Waiver Form For: Non-Covered Services: Fill & Download for Free

In the US, the first CAR-T immunotherapies for cancer were approved by the FDA in August and October of 2017.First Kymriah, Tisagenlecleucel - Wikipedia, from Novartis, for certain forms of acute lymphoblastic leukemias.Second Yescarta, Axicabtagene ciloleucel - Wikipedia, from Gilead, for adult non-Hodgkin lymphoma relapsed or resistant to other Rx.Both target a cell surface protein called CD19 expressed by B cells and therefore by such B cell tumors.Eye-popping US list prices - $475000 for Kymriah and $373000 for Yescarta - don't include additional costs for treating complications which may be frequent, for inpatient stays nor even for the initial process used to extract the patient's cells to genetically engineer the CAR-Ts in the first place. Such ancillary costs may equal CAR-T cost itself.CAR-T cancer therapy, Chimeric antigen receptor T cell - Wikipedia, is thus a case of technology outpacing the US healthcare payment system since insurers including Medicare had no billing codes in place when CAR-Ts were first approved (1),In December 2017, Bloomberg Businessweek (2) reported that a mere five patients had received Yescarta at the 15 cancer hospitals authorized to administer it in the US. No billing code for the therapy meant payment delays from insurers which meant hospitals preferred to hold off on using it.As the number of patients on wait lists for CAR-Ts continued to grow, some are even signing waivers to confirm they will pay for the therapy's cost themselves if insurance payments don't go through (1).The FDA set up a new Drug Shortage Task Force in July 2018 (3). Among other things, it's supposed to evaluate reimbursement policies to come up with solutions.Medicare billing codes are crucial since ~50% of patients eligible for currently approved CAR-T therapy are >65 years of age.CAR-Ts are no magic bullet. As Peter Bach points out in a 2018 NEJM article (4), the first patient to get CAR-T therapy outside of a clinical trial died within a few weeks of treatment.The FDA approved both these therapies based on small numbers of patients (69 total with 22 [32%] responders for Kymriah and 101 total with 51 [50.5%] responders for Yescarta).Medicare and private insurers may find such numbers insufficient to conclude they provide a net benefit.In his analysis Bach noted that (below from 4)“Under the 1965 law that created Medicare, the program must cover services that are “reasonable and necessary” for the treatment of illness.”He also speculated that CMS, the agency that administers Medicare may (below from 4, emphasis mine)“find the trial data sufficient to conclude that CAR-T therapy provides a net benefit for Medicare patients. But such a conclusion would be based on observations from only a handful of patients 65 years of age or older (and thus age-eligible for Medicare). If CMS reaches this conclusion, it need not simply say yes to coverage. It could limit which providers and hospitals are eligible to administer CAR-T, as it does for some organ transplantation, for instance, or it could use the Coverage with Evidence Development (CED) designation, which can either include a requirement that further outcome data be collected in a registry or limit coverage to patients enrolled in clinical trials. In either case, CED aims to buttress the evidence relevant to the “reasonable and necessary” question.”CMS seems to have done just that in its recent decision regarding Medicare payment for CAR-T therapy (below from 5, emphasis mine),“The proposed National Coverage Determination would require Medicare to cover the therapy nationwide when it is offered in a CMS-approved registry or clinical study, in which patients are monitored for at least two years post-treatment. Evidence from the registries and studies would help CMS identify the types of patients that benefit from CAR T-cell therapy, informing a future decision by the agency regarding the types of cases in which Medicare would cover the treatment with no registry or trial requirement.”Bibliography1. de Lima Lopes, Gilberto, and George R. Nahas. "Chimeric antigen receptor T cells, a savior with a high price." Chinese clinical oncology 7.2 (2018). http://cco.amegroups.com/article/download/19225/192672. Months After Approval, Breakthrough Cancer Drug Given to Just Five Patients3. Statement by FDA Commissioner Scott Gottlieb, M.D., on formation of a new drug shortages task force and FDA’s efforts to advance long-term solutions to prevent shortages4. Bach, Peter B. "National coverage analysis of CAR-T therapies—policy, evidence, and payment." New England Journal of Medicine 379.15 (2018): 1396-1398. National Coverage Analysis of CAR-T Therapies — Policy, Evidence, and Payment | NEJM5. CMS proposes Coverage with Evidence Development for Chimeric Antigen Receptor (CAR) T-cell TherapyThanks for the R2A, Robin Hubbard.

