SFR Medicare and Lyme Disease...

Sorta fishing-related
5

509

Steelhead
The following was posted on a retiree Forest Service discussion forum. If you have Lyme's, you will now be treated under Medicare.

I don't know if it covers other tick borne illness.

I do have a friend, whose wife had a real hard time convincing anybody that Lyme's even existed in eastern Washington. That was a couple of decades ago. It was difficult to get a diagnosis and the treatment was awful. Catch it quick when in doubt.


from a user post in The Smokey Wire.......

Another interesting development for readers of the TSW who are workin in-the-field or have had long-term field assignments and/or are general outdoor recreationists is the announcement by the Health and Human Services Secretary (RFKjr) and his adjutant, Dr. Oz, that the Centers for Medicare and Medicaid Services (CMS) will now include “Lyme Disease” in the Chronic Care Management (CCM) program. (https://us.pagefreezer.com/en-US/wa/browse/0a7f82bb-be6e-448a-ae11-373d22c37842?url=https://www.hhs.gov/press-room/secretary-kennedy-convenes-lyme-disease-patients-providers-announce-new-diagnostic-efforts.html&timestamp=2025-12-31T07:02:25Z)

What that means for chronic Lyme disease patients is that treatment is now covered in the CCM program (https://www.cms.gov/medicare/paymen...le/chronic-care-management-complex-conditions)

Summary of Expected Out-of-Pocket Costs (2026)
Service Estimated Patient Cost
Annual Drug Limit Max $2,000 (Part D)
Annual Medical Deductible $257 (Part B)
Doctor Visits 20% of the Medicare-approved rate
Care Coordination $0 to $20/month

Until now, Lyme Disease was considered by CMS and..................National Institute for Allergy and Infectious Diseases (NIAID) to be a “syndrome” that NIAID instructed was best treated by physicians referring their patients to psychiatrists and/or psychologists.

I supervised field data collection for the 1983/1984 Forest Inventory and Analysis (FIA) in Connecticut. One of the field employees contracted Lyme Disease near Ansonia, Connecticut. He exhibited the classic skin Andromeda rash of Lyme Disease and, likely, the first CA-1 filed in the Forest Service for this work-related injury; he was sent to Yale-New Haven Medical Center Emergency Room (ER). When he returned to work the next day, he reported that the ER physicians escorted him to all the medical school classes to display the emblematic skin lesion of Lyme Disease to the current student body.

At the National Society of American Foresters 2025 Convention in Hartford, Connecticut, I participated in a field tour of a small integrated forest products company, visiting their forest holdings near Hartford. At the end of the day, I pulled 8 ticks off my clothing. Forty years ago, while working in the woods of that state, my Ansonia colleague was the only employee to report a tick encounter.

In 2019, former North Carolina Senator Kay Hagen lost her life from the bite of a deer tick to the Powassan virus while hiking in the Blue Ridge Mountains of Virginia. Senator Hagan’s colleagues just renewed the “Kay Hagan Tick Act,” the purpose of which mandates that the Department of Health and Human Services (HHS) develop and maintain a national strategy to coordinate federal research, diagnostics, and treatments for tick-borne illnesses. The Powassan virus is listed in the PIADC’s germ catalogue.

......................
If you have Lyme Disease this is good news.

I edited to remove reference to a political figure and DOD research in this area.
 
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Unfortunately, a post that could have been useful for folks has been infected with a lot of garbage and misinformation.

Lyme disease is not new and did not suddenly appear in 1975, it was being recognized in the area in the 1960s (prior to the recombinant DNA technology required for a man-made vector), and early descriptions of erythema migrans were noted about 130 years prior:


History of Lyme Disease - Bay Area Lyme Foundation

Learn more about the history of Lyme disease, including information on the first reported cases and how our knowledge has evolved over the past few decades.
www.bayarealyme.org www.bayarealyme.org

The so-called Ice Man mummy appears to have been infected with the bacterium, a spirochete, that causes Lyme disease:

https://www.nature.com/articles/nature.2012.10130 (unfortunately behind a paywall, but you can find popular media accounts of the finding).

