Interesting News...updated 3/7/20

 Most of this information comes from monitoring the physician legal section of  LymeDisease.Org.  I encourage all my patients to join LymeDisease.Org.  It is one source that I can be sure my patients, their families and I can get credible information. There is a lot info out there and it can be  overwhelming!  

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Since 2017 some of us have been watching (with hope and fear) while 25 chronic Lyme-MSIDS patients decided to hold accountable those who denied them proper diagnostic testing and treatment, either hiding behind protocols and guidelines or insurance company policy.  Torrey vs The Infectious Disease Society of America et,al, was filed in  the U.S. District Court of Texas as a RICO  (Racketeer Influenced and Corrupt Organization) case .  

There were originally 25 plaintiffs (two passed away) and seven members of the Infectious Disease Society of America (IDSA) defendants (one passed away) along with eight insurance companies.  The defendants, Drs. Gary Wormser,  Leonard Sigal, Raymond Dattwyler, John Halprin, Eugene Shapiro, and Allen Steere,  are accused of being the architects of a 25-year conspiracy that would assure limited diagnoses, care and outcomes to patients with chronic Lyme-MSIDS along with financially destroying the careers and reputations of countless clinicians around the country.  The named insurance companies are Blue Cross and Blue Shield Associates, Anthem, Blue Cross and Blue Shield of Texas, Aetna, Cigna, Kaiser Permanente, United Health Care Services and United Health Care Groups.

In 2017, the court said the plaintiffs did not prove information that met the RICO standards.  However, the court did not dismiss the case.  Instead, the judge allowed it to be re-drafted.  The next draft laid out the proof that the defendants violated antitrust statutes.

 

Judge  Robert W. Schroeder III agreed, stating "...the seeming conspiracy would reasonably restrain trade in the relevant market by paying large consulting fees to IDSA panelists to pass IDSA guidelines. This effectively denied the existence of chronic Lyme disease and established the standard that all Lyme disease is cured with short term antibiotics..."

There are time when those of us who work in this field do so in fear.  We do not only battle these stealth pathogens, we also spend countless hours battling insurance companies, licensing boards, the CDC, state epidemiology and the media.  We have also watched colleagues be investigated by state boards, be sanctioned or lose their licenses and be forced to close their doors.

But...by the end of February, working through a court appointed  mediator, the fourth insurance company has now settled.  The first to settle with the plaintiffs was  Kaiser Permanente.  Then Blue Cross, Cigna and Anthem followed.  The individual IDSA members have tried repeatedly to  have their part thrown out, the judge has refused. While we have a LONG way to go, it is good to finally be able to stop and take a breath!

I thank my patients for pushing me to continually open my eyes, and of course, keeping Gen and me laughing!

As an unfortunate post script:  One of the few pediatric docs in the states just had her license taken by the Virginia state medical board...

© 2019 by Katie, Gin & Gen 

Anchorage, AK 99503 

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