Title: Medicare DENIES COVERAGE
Birdbomb - February 5, 2007 10:31 PM (GMT)
I just got a call from my favorite reporter asking me my reaction to this news. I am searching for links and will post them ASAP
My initial response is shock. I thought for sure with they would approve with all those public letters of interest.
WOW! This blows me away!
Birdbomb - February 5, 2007 10:35 PM (GMT)
http://www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=195Decision Summary
CMS is proposing that there is sufficient evidence to conclude that vagus nerve stimulation is not reasonable and necessary for treatment of resistant depression. Accordingly, we propose to issue a national noncoverage determination for this indication.
We are requesting public comments on this proposed determination pursuant to Section 731 of the Medicare Modernization Act. We are particularly interested in comments that include new evidence we have not reviewed here. After considering the public comments and any additional evidence we will make a final determination and issue a final decision memorandum. Birdbomb - February 5, 2007 10:41 PM (GMT)
CMS proposes noncoverage on nerve stimulation for depressionUPDATE 1-US Medicare rejects Cyberonics depression deviceWASHINGTON, Feb 5 (Reuters) - Medicare will not cover Cyberonics Inc.'s (CYBX.O: Quote, Profile , Research) implantable device to treat patients with depression, the U.S. insurance program for the elderly and disabled said in a proposal released on Monday.
Medicare "does not believe there is a treatment effect directly attributable to VNS therapy based on the current evidence," the agency said.
After the decision, shares of the company were volatile and down 10 percent in after-hours trading. The shares closed at $22.55 on the Nasdaq.
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The company had asked Medicare for a national coverage decision on its VNS Therapy device, which has faced resistance from private health insurers who mostly pay for it on a case-by-case basis.
Insurers often follow Medicare's lead when setting their own reimbursement policies.
Representatives for the company could not be immediately reached for comment.
In its decision, the Centers for Medicare and Medicaid Services said that while depression is a disorder that is hard to understand, there is sufficient evidence to show that VNS Therapy was "not reasonable or necessary ."
The agency said clinical trials of the device, approved by the Food and Drug Administration in 2005 for patients with treatment-resistant depression, failed.
"Further observational study and statistical manipulations of data from this group of patients provides little weight in the determination of reasonable and necessary," it added.
Medicare is expected to make its final decision in May after receiving public comments. Bernard - February 6, 2007 02:08 PM (GMT)
| QUOTE |
Cyberonics' nerve-stimulation device to treat chronic, severe depression shouldn't be covered by the Medicare program for the elderly and disabled, U.S. health officials said Monday. The company's shares plummeted in after-hours trading.
The device is "not reasonable and necessary" for that treatment, the Centers for Medicare and Medicaid Services said in a posting on its Web site. The device costs $10,000, with the bill rising to $25,000 when the cost of surgery is included. The rejection would have no impact on use of the device for epilepsy, a treatment for which the Houston-based company won approval in 1997.
...
If the agency's proposed nationwide rejection of the Vagus Nerve Stimulator Therapy System is adopted after a 30-day public comment period, that would end case-by-case approvals that have occurred around the nation through regional Medicare claims processors, said Steve Brozak, an analyst with WBB Securities.
"We are extremely disappointed," George Parker, Cyberonics' interim chief operating officer, said. "We will not rest until all eligible patients have full parity in access to VNS Therapy."
The company encouraged doctors, patients and families to express their support in comments to Medicare. |
labrat - February 6, 2007 08:37 PM (GMT)
I think it is discrimanated against just like insurance is. Insurance only pays 50% on mental issues. Just as the air that I breathe, my VNS keeps me alive. This make me upset and angry.
Labrat :im_033:
Bernard - February 7, 2007 01:02 PM (GMT)
It appears that Medicare will be taking public feedback on the issue for the next 30 days. You might offer them your :Two Cents:
Rocking4Epilepsy - February 7, 2007 01:46 PM (GMT)
Maybe this is a good sign....
WIth all the people who are having major trouble after getting VNS..
Do you think Medicare refusing may be a blessing in deguise?
Bernard, Can you PM me the link or where to toss my :Two Cents:
Bernard - February 7, 2007 07:04 PM (GMT)
Jen, I don't have the contact info - I know what you know from reading the news stories referenced above. I would suppose Cyberonics would be happy to direct interested parties to the right place.