Genomic studies demonstrated the disease-causing bacterium has been around of perhaps 20,000 years and explains its "explosion" in the 70's, 80's to the current time:


"Gain of function" is not some "dark art", it is used in labs all over the world, including my own when I was at Georgetown Medical School/Lombardi Comprehensive Cancer Center - we used "gain of function" to create cancer cells and determine what genes were oncogenic or contribute to oncogenesis, then in reverse, siRNA, to "silence" specific genes to reverse oncogenesis.

I won't even touch on the Fauci smears and the so-called "weaponization of ticks" during the Cold War era (1945-1972, which again predates the technology to do so), but they give you an idea of the source.

Please, in future, just give the useful information and refrain from the side-rail BS.

Edit to fix "migrans", which the spellchecker wants to change to "migraines" and/or "migrants", neither of which are correct.
 
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Canuck from Kansas said:
Unfortunately, a post that could have been useful for folks has been infected with a lot of garbage and misinformation.

Lyme disease is not new and did not suddenly appear in 1975, it was being recognized in the area in the 1960s (prior to the recombinant DNA technology required for a man-made vector), and early descriptions of erythema migrans were noted about 130 years prior:


History of Lyme Disease - Bay Area Lyme Foundation

Learn more about the history of Lyme disease, including information on the first reported cases and how our knowledge has evolved over the past few decades.
www.bayarealyme.org www.bayarealyme.org

The so-called Ice Man mummy appears to have been infected with the bacterium, a spirochete, that causes Lyme disease:

https://www.nature.com/articles/nature.2012.10130 (unfortunately behind a paywall, but you can find popular media accounts of the finding).

Genomic studies demonstrated the disease-causing bacterium has been around of perhaps 20,000 years and explains its "explosion" in the 70's, 80's to the current time:


"Gain of function" is not some "dark art", it is used in labs all over the world, including my own when I was at Georgetown Medical School/Lombardi Comprehensive Cancer Center - we used "gain of function" to create cancer cells and determine what genes were oncogenic or contribute to oncogenesis, then in reverse, siRNA, to "silence" specific genes to reverse oncogenesis.

I won't even touch on the Fauci smears and the so-called "weaponization of ticks" during the Cold War era (1945-1972, which again predates the technology to do so), but they give you an idea of the source.

Please, in future, just give the useful information and refrain from the side-rail BS.

Edit to fix "migrans", which the spellchecker wants to change to "migraines" and/or "migrants", neither of which are correct.
Click to expand...
I thought about editing out the Fauci comments, but it is a repost. And I decided just to leave it. It is woven through the post. The person is a former Forest Service employee with obviously a background of dealing with Lyme's on several fronts.

Ignore the Fauci comments. I did.

I don't know if you have dealt with Medicare. It has been an adventure for me. Having Medicare finally treat Lyme's disease as a disease instead of a psychiatric disorder is huge. And Lyme's is a health hazard throughout the nation now not just the northeast.d

I frankly was stunned that Medicare did not cover long-term continuing care for Lyme's. Then again, I discovered that they also do not cover othrdothics and a few other medical procedures.

Again, ignore the Fauci comments. Sorry, feel free to edit, however, you chose and I will go ahead an edit my submission to match yours.
 
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Like I said, the Medicare information is useful, and I'm very glad for the expanded coverage. If you had stopped with that information, I would have no beef. The history of lime disease as you posted is incorrect and not supported by any facts. Saying it is a repost does not absolve anyone of responsibility. There is enough of that crap about, let's not bring it here.

This would be my edit:

The Centers for Medicare and Medicaid Services (CMS) will now include “Lyme Disease” in the Chronic Care Management (CCM) program. (https://us.pagefreezer.com/en-US/wa...c-efforts.html&timestamp=2025-12-31T07:02:25Z)

What that means for chronic Lyme disease patients is that treatment is now covered in the CCM program (https://www.cms.gov/medicare/paymen...le/chronic-care-management-complex-conditions)

Summary of Expected Out-of-Pocket Costs (2026)
Service Estimated Patient Cost
Annual Drug Limit Max $2,000 (Part D)
Annual Medical Deductible $257 (Part B)
Doctor Visits 20% of the Medicare-approved rate
Care Coordination $0 to $20/month"

Full stop!!