I am going to answer this question from the standpoint of a Medical Office that has sometimes dealt with Patient Requests to get Utility Bill Waivers.Rule # 1: Electricity is NOT Free. The Electric Company WILL be Paid or the Power WILL be cut off.Rule # 2: The Fact that you have a Medical Condition that requires electrical Power means that the Responsibility to maintain that Power supply lies with the Resident or their Family Members at the address to make sure that the Utility Bill is Paid.Rule # 3: The Fact that a Resident may have a Medical condition that requires Power to maintain Life IS NOT THE UTILITY COMPANY’S RESPONSIBILITY. In these cases, the Utility company may have a special form or hotline to notify and flag a resident as being dependent-risk because they utilize Life-Support Equipment. When a Resident acct is flagged, it can usually result maybe in an extra month or more of leniency against a Delinquent Acct as the Resident or their representatives arrange for Payment or Relocation.NOTE— Even if you Notify the Utility that you have a Medical Condition that requires Power…Notification does NOT remove the Requirement to Pay any Amounts Past Due. The Utility Company MUST be Paid.In the case of the woman in this article…as tragic as it sounds, there was a failure of responsibility on the part of herself and her Family Members, even though, I gather she lived alone. A chronically Ill person who lives alone must be able to maintain their Basic Utilities: Heat, Electricity & Water.If this person is NOT capable of maintaining these accounts, it is up to their relatives, family members or a Legally Assigned Guardian to step in and take control of the accounts and make payments.If there are NOT ENOUGH FUNDS to maintain a Chronically Ill person in their residence, then it is the Responsibility of the Relatives, the Family Members or a Legally Assigned Guardian to make arrangements to make sure the person’s funds take care of their Basic Bills and accts or to arrange for cheaper accommodations…including the possibility of moving the person in WITH A CONSENTING FAMILY MEMBER OR RELATIVE.Failing that…the remaining option usually means Institutionalization. And Yes…that option can get really ugly. That’s why ‘Family is Important’. It’s the last bulwark.A Letter from a Doctor WILL NOT ELIMINATE THE UTILITY BILL.In Fact, a Letter from a Doctor to the Utility will invoke the mailing of a SPECIAL FORM to that Doctor. If the Doctor Signs it, it re-assigns the Responsibility for Payment from the PATIENT to the DOCTOR or MEDICAL FACILITY.And NO DOCTOR will Sign that form.There is also a Form and a Process wherein a Family Member or Relative Can Assume Direct Responsibility for the Patient’s Electric Bill. The Bill would then be re-directed to the NEW ADDRESS Under the Relative’s or LEGAL GUARDIAN’s name.And the Past Due Amounts WILL STILL BE DUE.Judging from the Article— No-one in this woman’s Family was willing to take responsibility for her Bill. Nor were they willing to relocate her. No-one wanted, or were able, to take her in to their Homes.But Unfortunately, I am guessing that her personal funds were insufficient to cover her monthly costs on more than one level.In short— there is a widespread misconception that if a person is Elderly and Critically Ill, that Utility Bills can be ‘Waived’This is FALSE.Fail to Pay the Oil Company…and they WILL Cease Delivery even if it is the Middle of Winter.Fail to pay the Gas Company…and they WILL cut off your Gas supply to your Water Boiler, your Water Heater and your stove, even if it is the Middle of the Winter.Fail to pay the Electric Company…and they WILL cut off your power to EVERYTHING.There can be some Delay…but there are no Waivers.Utility Bills MUST be Paid.EDIT— a Commenter posted a Link to the NJ PSE&G ‘Bill of Rights’The BOLD