Rocking4Epilepsy - February 7, 2007 07:31 PM (GMT)
Thanks Bernard...
I found It :)
Arthur - February 7, 2007 07:33 PM (GMT)
If Medicare denies coverage of VNS for depression, what will happen to Medicare patients with existing VNS implants for depression when their VNS generators require replacement due to a depleted battery? For that matter, would Medicare cover routine treatment for existing VNS depression patients such as monitoring and dose adjustments? One would hope that Medicare will handle these questions in a humane manner.
Rocking4Epilepsy - February 7, 2007 07:56 PM (GMT)
That is an EXCELLECT question...
If I were you I would be on the phone with CYBX and ask them what is going to happen.
I know others have had battery problems recently and had to have them replaced.
I would hope CYBX would be an updstanding company and make sure their patients are taken care of.
hugs
labrat - February 8, 2007 06:38 AM (GMT)
I've already asked the question and have not received an answer.
Labrat
Birdbomb - February 9, 2007 05:57 PM (GMT)
Medicare cutting VNS is just the tip of this iceberg.
I got a call last night from my favorite mental health expert and we talked at great length as to the ramifications of this. She only sees military active duty, their families and retired military and families. She chooses not to accept civilians. Her contacts with Triwest are impressive.
Triwest is taking a 10% pay cut on these health care providers. In a time of war. This means less providers will accept Triwest, fewer providers will be willing to work for the government. Less medical care will be available. And a lower caliber of available doctors will be taking care of these families. Less medical services will be approved no matter the need.
Saying she was upset is like saying the suface of the sun is a little warm.
VNS will still be available, BUT it may have to come out of pocket. Who can afford $50-80,000 surgery that may or may not work?
The denial is just a small ramification of the problem, the REAL issue is the hugh budget cut to Medicare. Congress tried this about 20 years ago and it was a fiasico. (I am speaking form the military aspect) It took years to recover.
We are in for some very rocky times. :So Sad:
labrat - February 10, 2007 05:28 AM (GMT)
I'm on this board to offer hope; the VNS has done wonders for me and my situation with TRD. It has improved my life 100%. ALL this with Medicare is very disturbing to me.
Labrat :So Sad:
labrat - February 10, 2007 05:32 AM (GMT)
I've already added my :Two Cents: +
Labrat :So Sad:
sisymay - February 18, 2007 02:27 AM (GMT)
'''In its decision, the Centers for Medicare and Medicaid Services said that while depression is a disorder that is hard to understand, there is sufficient evidence to show that VNS Therapy was "not reasonable or necessary ."'
What is this evidence? Has medicare proven what this evidence is?
Rocking4Epilepsy - February 18, 2007 02:44 AM (GMT)
| QUOTE (sisymay @ Feb 17 2007, 08:27 PM) |
'''In its decision, the Centers for Medicare and Medicaid Services said that while depression is a disorder that is hard to understand, there is sufficient evidence to show that VNS Therapy was "not reasonable or necessary ."'
What is this evidence? Has medicare proven what this evidence is? |
Can I just ask?
Have you taken some time to read some of the threads here?
Have you read some of the horror stories the VNS has done to chiildren?
I feel medicare is taking steps in saving much harm to others by denying this device.
Can I ask what meds your dad has taken?
How long he has had depression?
What state he had the implant surgery done in?
Why would ANY doctor do this surgery without a gaurentee payor?
Did your dad sign any paperwork stating HE would pay for this?
Bernard - February 18, 2007 12:30 PM (GMT)
sisymay, Medicare is claiming that the studies that were done for VNS and depression did not show a clear therapeutic effect. A national non-profit public interest group, Public Citizen, has been lobbying the FDA on the subject:
| QUOTE |
| While the long-term phase of Study D02 certainly was one study submitted to the FDA, it was not the most important one. In fact, it was a nonrandomized extension of a short-term (12-week) study called Study D02. In the short-term phase of Study D02, patients with treatment-resistant depression were implanted with the VNS device and then randomized to have the device turned on or not. The strengths of this study design are obvious, notably assuring that the two study groups were similar at enrollment and thereby controlling for any confounders. But the advertisement makes no mention of these most-important results: at the end of 12 weeks there was no statistically significant difference between the two treatment groups on the primary outcome variable (p=0.238) in the short-term phase of Study D02. In plain English: the primary efficacy study failed to demonstrate efficacy. For the long-term phase of Study D02, patients whose VNS device was not turned on in the short-term phase were allowed to have their devices activated. However, the doctors and the patients were not blinded and concomitant therapies were permitted. |
| QUOTE |
On August 12, 2004, scientists at the FDA overruled a 5-2 Advisory Committee vote and declared VNS “not approvable” (Cyberonics 2004). In a surprising move, after apparently receiving more data from the nonrandomized third study, the FDA mysteriously reversed itself on February 2, 2005 and declared the device approvable (Cyberonics 2005). An investigation by the Senate Finance Committee found that all of the more than 20 FDA officials contacted by the Committee opposed the approval of VNS for depression. The director of the device bureau overrode them all (United States Senate Committee on Finance 2006).
