MDwise to Cover Treatment for Baby Seth

12/10/2010
 

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.”


# # #

 

About MDwise

MDwise is an Indiana-licensed nonprofit health maintenance organization offering health care benefits to 300,000 Medicaid members. Since 1994 MDwise has provided access to compassionate, high-quality, coordinated health care and education to Medicaid members in communities throughout Indiana.
 
MDwise is a provider-owned health plan with a large network of doctors, specialists and hospitals located throughout the state. By meeting the basic requirements of the National Committee for Quality Assurance’s (NCQA’s) rigorous standards for consumer protection and quality improvement, MDwise was awarded NCQA’s accreditation status of Accredited for service and clinical quality. Ninety-seven percent of MDwise members surveyed would recommend MDwise to their family and friends. For more information, visit MDwise.org.