Health Care Story of the Week - 11/5/09

Bradley is dependent on a ventilator and a feeding tube. He cannot talk or move; he sits in a wheelchair during the day. Bradley relies on eye gazes to communicate.

Suzette, his mother, explains: "Bradley has not spoken any verbal words in his thirteen years, but his life has spoken volumes of his zeal to live. Despite his physical disabilities, Bradley loves to play basketball, attends school with his friends, and enjoys walking the dog and watching cop videos with his Dad. His perseverance, strength and courage, gives us the motivation to provide him with the best care that we can."

Bradley's father, Barry, works full time and his company provides health insurance for the family. However, in June 2006, the insurance company told the family that Bradley had exhausted his lifetime limits.

With Bradley’s continuing intensive medical needs, and no private insurance, the family was fortunate to have TennCare to rely on as a safety net for Bradley. However, after becoming exclusively reliant on TennCare, bills began to arrive. Children receiving TennCare benefits are not supposed to receive bills from providers. More and more of the illegal bills continued to arrive. The family talked with the hospital and with doctors, trying to assert their rights, however, they were tangled in billing bureaucracy. Worried about the mounting bills and the impact they might have on her son’s medical care and her family’s future, Suzette contacted the Tennessee Justice Center for help. After receiving letters from the Tennessee Justice Center, TennCare acted and notified the family that they were not liable for the bills.

However, Bradley and his family, as well as thousands of other Tennessee families face new hurdles. Pending changes to TennCare mean that Bradley could lose his TennCare coverage. Without TennCare, his family could be in very serious trouble, facing tremendous medical care challenges for Bradley and overwhelming financial problems.

Suzette said, "The work that the Justice Center does on behalf of the medically fragile children of Tennessee is greatly appreciated by our family and other families across the State...they have stepped in and become our advocate in the billing process for Bradley. This has removed the worry of billing and given us the time to focus on what is important - Bradley’s care."