MDwise to Cover Treatment for Baby Seth


INDIANAPOLIS, Ind. – December 10, 2010
Six-month-old Seth Petreikis is in need of a Christmas miracle. MDwise, Inc. and AmeriHealth Mercy of Indiana, answered his parents’ wish by deciding to pay for Seth’s surgery.
Baby Seth, child of Tim and Becky Petreikis from Dyer, Indiana, has complete DiGeorge Syndrome. Medical experts have recommended that he get a thymus transplant, an investigational therapy. Without this surgery, Baby Seth faces serious infections that would end his life before his 2nd birthday.
Seth’s health care is covered by Indiana Medicaid, however this treatment was denied because investigational treatments are not covered by Medicaid.
Caroline Carney Doebbeling, MD, the MDwise Chief Medical Officer and Jay Feldstein, DO Regional President with AmeriHealth Mercy carefully weighed the research evidence and potential outcomes. They conducted an extensive review of the medical literature, and found the procedure compelling. “Based on Seth’s unique and compelling story, we believe making a compassionate allowance in this case is appropriate,” said Caroline Carney Doebbeling, the MDwise Chief Medical Officer.
MDwise Hoosier Alliance is the delivery system operated by AmeriHealth Mercy under the MDwise health plan that covers Seth’s health care expenses. They will negotiate payment for this procedure with Duke Hospital, where the surgery will be performed.
When Dr. Carney Doebbeling called Seth’s mom, Becky Petreikis, to give her the good news, she said, “We are extremely grateful from the bottom of our hearts.”

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About MDwise

MDwise is a provider-sponsored nonprofit health maintenance organization offering health care benefits to more than 407,000 Medicaid and Medicare members. Since 1994 MDwise has provided access to compassionate, high-quality, coordinated health care and education to Medicaid members in communities throughout Indiana. Ninety-seven percent of MDwise members surveyed would recommend MDwise to family and friends.