Access to Brain Health Treatment
“Picture a hard-working scientist, who learns after years of research that his work can bear fruit in the form of a ground breaking treatment. He knows this treatment can be scaled to help people around the world. But . . . what does it matter if patients most in need of this treatment cannot access it?”
- Dr. Barney Singer
Inspired by successful outcomes from treatment of patients (including in clinical trials and case series) that have been documented and measured since the very first patient was treated using a protocol developed by Dr. Yi Jin more than 10 years ago, the Brain Health Leadership Foundation wants every patient for whom EMBP is a recommended treatment to be able to have access to it.
Access to the EMBP protocol for every patient for whom it is recommended will be possible only when there is payment for it through health insurance, which is how most Americans’ healthcare is paid for. Regardless of whether health insurance is obtained through employment, a health-insurance marketplace, Medicaid or Medicare, an insurer is the gatekeeper who must approve medical treatments before care is provided.
When making coverage determinations, insurers use Current Procedural Terminology (CPT) codes tied to specific medical procedure reimbursement rates to pay for medical treatment. The elements of the EMBP protocol include procedures that are identified with CPT codes and covered by reimbursement; however, insurers must proactively make decisions to cover EMBP in order to reimburse for it. Until reimbursement is made universally available for EMBP, BHLF is committed to educating insurers about its efficacy and enlisting others to assist in this effort.