It is disturbing that the FDA considers these data adequate grounds for approving a new device, particularly when it would never approve a drug for depression on these grounds. We recommend that physicians take the gross inadequacy of these data into account before prescribing VNS to their patients. |
| QUOTE |
Public Citizen today urged the Centers for Medicare & Medicaid Services (CMS) not to reimburse for the surgically implanted Vagus Nerve Stimulation (VNS) electronic device in the treatment of severe depression because it is ineffective.
Public Citizen is apparently the first advocacy group to seek a National Coverage Determination denying reimbursement under Medicare. The consumer group also is filing a petition today with the Food and Drug Administration (FDA) urging the reversal of its July 2005 approval of VNS for depression.
...
Cyberonics, which manufactures VNS, has already sought and been denied approval for reimbursement from 10 local CMS contractors in 14 states. To date, no contractors have agreed to reimburse for the device. Although the FDA has approved VNS for severe depression, the Social Security Act allows Medicare-sponsored reimbursement only if the device is proved “reasonable and necessary,” which Public Citizen contends it is not. This is a more rigorous standard than that followed by the FDA.
The FDA requires that a medical device be proven safe and effective, which Cyberonics has yet to do, Public Citizen says. Cyberonics conducted a three-month study of VNS’ effectiveness in which half the participants’ VNS devices were not turned on. VNS patients fared no better than patients whose device was not turned on. Instead the company has relied upon a series of non-randomized, unblinded studies with questionable control groups to make its claim for the effectiveness of the device.
“Without proof that VNS is a viable therapy for severe depression, it is unreasonable for the Medicare program to reimburse for this device,” said Dr. Peter Lurie, deputy director of Public Citizen’s Health Research Group. “With substantial constraints on the Medicare budget and so many clear needs going unmet, it seems absurd to flush away millions of dollars on this unproven device.” |
Arthur - March 6, 2007 04:26 AM (GMT)
Well, I just found out the answer to my earlier question as to whether Medicare will continue to cover VNS for TRD for patients who were implanted before Medicare's recent annoucement of non-coverage. I had my VNS implanted in the middle of April, 2006. I had numerous problems, which ultimately led to a re-implant of new leads the last part of February, 2007, just before the recent Medicare announcement of non-coverage.
The hospital filed it's claim with Medicare, along with plenty of supporting documentation from my psychiatrist and my neurosurgeon. My claim was denied, based upon Medicare's policy of non-coverage for VNS for TRD. I have no reason to believe that this denial will be reversed on appeal, and expect to be receiving a bill from the hospital for $26,000. in the near future. I will have to sell my house to pay the hospital.
[/U]Based on my experience and the current atmosphere of uncertainty, I would think long and hard before having any VNS surgery for TRD if one cannot obtain binding pre-approval from one's insurance carrier. Unfortunately, Medicare does not provide pre-approvals.[U]
As for myself, I have had all the nonsense I am going to take regarding VNS. When I learned about my claim denial today from my psychiatrist, I had him turn off the unit. I don't want to be in a position where it helps me, then have the batteries wear out and not be able to have them replaced.
In my opinion, Cyberonics has lost any semblence of credibility. Now I hear they are saying that they will provide VNS devices when needed to pre-Medicare annoucement patients at no cost if not covered by insurance. However, Cyberonics will not cover the cost of surgery. That just isn't enough. If they had provided more clinical data on a more timely basis, perhaps Medicare wouldn't have taken it's recent action. I have a feeling that Cyberonics is going to end up folding up it's tent in the not-to-distant future. Who knows? Sometimes things happen for a reason, and maybe that would be the best thing for TRD patients.