Cheers
 
Somewhat of the same situation exists for the mosquito borne disease West Nile Virus. Several years ago a coworker spent weeks on life support in an ICU recovering from WNV that was finally definitively diagnosed via serological testing. He still routinely encounters adamant disbelief from physicians that WNV exists in WA despite his extensive medical record documentation and the fact that he had traveled nowhere out of the PNW for many years prior to his diagnosis.
 
You know better the timeline.

What I remember is the information in the field that I was getting from the Forest Service in the 1970's forward.

Working in Idaho in the early 1970's the focus was on Rocky Mountain Spotted Fever. There was lots of concerns among field folks with ticks for that reason. It was about that time, that people started asking about Lyme's in the west. These were mostly Forest Service folks that came from the east coast. That is where I first heard about Lyme's.

Then in the 1990's within the hiker community and Forest Service is when I heard discussions about Lyme's being in eastern Washington. There was lot of controversy about whether is really was Lyme's. I think the general consensus is that Lyme's in now present in Washington state.

I did go to the Russian Far East in 1996 and the tick borne diseases carried by the Siberian Tick are awful. The Russian Foresters literally will not go into a forest stand during tick season. The odds are 1 in 4 of getting really sick.

At the insistence of the American foresters we went into several timber stands to talk about disturbance events and I ended up with a Siberian Tick inbeded in my skull. I didn't lose the lottery and was fine. However, I did file a CA-1 form with the Forest Service.

When I saw my Dr. he gave me his personal cell number and told me that if I get a headache to call him right away. I quit drinking for well over a month as a result.

Tick borne illness is nasty.

Canuck, I did make some changes. I think it is important for folks to know that it is a Forest Service concern. Tick disease is not taken lightly by the Forest Service.
 
509 said:
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Tick borne illness is nasty.

Canuck, I did make some changes. I think it is important for folks to know that it is a Forest Service concern. Tick disease is not taken lightly by the Forest Service.
Click to expand...

Absolutely agree that folks, forest service folks included, should be aware of tic-borne diseases, and not take them lightly. Here in the Poconos, we sure don't, nor did we when we were in Oregon, they are, as you note, very nasty and leave you with chronic symptoms if not treated early and properly. Should the VLA15 vaccine prove efficacious (it is currently in Phase 3 trials, with results expected this year), the wife and I will likely get vaccinated.

I appreciate you editing the original post.

Cheers
 
Lyme is no joke, a friend’s nephew caught it in his senior year in high school in upstate New York. Took months to properly diagnose and almost killed him, he lost a full ride scholarship to play baseball at a major and major motor skills. Recovery was/is long and slow.
 
krusty said:
Somewhat of the same situation exists for the mosquito borne disease West Nile Virus. Several years ago a coworker spent weeks on life support in an ICU recovering from WNV that was finally definitively diagnosed via serological testing. He still routinely encounters adamant disbelief from physicians that WNV exists in WA despite his extensive medical record documentation and the fact that he had traveled nowhere out of the PNW for many years prior to his diagnosis.
Click to expand...
I ran into the same thing with my doctors when I talked to them about WNV.

I think it is simply that doctors today are not required to take any ecology classes!!! In the 1970' all the pre-med and foresters had to take a year of biological sciences for biology majors. We both suffered through Bio-Chem, the foresters suffered through human physiology, and the pre-med students suffered through ecological principals.

Doctors treat an individual. Foresters "treat" a ecosystem. I put "treat" in quotes so you environmental types don't go ballistic!! I think we would do a lot better treating pandemics as a society if we thought about the human ecosystem. Planes, trains, and all the other human interaction when you have a new species exploiting the ecological niche known as humans settlement.

My first question when a new disease vector shows up is "can it survive here". There was no question that WNV was going to make a home in the Pacific Northwest. A new species showing up in an "unexploited" ecological niche can rip through the population at wrap speed. Foresters, range managers, and botanists see it all the time with invasive species.

So we tend to get jumpy when a "new" species shows up locally.
 
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