is my Translation of what it Actually means…You shall not be asked to pay unreasonably high deposits as a condition of service, or to make unreasonable payments on past due bills. Focus on the word ‘Reasonable’. The Delinquent customer does not get to determine what ‘Reasonable’ is. The Utility Co Delinquent Accts Rep does. They do not say what financial formula they use.You may have the right to budget billing if you are an electric and/or natural gas customer. Note the word MAY. It’s there for a Reason. It’s a Legalism. Take the word MAY out and the sentence reads differently. Here in NY, we also have a Budget Billing option from Con Ed. It is not generally offered as an option because of Past Due Unpaid Amounts.You are entitled to at least one deferred payment in one year. This means you can go ONE month without the Power Company receiving Payment. Think of this you are away on Vacation when the Bill comes. This may also be the case with NY Con Ed, but I’m not sure (Con Ed’s Bill of Rights is suspiciously hard to get a hold of) But I DO know that if no Payment is received TWO consecutive months, a Termination order will be started.You have the right to have any complaint against your utility handled promptly by that utility. What’s not said here is whether the complaint should be done IN WRITING and then FAXed or MAILED. Or maybe there might be an Online Form. Sometimes, a Phone Call is NOT Sufficient. The Complaint must be DOCUMENTED.You have the right to call the Board of Public Utilities to investigate your utility complaints and inquiries. Your service may not be terminated for non-payment of disputed charges during a BPU investigation. Now we’re talking to a Governmental Agency. Again, Documentation is generally MANDATED. If it’s a Medical related complaint, then you need to have the Doctor’s Letter, the Form, everything stamped and dated. Again…just a Phone call is NOT sufficient. And while the case is being Review—The METER is STILL TICKING.If you suspect it is not working properly, you have the right to have your meter tested, free of charge, once a year by your utility. For a $5 fee the meter test will be conducted under the supervision of the staff of the BPU. This is straight forward. But the Meter is RARELY the problem.You have the right to a written notice of termination, ten days prior to the discontinuance of service. In NY, Con Ed will send that Notice after the third UNPAID month, like clockwork. To People who say: “I never got any such notice…” That game does not work today.Residential service may be shut-off, after proper notice, Monday through Thursday, 8:00 a.m. to 4:00 p.m. A utility may not shut-off residential service on Friday, Saturday, Sunday or a holiday or the day before a holiday or if a valid medical emergency exists in your household. Note the Word VALID medical emergency. VALID means: The Utility has been Properly Notified of the Medical Life Support condition with the Requisite Forms signed and validated by a Licensed Physician and an Arrangement via your Doctor, a Hospital or some other Government Agency for PAYMENT to be MADE. It does NOT mean you tell the Power Company: “My aunt has a heart condition and you can never turn the power off.”And Again— If you’ve Waited until the DAY OF the Power Cut-off.It means you ALREADY had not paid ANY Past Due Bill for at least 2 months.It means you did not make any PARTIAL Payments for the past 2 months…or you made INSUFFICIENT Below Reasonable Amounts (Again— The COMPANY decides what is ‘Reasonable’… not you)It means your Past Due Amount and length of Delinquency disqualifies you for ‘Budget Billing’It means you failed to respond to Calls and Letters.By this point, crying Medical Emergency is like plugging a hole in the dike with your finger while the River is flooding its banks all around you.

