But when the Samuels'
sought reimbursement for this professional therapy from TRICARE, the
military's health care system, the request was denied. Such therapy, officials declared, was "unproven" and thus not reimbursable. What followed over the course of the next few years was a typical story of Pentagon mindlessness. Federal officials declared that they would reimburse the family for therapy that didn't work on Kaitlyn -- like sitting on a bench -- but would not reimburse the family for the physical therapy that did. The family's efforts to seek legal relief failed. The Pentagon said it needed additional guidance from Congress.
That was then. This is now. Since November, the family has received financial support from Jeff Gural, a racehorse owner and breeder and owner of racetracks in New York and New Jersey. (The ever-gracious family, in turn, re-donated some of that money to other children in need of hippotherapy.) The Samuels also have received legal help from Marcella Burke, a smart attorney with the powerful Akin Gump law firm. And, just in the past few days, the family finally has received a measure of political support from Rep. Burgess and Rep. Tom Cotton, an Arkansas Republican who served tours in Iraq and Afghanistan and who thus understands more than most the burdens TRICARE may impose on military families.
Both the text and the purpose of "Kaitlyn's Law" are simple -- Rep. Cotton also is a graduate of Harvard Law School, and that no doubt helped. Listed as HR 1705, and formally titled the "Rehabilitative Therapy Parity for Military Beneficiaries Act.'' it reads in pertinent part:
(g) Rehabilitative therapy provided pursuant to subsection (a)(17) may include additional therapeutic exercises or therapeutic activities if such exercises or activities are included in the authorized individual plan of care of the individual receiving such therapy. Such exercises or activities may include, in addition to other therapeutic exercises or therapeutic activities, therapies provided on a horse, balance board, ball, bolster, and bench.
That's it. That's all. One paragraph that will tweak federal policy to make a vital difference to families without burdening federal resources. The clarifying paragraph above does not create a new mandate on private insurance carriers. It does not broaden existing coverage but rather precludes military insurers from second-guessing the diagnoses and treatment choices made by doctors and therapists who are treating patients like Kaitlyn. Those professionals still will have to justify their choices on medical grounds -- but when they agree that hippotherapy is effective and working their patients will get more support from TRICARE.
The measure has the support of the American Physical Therapy Association. "One patient may not respond well to one type of treatment, while another
patient getting the same treatment is very responsive," said Michael Hurlbut, the APTA's Congressional liaison. "This particular measure is important
because it helps ensure access to services that are critical for maintaining,
improving, or regaining function... It can be an effective strategy for gait simulation and maintaining function. This legislation just ensures that physical therapists are not limited in what care they can provide."