Birdbomb - March 6, 2007 06:43 AM (GMT)
| QUOTE |
I will have to sell my house to pay the hospital.
|
Man that is just down right ugly! Arhur I am so sorry that things have turned out this way for you. Surely there must be some other means! This has opened a window to a nighmare. Labrat had to have her unit replaced after 15 months due to premature EOS, right around the time all this mess was coming to fruition. She may not be aware of this yet as she was a victim of the recent tornado in Ga. Her home sustained considerable damage and has not been able to have computer access as of yet. She too had doccumention that her's was a medical necessity. OMG.
| QUOTE |
| In my opinion, Cyberonics has lost any semblence of credibility. .... If they had provided more clinical data on a more timely basis, perhaps Medicare wouldn't have taken it's recent action. |
In my opinion, they just didn't have the hard evidence they really needed. Even though there is some level of improvement for a small margin of TRD patients, they just didn't have the numbers. That is why they kept submitting the same studies only in a new and improved package.
"Lipstick on a pig." It might make the pig cute but it's still a pig.
| QUOTE |
| I have a feeling that Cyberonics is going to end up folding up it's tent in the not-to-distant future. Who knows? Sometimes things happen for a reason, and maybe that would be the best thing for TRD patients. |
Many others share those very same thoughts.
Arthur - March 6, 2007 12:59 PM (GMT)
Hi Birdbomb,
It certainly is a nightmare. My doctor assured me that this procedure would be covered. I did everything possible to confirm coverage, including reassurances from the neurosurgeon on the day of surgery. Ay this point, I believe that it would be absolutely foolhardy for anyone to have a VNS implant done for any reason. In my opinion, the former CEO of Cyberonics and his cronies destroyed any credibilty that Cyberonics might ever have had, and that Cyberonics will not be able to recover.
My current problem seems surreal. I keep asking myself how anything like this could possibly happen. However, in today's health care environment, it truly seems like anything could happen, regardless of how irrational it might appear.
Bernard - March 6, 2007 01:31 PM (GMT)
Hi Arthur,
I'm sorry to hear that Medicare refuses to cover your VNS bills, but you do not need to sell your house. I'm guessing you are already aware of this and just used a bit of hyperbole, but no bill collector can force anyone to give up their home. You can file bankruptcy if it ever came down to that.
When my wife went status 3 times within a 6 month span, her ER bills (including ambulance, labs, doctors, hospital, etc., etc., etc.) totalled something like 32K. We applied for charity for the hospital bills and they knocked off 60% of their bills. We then worked out a payment plan for $100/mo (zero interest). We worked out payment plans with all the other parties too.
Again, sorry about the decision. Did you speak to CYBX about covering the cost for your procedure and incorporating you into the TRD study that they are having trouble finding enough patients for?
Arthur - March 6, 2007 03:55 PM (GMT)
Hi Bernard,
Thanks for your reply. I know that a bill collector can't force me to sell my home. However, the hospital can and will file suit against me, obtain a judgement, and I will be forced to sell my house to satisfy the judgement. Bankruptcy is not a viable option for me. I called Cyberonics, and they are not responsive. I'm in a very bad position.
Bernard - March 6, 2007 06:51 PM (GMT)
| QUOTE |
| However, the hospital can and will file suit against me, obtain a judgement, and I will be forced to sell my house to satisfy the judgement. |
No, that's what I was saying above. No court can force you to sell your house to satisfy a judgement. Call the hospital - I'll bet they will work with you on a payment plan that you can manage.
Arthur - March 7, 2007 03:30 AM (GMT)
| QUOTE (Bernard @ Mar 6 2007, 10:51 AM) |
| QUOTE | | However, the hospital can and will file suit against me, obtain a judgement, and I will be forced to sell my house to satisfy the judgement. |
No, that's what I was saying above. No court can force you to sell your house to satisfy a judgement. Call the hospital - I'll bet they will work with you on a payment plan that you can manage.
|
A judgement will become a lien against my home. However, the hospital can then choose other avenues to satisfy the judgement, ruining my credit and pursuing any other assets they can find, which aren't much. The other assets wouldn't cover the amount owed, and I would eventually have to sell my house to make up the difference, unless I want to live with all the hassles of having a very low credit rating, which I do not. Therefore, it is best to sell the house, get more equity out by avoiding a potential economic forced sale scenario, and pay what I have to. My other assets would still be available and I would maintain my credit rating and what little is left of my sanity. Legal judgements are not very therapeutic, and are best avoided if at all possible. Interestingly, the first thing the hospital asked when I told them of the problem was what my house was worth. Before I became disabled, I was a lawyer. I consulted my own lawyer today, and she concured that when the hospital comes after me, this would be the better course of action for me. But hey, these days, everyone is a legal expert, especially if they watch TV.
