~ Atlanta's Queen~* Just~Zayna *
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Zayna Varner
- 30 / Female
- Atlanta, Nationwide , US
- Last Login: 9/17/2010
Blurbs
About me:
Atlanta, Georgia – Her name is Billie. She has two eyes, ten fingers, two ears, ten toes, two legs and one ailing little heart. For six months her mother, Zayna Varner, 30, has been fighting the Georgia Department of Community Health (Division of Medical Assistance: GA Medicaid Program), Children’s Healthcare of Atlanta at Egleston & Children’s Healthcare of Atlanta Sibley Heart Center to save 1-year-old Billie’s life. Varner has a heart apnea monitor, pulse oxygen machine and oxygen tanks in her home to stabilize and monitor Billie’s heart rate. Ultimately, Billie needs heart surgery, recommended by Dr. Cyrus Samai of the Sibley Heart Center.
Egleston’s pre-surgery policy requires Varner to sign a hospital surgery consent form (which states that, in the event of an emergency, the hospital has the authority to administer a blood transfusion). Previously, while at Cobb Wellstar, Billie contracted a bacterial infection in her blood from a blood transfusion making surgery very risky and possibly fatal.
Varner refused to consent to the surgery with any possibility of a transfusion, and was told by an Egleston Hospital social worker, Jody Nuyg, that if she found a facility (with a GA Medicaid approved physician) to conduct the surgery with less probability of transfusion, it would be covered. Instead, the Sibley Heart Center social worker Christine Post and Ms. Nuyg are prepared to advise the Georgia Department of Family and Children’s Services to “temporarily” take custody of Billie. Once the state has custody of Billie, they will have the surgery done and the hospital will discharge her back to the state until the necessary paperwork is completed to return her to her mother (this with the assumption that the surgery is successful considering complications result in death).
In March, through diligent research, Varner located a GA MEDICAID APPROVED Physician (Mark E. Galantowicz, M.D.) and hospital (Nationwide Children’s Hospital) in Columbus, Ohio, with the capabilities to conduct the surgery without the blood transfusion. Nationwide has a dedicated blood conservation program (Information of the Blood Conservation Program) and specializes in no blood surgeries for infants. Immediately, Varner requested all records and referral requirements from Sibley Heart and Egleston to be sent to Nationwide in preparation of Billie’s surgery.
On July 16, Billie was re-admitted to Egleston by her pediatrician, Dr. Kevin Mason of Cumberland Pediatrics. Before Billie was discharged the following day, Varner discovered that Billie’s records were never sent to Nationwide. Varner demanded Billie’s records (and refused to leave without them) and they were surrendered to her at the hospital. She immediately had the documents expressed to Nationwide. In addition, a new requirement was presented. According to Medicaid, a referral from a patient’s cardiologist is required to have the patient travel out of state for a surgical procedure. Immediately, Varner obtained the required letter from Dr. Samai.
Finally, Nationwide had all the materials required for an approval. The physical request was sent to the GA Medicaid Program on July 20 by Nationwide. On July 27, Melissa Loveless, at Nationwide contacted Medicaid to obtain a pre-approval but she was told at that time that the request was denied. Documentation was not sent to Nationwide or Varner to inform them of the denial until July 30.
Varner and Nationwide should have been contacted by mail, phone or fax with the decision. The stated reason in the document sent to Nationwide was: “Medical necessity has not been established. There is no medical necessity to transfer the child out of state since these surgical services are available in Georgia.” The procedure is available in Georgia, but under very hazardous circumstances for such a young patient. In addition, the GA Medicaid Program has failed to pay WellStar Home Care for the equipment being used to maintain Billie’s heart at home. Soon, Varner may be forced to surrender the equipment, due to nonpayment.
Varner requested an Emergency Hearing (on August 18, through her attorney, Chuck Sylvester of the Law Offices of Sylvester & Associates, P.C.) requesting approval for the emergency surgery, but the requests have gone unanswered. The lack of urgency and empathy is disheartening to this mother of two, Billie and her twin sister, Brooklyn. She continues her fight and urges citizens to hold these government funded entities accountable. There are procedures written in the guidelines and laws of this program (Georgia Medicaid receives $1.63 in federal funds for every $1 of state funds) that were not followed despite the critical nature of this case. However, there is a sudden sense of urgency in forcing this mother to surrender her child to state authorities to protect the insurance provider from liabilities incurred due to their lack of service.
The fact that Varner has been waiting 30 days for a response for an EMERGENCY Hearing is unacceptable.
Right now, Billie’s heart is critically failing, SHE does not have time for inaction, and neither do you or anyone else with a beating heart.
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