazine
IMMUNE  GLOBULIN  COMMUNITY
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Dedicated to bringing comprehensive healthcare information, immune globulin information, community lifestyle and reimbursement news.

Posted on 12. September 2019

A National Increase in the Demand of Immune Globulin: A Statement from IG Living Magazine

By IG Living Magazine

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Since the U.S. Food and Drug Administration approved the first intravenous immune globulin (IVIG) product in 1981, IG has experienced a sustained record of near-continuous demand growth. More than 35 years after they were first introduced, demand for IG products continues to grow more than 8 percent a year. In 2018, as it has over each of the past several years, demand for IG products grew by more than 7 million grams. Collectively, IVIG and subcutaneous IG (SCIG) product shipments last year approached 88 million grams.

Even though there are currently 15 IG products available today, this demand growth nevertheless poses two special challenges for IG manufacturers: 1) they must forecast and invest in plasma collection facilities to ensure sufficient additional donor plasma is available to process into IG products, and 2) they must plan, invest and provide adequate lead time to construct and secure regulatory approval to operate new or expanded fractionation (how plasma is manufactured into IG products) and related IG production facilities.

IG manufacturers are making every effort to address these issues. In fact, every major plasma fractionator is investing in new production capacity, and manufacturers are producing IG products at top capacity. In addition, some new products are coming to market this year, and one that was removed from the market is being reintroduced. It is hoped these efforts will help to better meet demand in the near future.

If you are a patient who has been told future treatments with your brand of IG will not be possible, here are some steps you can take:

  1. If being treated in the home, ask if there is another brand to which you can switch. If no product is available, talk to your ordering physician about another homecare provider.
  2. If being treated in a physician's office, ask if there is another brand to which you can switch. If no product is available, look for other sites of care. Specifically, check with the hospital where your ordering physician has privileges. Or, check with a homecare provider.
  3. If being treated in a hospital outpatient infusion center, go back to your ordering physician and ask about another outpatient center. Or, check with a homecare provider.
  4. Consider exploring the subcutaneous route of infusion if it makes sense for your condition.

Patients can also contact our patient advocate Abbie Cornett acornett@igliving.com for assistance.

 

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Janiece Durham
7:17 AM on Friday, September 13, 2019

I tried to email to Abbey Cornett & it states email is invalid

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IG Living Blog | Follow the Profit
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Dedicated to bringing comprehensive healthcare information, immune globulin information, community lifestyle and reimbursement news.

Posted on 12. May 2011

Follow the Profit

By Kris McFalls

Physician-owned medical facilities are often criticized as an unethical way to raise profits and increase the cost of healthcare. Critics from public-owned facilities, government and insurance companies, cry foul saying physician-owned facilities are motivated by profit and, as a result, use their facilities to cherry pick the well-funded patients. The fact is, however, those same critics are often guilty of the same infractions. The difference is when the government and insurance companies do it; they take away patient choice, which some patients would argue leads to less competition, a lower quality of care and, in some cases, higher healthcare costs.

One example of this is of a patient with common variable immune deficiency (CVID) in the state of Michigan. Her insurance company gave her no choice but to attain her subcutaneous immune globulin (SCIG) product from its company-owned specialty pharmacy. Because of the lack of competition, the specialty pharmacy was not compelled to offer a charity care program or a way to pay down her debt on a monthly basis - as is common with privately owned specialty pharmacies. The patient soon accumulated $1,000 in debt. As a result, the specialty pharmacy refused to ship any more product until the debt was paid in full, even though at the time of the order, she had reached her yearly out-of-pocket maximum. That meant all future shipments would have been covered at 100 percent and the patient’s debt would not have increased.

The patient, then, was forced to stop her treatments. Not long after, she contracted a severe case of pneumonia requiring hospitalization. The same insurance company paid 100 percent of the $75,000 hospital bill. Regardless, even after discharge, the specialty pharmacy still refused to send the patient her SCIG. In order to receive treatment outside of the insurance-owned specialty pharmacy, this patient was forced to go back to the more expensive, clinic-based, intravenous immune globulin (IVIG) treatments. This allowed her to receive treatments at a facility that would work with her on the out-of-pocket costs. Once this patient returned to regular treatments, her health improved and she was able to avoid hospitalizations and severe infections.

In another example, the New York state attorney general accused insurance companies of defrauding patients by manipulating reimbursement rates. As it turned out, insurance companies owned the third-party companies that were tasked with determining usual and customary rates. Those rates were then used to determine how much patients were reimbursed for out-of-network charges. Insurance companies were accused of defrauding doctors and patients out of millions of dollars. Other states and the American Medical Association followed New York’s lead and filed lawsuits. Many cases have since been settled resulting in multi-million dollar settlements.

