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Obama Succeeds Where Noem, Thune, and Rounds Fail to Help SD Medicare Patients Get Care

Suppose you’re a South Dakotan, and you’re having trouble getting necessary health care because of some federal rule. Who do you think is more likely to solve your problem: a member of your Congressional delegation or the President of the United States?

Betty Beyer grew up in Aberdeen and taught in Chester. She and her now-departed husband Maury ran Marrs Beach on Lake Madison through summer 2000. Beyer is spending her retirement back here in Aberdeen, organizing for the retired teachers association, making teddy bears and other crafty wonders for family and friends, and refusing to sit around and do nothing.

Last year, though, Beyer’s bad hip made even sitting a real pain. Beyer’s doctor said she needed a new hip, but the Avera Dakota Plains Surgical Center on the northwest corner of town said they couldn’t they couldn’t do the operation right away. The Avera folks said new Medicare rules required that she had to wait twelve weeks before the doctors could deem her hip replacement necessary and bill Medicare for the procedure. Even though Beyer was in obvious pain, and even though the hip replacement would alleviate that pain, Uncle Sam apparently was saying, “Sit and suffer.”

Beyer preferred to do neither. She wrote to Rep. Kristi Noem, Senator John Thune, and Senator Mike Rounds. On August 26, 2015, Beyer also penned her plight to President Barack Obama:

Betty Beyer, letter to President Barack Obama, 2015.08.26, p. 1.
Betty Beyer, letter to President Barack Obama, 2015.08.26, p. 1.
Betty Beyer, letter to President Barack Obama, 2015.08.26, p. 2.
Betty Beyer, letter to President Barack Obama, 2015.08.26, p. 2.

From Noem, Thune, and Rounds, Beyer got calls and commiseration. From the White House, Beyer got action. The White House passed her letter on to the Centers for Medicare and Medicaid Services. She received several calls from the CMS Regional Office in Denver, which oversees Region 8, including South Dakota.

And on October 22, 2015, Beyer received this letter from Region 8 Administrator Jeff Hinson:

CMS Region 8 admin. Jeff Hinson, letter to Betty Beyer, 2015.10.22, p. 1.
CMS Region 8 admin. Jeff Hinson, letter to Betty Beyer, 2015.10.22, p. 1.
CMS Region 8 admin. Jeff Hinson, letter to Betty Beyer, 2015.10.22, p. 2.
CMS Region 8 admin. Jeff Hinson, letter to Betty Beyer, 2015.10.22, p. 2.

Hinson’s office found that the Avera doctors had been looking at rule guidance that had been issued for Colorado but not for South Dakota. The 12-week-wait rule did not apply to South Dakota. Beyer’s doctors could schedule Beyer’s hip replacement without further delay.

When Beyer went back to the surgical center, two staff members greeted her with, “You’re the one who wrote the letter!” The staff weren’t displeased; quite the contrary—they were happy that Beyer’s efforts had clarified a rule that had been delaying needed treatment for numerous patients.

None of our Congressional delegation took the time to find this answer. President Obama did. The White House sent Beyer’s letter to the right people who could find the right answer and thus spared numerous South Dakotans needless suffering.

Thank you, Betty, and thank you, Barack—Mr. President.

14 Comments

  1. Jerry Sweeney

    The perfect end to this story would be questions posed to the senators and the representative by every newspaper and television station in the state. If nothing else, there should be openings on the staff of all three persons.

  2. Rorschach

    Ms. Beyer seems to have made a difference for potentially a lot of people and also saved taxpayers a lot of money on unnecessary PT avoided.

    Looks like Avera’s lawyer Matt Michels really dropped the ball here. Why in the world would a large hospital system be relying on outdated Colorado guidelines rather than current Colorado guidelines – or more appropriately South Dakota guidelines? Is everyone in state government incompetent at their day job?

  3. mike from iowa

    Wingnuts response will be Obama exceeded his authority as usual. They will hold a useless vote to take it back like usual.

  4. mike from iowa

    Jerry Sweeney’s idea would make a great topic for Cory to post. Let Cory ask them those tough questions. Get the word out how Dakota’s congress critters failed their own constituents, again.

  5. Gail L. Swenson

    Great post–I’m not at all surprised at Betty’s “gumption,” to take things into her own hands. I knew Betty as a “newbie” speech coach and learned a great deal from her and the other veteran, regional coaches. As happy as I am for her, I am also not surprised about our three do-nothings in D.C.’s responses–nor am I surprised about the President’s actions. I also agree with Mr. Sweeney and MfI about media coverage of this and the bottom line of Thune, Noem and Rounds failing constituents. Get the word out!

  6. Mike

    It is obvious that South Dakota Republicans have lost the common touch. If you are not rich or powerful, you get an impatient waive of the hand. How dare they! Out with them!

  7. Jerry, I welcome the rest of the press to follow up on this story and seek comment from our Congressional delegation. I’m sure Noem, Thune, and Rounds will graciously congratulate the Executive Branch on its excellent constituent service.

    Gail, Betty was just saying how important speech activities are for getting kids to think. Her willingness to speak up brought this problem to the attention of CMS and wrested a solution that helped many people besides herself.

  8. Curt Jopling

    One was too busy repealing the ACA and the other two were working on a replacement that will set us back to the days of “the best medical care in the world…….for those that can afford it”.

  9. 63 ACA repeal votes, Rep. Hawks said at her Aberdeen town hall tonight. Full report on the Hawks event coming tomorrow!

    I get the feeling that if Beyer calls Congresswoman Hawks with a question, Congresswoman Hawks will get the right answer.

  10. Loren

    Do you suppose that extending the work week beyond 3 days would benefits anyone seeking answers to problems? Of course, if you work 5 days and then take the rest of the month off, I guess it wouldn’t help much! Another chapter in the continuing saga of “Republicans in Action”!

  11. James

    That really speaks to SD being a republican state. With the wealthiest majority being republican and not wanting to pay for additional care. Sadly they refuse to increase the minimum wage to a level that people could live on and employers refuse to offer health insurance. The result is more low income people needing health care at the government expense. How does this effect SD they need to contribute a match of around 30% for every dollar the Feds spend. By the way SD 30% is one of the lowest rates in the nation. Wyoming pays a 50%match.

  12. lrads1

    This example speaks to one of the sad consequences of the complete partisan turnover in the SD delegation: the loss of constituent service expertise in our delegations’ offices. Sen. Johnson maintained excellent constituent services with an experienced staff that knew how to get things done. I’m sure it was abused by some constant whiners, but they did many good things, and dismantling that service mindset and experienced resource is hurting everyday South Dakotans.

  13. leslie

    wonderful coverage cory. it’ll only take a few of these for kristie and john to lose their Barbie/ken do-nothing status in SD. GO JAY AND PAULA

  14. grudznick

    Mr. Williams and Ms. Hawks are a very attractive couple, indeed. Ms. Hawks seems a bit of an Amazon when standing next to Jay but I would not put it past them to be little dolls of some sort someday. Bobbleheads at the Rush hockey game perhaps. That would be fitting.

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