Birdbomb - March 7, 2007 05:23 AM (GMT)
That is why my house is homesteaded. There are only two organizations that could possibly take it, the morgage company and the IRS.
Considering the circumstances, trying to get the hospital to reduce the bill may be an avenue.
[scarcasm]Wonder if I should add homelessness and hugh hospital bills to the list of possible side effects in the TRD catagory?[/scacasm] : nono :
Arthur - March 8, 2007 07:54 PM (GMT)
I just received the monthly e-mail newsletter from Cyberonics.
Although it contains some information on how to obtain insurance approvals for VNS, it makes [U]no[U] mention of Medicare's proposed decision of not covering VNS for depression. In the interests of full disclosure, I believe that it should have done so. I guess the name of the game is "Caveat Patient" , at least as it applies to Medicare beneficiaries.
Birdbomb - March 8, 2007 11:01 PM (GMT)
This does not surprise me. They also encourage implanting in children even though FDA approval only allows 12 yo and up for Epilepsy and 18 yo and up for depression.
Arthur, the sin of omission has been a bane with this company for years. My site is riddled with comments from many individuals who have experianced this "lack of disclosure"Puffery Arthur - March 9, 2007 02:37 AM (GMT)
| QUOTE (Birdbomb @ Mar 8 2007, 03:01 PM) |
This does not surprise me. They also encourage implanting in children even though FDA approval only allows 12 yo and up for Epilepsy and 18 yo and up for depression.
Arthur, the sin of omission has been a bane with this company for years. My site is riddled with comments from many individuals who have experianced this "lack of disclosure"
Puffery |
Next thing we know, they'll be dreaming up a VNS intra-uterine implant if one or both parents have epilepsy or depression. :fear:
Bonnie - November 23, 2007 05:55 PM (GMT)
Medicare: Just Another Nasty,Government System!
This does not surprise me, after dealing with Social security! Everyone will have to fight against this system, like fighting against insurance companies. I will say what I said when fighting against Aetna; you are refusing to look at the benefits of VNS on patients that have TRD. They will not look at the data! They will just keep saying; it is experimental and not needed. People with mental health issues will have to keep beating this system down, until they pay for this needed treatment. People are dying from depression, that is a fact. They are acting just like the insurance companies! The amount of life & job loss is staggering from depression. VNS could help much to save this and restore life to people so that they could keep working and have their lives back. The bottom line is this: it's either suicide or VNS to save someones life. If someone is dying from a disease then treatment is needed to help! If a person is dying from cancer then chemotherapy would be given. That is the comparison I gave when fighting Aetna. So, what is the difference here?! I basically stated that fact when fighting with Aetna. If the medicines stop working, and other treatment is denied, then what options are available?! Death, as I was not willing to suffer with the pain of TRD. I was not willing to feel that way the rest of my life. And as far as money goes, I would like to see the budget of medicare, and see where their money goes! I bet there is money available to pay for VNS. I bet they are spending money on things that are NOT needed!! Let's see how much money they have, and what are they doing with it, where is it being spent!! They need jurisdicition over them! Damed bastards! :Really Mad: This fight can be won, but it is going to take awhile. Maybe several years. If I can beat social security alone, then we as a group of people together can beat another cruel government system. It is only a matter of time. Anyone can use this letter in this fight against the systems, to provide mental health care for United States Citizens! :FYI: We must keep fighting for our rights!
Sincerely,
Bonnie
labrat - November 23, 2007 08:34 PM (GMT)
dreambeliever128 - December 21, 2007 02:52 PM (GMT)
Hi,
I just started posting to the board last week but I wanted to say that my VNS was approved by Medicaid.
Mine is off right now and it may never be turned back on. My feelings are though that everyone should have the choice of wheather they have the VNS or not.
I also wanted to say that mine was approved by Medicaid in Co. on the first try. My PCP had taken care of me for 17 years and has councelled me for 8 so he wrote a letter to help me get it.