Updated: 12/03/2021[1] ICICI Amazon Pay Credit Card {For Beginners} :Benefits :Earn 5% back on Amazon India for Amazon Prime customers.Earn 3% back on Amazon India for non-prime customers.Earn 2% back on 100+ Amazon Pay partner merchants using this card on Amazon Pay as payment method even on Life insurance Premiums (E.x: LIC and other private company)Earn 1% back on all other payments.Fees :No Joining Fees, No Annual Fees.**********************************Catch: you will receive all cashback as amazon pay balance only.**********************************Conclusion: it is the best credit card for first-time credit card users, you have nothing to lose if you have this credit card.[2] Axis Bank ACE Credit Card***Fees***:Joining Fee = Free (Till 31st December 2020)After 31st December ₹ 499 +GST = ₹589 , Can be waived if you spend ₹10,000 within 45 days of issuance.Annual Fee₹499 + GST can be waived if you spend ₹2,00,000 per annum/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\***Benefits*** :###Airport Lounge Access###: 4 Domestic Airport complimentary lounge visits to select domestic airport lounges every calendar year with the card.### 5% Cashback ###on bill payments(electricity, internet, gas and more), DTH and mobile recharges through Google PayBigBasket and Grofers (Till 31st December)### 4% Cashback ###Swiggy, Zomato and Ola### 2% Cashback ###All Other Spend/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\***Catch****###Cashback Calculation#### :The cashback will be rounded off to the nearest rupee value for each individual transaction.For Lower Rupee Round Off: Ex. for a transaction of ₹310 , as per calculation cashback of 2% i.e., 330* 2% =₹6.2 in such case You will get ₹6 cashback.Higher Rupee Round Off: for Ex. for a transaction of ₹380 , as per calculation cashback of 2% i.e., 380* 2% =₹7.6 in such case You will get ₹8 cashback.###Cashback shall not be eligible for following spends/transactions on the card###Fuel SpendsWallet loading transactionsCash advancesPurchases converted to EMI post factoEMI transactionsPayment of card fees and other card chargesPayment of outstanding balances/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\Conclusion: if i compare with the same bank Flipkart credit card i can say this credit card is best for Daily needs (More Info about Axis Bank Flipkart Credit card On Number {5} ) as you will get a minimum 2% cashback, as well as cashback of 4% category, is also good which includes Zomato , swiggy and ola.Here i compare 4% cashabck category of Flipkart credit card & ACE Credit card.it’s hard to predict which is the best in 4% cashback category but if i look in current situation (Travel Restriction & Gym partially open) i think for 4% cashback Axis Bank ACE Credit card offers more benefit.Overall I will Go with AXIS Bank ACE Credit Card because through this credit card i can more cashback compare to Axis Bank Flipkart Credit card. as it offers 5% cashback on utility bill payment which is a very good reward for any Indian household. (i will not miss the 5% cashback credit card {which is main one of the main feature of AXIS Bank Flipkart credit card } as i rarely shopping on Flipkart and myntra )[3] American Express Membership Reward Credit Card :This is one of the Credit card which offers Rewards On Wallet Load.(Nowadays most of all indian credit card does not offer rewards on wallet Load)Fees:Joining Fee = Free (only if you applied through Referal link)Annual Fee₹1500 +Tax = Around ₹1800, which can be waived if you spend ₹1,50,000 per year. else 50% waived off if total spend on the card in the immediately preceding membership year is ₹ 90,000.Benefits :[1] 1 Reward point for every ₹50.[2] makes 4 transactions of ₹ 1000/- and more in a month, you will get a bonus of 1000 points for that month.[which easily achievable as adding money in wallet in paytm, Amazon etc. will also be considered or you can use on other online platforms also.] as well as the physical swap is also considered.