Politicians have their hand in the cookie jar as well. Healthcare reform and the advent of Medicare drug plans stimulated research that revealed many politicians owned stock in pharmaceutical companies that would benefit from legislation being considered. Therefore, if the companies profited from regulations, so did the politicians. Some politicians soothed their guilt by placing stocks into a blind trust so they didn’t know exactly which drug company stock they truly owned. Surely, voting for laws that would benefit themselves financially had nothing to do with the increased cost of healthcare.

There is no easy solution to any of these problems. At the end of the day, healthcare is still a business and there will always be healthcare decisions based on profits. It is also true that patients clearly benefit when there is competition in the marketplace. Maybe the solution lies more in the transparency of the details than the details themselves?

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IG Living Blog | Will Justice (and the Justices) Prevail?
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Dedicated to bringing comprehensive healthcare information, immune globulin information, community lifestyle and reimbursement news.

Posted on 8. March 2012

Will Justice (and the Justices) Prevail?

Ronale Tucker Rhodes, MS

On Monday, U.S. Health and Human Services Secretary Kathleen Sebelius kicked off National Consumer Protection Week by reminding Americans about their health insurance rights under the Affordable Care Act. The question is: Will these rights remain? Or, will some or all of them be taken away just as many of the benefits of this Act begin to take effect?

No doubt, many patients - especially those with a chronic illness - are eagerly awaiting the fate of this Act on two fronts. The first will be the decision by the U.S. Supreme Court about whether the federal government has overstepped its powers to force people to buy health insurance. The court is scheduled to hear oral arguments this month, and is expected to issue its ruling in June. If the court does in fact rule that mandatory health insurance is unconstitutional, will the rest of the Act remain in effect? It is believed by many legal experts that the vast changes put into effect to date such as tougher oversight of health insurers, the expansion of coverage to young adults and more protections for workers with pre-existing conditions will persist no matter what the court’s ruling.

The second will be the 2012 presidential campaign. If the U.S. Supreme Court decides in favor of the Act’s constitutionality and Mitt Romney beats President Obama in the 2012 presidential race, will Romney veto the Act? While Romney’s campaign speeches have been designed to appeal to the conservative voters, let’s not forget that he enacted the Massachusetts healthcare law that has striking similarities to the Affordable Care Act. And, then, there’s public sentiment. A Gallop poll taken at the end of 2011 found that most Americans believe that it’s the “federal government’s responsibility to make sure all Americans have healthcare.” That poll also found that while the majority of Americans oppose the Act, they support its provisions - the individual requirement and a private system of insurance (state-based exchanges that will offer private coverage).

Whether one is in favor of the Affordable Care Act or not, it’s difficult to deny that many of its provisions have proved and will prove to be good for consumers. As Sebelius reminds us:

  • Children can no longer be excluded from coverage because of a pre-existing health problem.
  • Most young adults can stay on their parents’ insurance policies until age 26.
  • Adults with pre-existing conditions can seek coverage from the new Pre-Existing Condition Insurance Plan.
  • In 2014, new Affordable Insurance Exchanges will provide all Americans with access to affordable, high-quality coverage.

Americans spend more on healthcare coverage than those in any other country on just about every medical procedure and doctor visit, according to a new report from the International Federation of Health Plans. Despite decades of efforts by Democrats for universal access to health insurance, one major fact sets this Act apart from all others that have been proposed: Employers, business groups and insurance companies all admitted to the need to deal with the relentless rise in healthcare costs, and they came to the negotiating table.

Will justice prevail? What do you predict?

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Betty
2:10 AM on Friday, March 09, 2012


I look at this word affordable in two ways. In one it refers to purchasing insurance;in another (which may be another topic all together) it refers to what is considered afforable treatment.If I am off topic, I apologize.

I would prefer not having Medicare and being able to afford my previous health insurance. In another way I look at whatthe CMS considers affordable and timely treatment.

My worry about Medicare is what is considered affordable? Already under Medicare we see vast changes- my own brother who used to get a blood supplement every two weeks has been changed to every 6 weeks once he went on Medicare.

A CMS rule says the blood test results he used to be treated on are too high- the number must be 10 not 12. If all these years he has been successfully treated on the previous protocol , why must it change? He must become ill inorder to received his previous treatment.

I wouldlike to see some actthat protects consumers' rightsto be treated as the Md says he or she should.

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