I am thinking that if there is enough evidence to prove that a person has done all the can to help their depression and nothing has worked then Medicare may approve it.
I can't take depression meds at all. I have tried most all of them and been sick from all of them, I had seen two Physchitrist that wanted to do ECT treatments on me and I refused them. I feel we did everything we did to get my depression under control before the VNS.
As I said, I am not sure mine will ever be turned back on but I believe it should be a choice of the patient.
Ada
MissJennie - August 30, 2009 09:22 PM (GMT)
I am sooooooooo upset. I fell soooooooooo stupid.
Before I knew the truth about my VNS, I really thought it was going to save my life!!!
So, I posted my history on the Medicare web site defending payment for the VNS.
I did a google search for my name the other day, and THERE WAS MY HISTORY.
Does anyone know what I can do. I don't want my family or grand child to see that stuff.
I thought the only people that would see it is people on the Medicare web site, people like my self, suffering!!!
I AM SOOOOOOOOOOO WORRIED.
:So Sad:
Birdbomb - August 31, 2009 05:57 AM (GMT)
Contact the site administrator and asked that your information be removed or edited. Word of advice, avoid using your real name on the internet. You just never know where it will end up. Please check your PM's
Dispatch - August 31, 2009 09:29 AM (GMT)
:D HI MissJennie!
It is so great to hear from you. I'm awfully sorry to hear you are under this amount of stress. I hope you can get some resolve to this very soon.
I agree with what Birdbomb said about contacting the site administrator to see what kind of assistance they can give you. If they say they can't help you for some odd reason, check and see if you are able to make another post. If so, consider retracting your original post, and tell what has happened to you with VNS.
In another siuation I was in unrelated to VNS, my story was plastered all over the net and I fortunately didn't use my name. I ended up contacting a senior moderator explaining why I wanted the whole thread and replies deleted, and it was done. Now you can't find it anywhere on the net. I am so grateful!
Please do visit again and give us an update about how you are doing and what happened in this situation.
Take care!
B)
MissJennie - September 2, 2009 12:48 AM (GMT)
Birdbomb,
This is driving me crazy!!!!!!!!!!!! I can't even think straight!!!!!!
I went to look and see if the google search was still there (after sending a email to
medicare) and I noticed it is posted BY THAT MAN, LINKED TO MEDICARE.
OH MY, WHAT AM I TO DO?????????
I TRIED TO GO TO HIS SITE, AND IT KEEPS TIMING OUT ON ME. (ONLY HIS SITE???)
I TRIED TO CLICK ON THE GOOGLE SEARCH AND IT KEEPS TIMING OUT.
SO IT WASN'T MEDICARE THAT POSTED IT, IT WAS HIM.
MY NERVES ARE SHOT!!!!!!!!!! :Tantrum:
Dispatch - September 2, 2009 09:47 AM (GMT)
:D HIMissJennie!
OK-in the email to Medicare, did you mention this mans name? If not, do another email to Medicare and tell them he is the one who posted this, and ask if they have contact info for him.
Keep googling his name and see if you can bring him up. It may be timing out if his site is down. Then, when you finally get thru and can contact him, if this were me, I would give him a : rocket : for puting something on the net without your permission. He could've at the very least removed your name.
Please hang in there, and please do keep us updated. Until then, please try and take good care!
B)
MissJennie - September 2, 2009 03:36 PM (GMT)
I opened his web site this morning. I tried to join, so I could ask him to remove it.
I had trouble joining??? This is really getting to me!!
There was an email to the administrator on his site, so I sent an email there, begging him to remove my personal information.
I did not give any name in my email to Medicare, I sent them a copy of the http address I had found my information on.
Medicare has not replied yet.
It really hurts my heart, ALL I WAS TRYING TO DO WAS HELP OTHERS. I WILL NOT DO THAT AGAIN!!!
Thanks for your support, I need it!!
:So Sad:
MissJennie - September 2, 2009 03:55 PM (GMT)
I sent Medicare another email, with all the information, his name etc.
I have asked for a reply, or even another email address I could use to get some help.
:Tantrum:
Dispatch - September 4, 2009 08:27 AM (GMT)
:D HI MissJennie!
Sounds like you've taken some great steps to get this resolved. Please do keep us updated on what's happening.
Take good care and hope inspite of this you are doing alrighty!
B)