[3] joining by referral, one will get 2000 points(and if someone applied for a card through your invitation you will get 8000 Points + person who gets the card through your invitation will get 2000 Points). on spend of ₹5,000 within the first 90 days of Card Membership.[4] get 2 add on card for free (Revised On 1st Feb 2020)[5] The points that you earn never lapse.[6] Earn 2x Reward On Below Brands through Amex Reward Multiplier.[7] Excellent Customer Service.**********************************[7] Reward Programme (Revised On 1st Feb 2020) :18,000 Points / 18 Karat Gold CollectionTaj Hotel Voucher ₹9,000Statement Credit worth ₹6,000Amazon Gift Card worth ₹7,000Amex Domestic Travel E-voucher ₹ 7,00024,000 Points / 24 Karat Gold Collection:Taj Hotel Voucher ₹14,000Tanishq voucher worth ₹10,000Statement Credit worth ₹9,000.**********************************Now With Example : (i am not into the deep calculation, simple logic)Check Below Image : Here, i suggest you to (Condition: 1a) spend average ₹12,500 per month out of which (Condition: 1b) you have to make 4 transactions which value is more than ₹ 1,000 so you can get 1,000 bonus point every month(condition {1b} is must). so at the end of the year you spend ₹1,50,000 , so did not have to pay annual fees.Now for the next 3 months, you have to spend ₹4,000 per month (4 transactions of ₹1,000 for 3 months). so after getting 18,000 points, you can redeem against below of the any option, if you wish to go with Taj hotel then it is the best reward but as per my suggestion you can go with Amazon gift card (which is the most practical OptionTaj Hotel Voucher ₹9,000Statement Credit worth ₹6,000Amazon Gift Card worth ₹7,000Amex Domestic Travel E-voucher ₹ 7,000On 1st Year if you apply through Referral Link you will get 4,000 Bonus Point so in 1st year you can get by spending 1,40,000 in 11 months (but condition {1b} must be satisfied) Return Rate would be 5%This is for 2nd Year onwards || So Against ₹1,62,000 You will get ₹7,000 Vouchers so Return Rate is Almost 4.32% however if you calculate For Taj Voucher then Return Rate would be 5.55%.**********************************You Can Apply From Referral: The American Express Membership Rewards® Credit Card**********************************Catch: You will not get rewards points at Fuel, Insurance, Utilities and Cash Transactions.However, the Solution is: You can load Money Into Amazon wallet (where you get the rewards) and pay your Utility as well as Insurance Premium.Conclusion: IF YOUR SALARY IS 50K THEN AMERICAN EXPRESS MEMBERSHIP REWARD IS THE BEST OPTION.[4] HDFC Diners Club Privilege Credit Card:** Eligibility ** :Salary: ₹ 40,000 Per MonthBusines: ₹ 6L Or Higher************************************Fees **Annual Fees: ₹ 2500 + GSTRenewal Fees: ₹ 2500 + GSTSpend ₹3 lakh in 12 months and get a renewal fees waiver************************************ Benefits **HDFC Diners Club Privilege Credit Card comes with following complimentary annual memberships:[1] Zomato Gold[2] Amazon Prime[3] MakemyTrip Double Black[4] Times Prime[5] Big Basket Star** Monthly Milestone **:MonthlyComplimentary choice of any 1 voucher can be availed amongst Ola Select membership or BookMyShow or TataCLiQ worth ₹ 500 every month on spends of ₹ 40,000 in a calendar monthYearlyComplimentary annual memberships can be availed from below partners upon achieving annual spend milestone of ₹5 Lakhs at the time of card anniversary.Zomato Gold, Amazon Prime, MakeMyTrip Double Black, Times Prime, BigBasket Star.************************************ Reward Points **4 reward points per ₹150 spent, 1.3% reward rate1 reward point = ₹ 0.50 if used for booking hotels and air tickets at From their Portal1 reward point ~ ₹0.20 if used for redeeming from the reward catalog or cash10X Rewards on Smartbuy (Hotels & Flights, Amazon, Flipkart, IRCTC, Oyo Rooms cleartrip, Yatra) + Partners { Myntra, ola, zoomcar , First cry } : 13% reward rate2X rewards on weekend dining, 2.6% reward rate Minimum transaction: ₹150 Maximum Points can be earned on weekend dining reward points: 2,000Reward points can be converted to AirMiles across British Airways Executive Club (Avios), Singapore Airlines (KrisFlyer Miles) or Club Vistara in 2:1 ratio (2 Reward Points = 1 Air Mile)Rewards Points are valid only for 2 years from the date of accumulation************************************ Airport Lounge Access **12 Airport lounge access to 1000+ Lounges in India and worldwideLounge access is complimentary for both primary and add-on card holders.No need to carry extra Priority Pass/Dreamfolks DragonPass.** Foreign Exchange Markup fee:**1.99% + GST (get an additional 1% cashback by enabling Global Value Program)** Insurance **Air accident insurance cover worth ₹1 croreMedical emergency insurance cover of up to ₹25 lakhTravel insurance cover of ₹ 55,000 for baggage delay or loss.** Golf Privileges **2 Complimentary Golf Games per Quartercatch: Now they limit 5000 Points per credit card billing cycle. and Dinner’s club has acceptance Problem Outside India. Partners List changed Frequently (not on daily basis but on mostly quarterly )Conclusion: Overall, it is still preferable Credit card as it offers international as well as Domestic lounges, And the Reward is also good.[5] Flipkart Axis Bank Credit Card :Benefits :Flat 5% Cashback :FlipkartMyntra2GUDIt will be auto-credited to the card account every month, so will get adjusted against the bills.Flat 4% Cashback on Preferred Merchants namely:UberCure.fitPVRGoibiboMakeMyTrip &It will be auto-credited to the card account 3 days prior to next statement date. (Purchase on 10th Jan || Cashback earned in the Jan cycle with statement date of 15th Jan || Cashback credited 3 days prior to next statement date i.e. on 12th Feb )Flat 1.50% Cashback: on all other categories - except Gold, wallet loading and fuel spends.Airport Lounge Access: 4 Domestic Airport complimentary lounge visits to select domestic airport lounges every calendar year with the card.**********************************Fees:Joining ₹ 500 + tax = ₹590, but against which you will get welcome benefits of₹500 worth Flipkart vouchers on your first transaction anywhere with your Flipkart axis bank credit card in Digital Form within 30 days of First Transaction.Six months complimentary Gaana subscription₹500 off on domestic hotel booking with Goibibo on a minimum booking of ₹ 2,000.Rs. 500 off on domestic hotel booking with Makemytrip on a minimum booking of ₹2,000.15 % cashback up to ₹500 on the first transaction on Myntra20 % instant discount up to ₹400 for new Urban Clap customers.Annual Fees: ₹500 can be waived if you spend ₹2,00,000 per annum**********************************Catch: here they settle cashback in the lower rounded rupee which not same as icici amazon pay credit card if you spend ₹145, then you will get only ₹2 cashback, not ₹2.17(as per 1.5% cashback or you spend ₹595 in Flipkart you will get the only ₹29 cashback, not ₹30 {as per 5% cashback})Be aware If you making payment for flight ticket(Domestic & international) as well as bus ticket on makemytrip …for availing 4% cashback you have to apply some code…also, it will not be allowed for a multi-city flight ticket.Cashback shall not be eligible for following spends/transactions on the card,Fuel SpendsPurchase of Gift cards on Flipkart, Myntra ,2gudEMI transactionsPurchase converted to EMIWallet Loading TransactionsPurchase of gold itemsCash advancesPayment of outstanding balancesPayment of card fees and other card charges.**********************************Conclusion: After the Launching of Axis Bank ACE Credit card(12/10/2020) go only for this credit card only if you are doing heavy shopping on Flipkart & Myntra ,As far as 4% cashback on Makemytrip & goibibo concern: it is not guaranteed that make my trip & goibibo offer the best Deal all-time sometime(also 4% cashback are not clear you have to follow if else condition as well) you have to switch to another Travel website as well.[][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][][]From above as per my opinion,[1] Amex Membership Reward Credit Card is the Best credit card as of now in India.[2] ICICI amazon Pay Credit Card[3] Axis Bank ACE Credit Card[4] HDFC Diners Club Privilege Credit Card[5] AxisBank Flipkart Credit Card.