Mom, inventor seeks change in how insurance companies operate - PineCreek Journal

Mom, inventor seeks change in how insurance companies operate

Sunday, October 20, 2019 | 12:01 AM


When Rose Morris couldn’t find a suitable product to keep her special needs son safe while he slept, she invented one.

Now, the president and founder of Abram’s Nation (www.abramsnation.com) has hopes of finding others who can help influence the way insurance companies pay for safety beds for special needs kids.

“(Insurance) now is a giant money-making machine,” Morris said. “And they need to protect themselves, too. They can’t pay out a million dollars for every child, I get it. It’s a business. However, you also need to have a level playing field. My goal is I would love it if this gets posted and shared and I do meet someone who has that political mindset to get in there and talk to the lawmakers and people who do affect change.”

Ten years ago, Morris’ son Abram, who has autism, was prone to wandering and self-injuring behavior at night. All she could find at the time were beds that were designed for medically fragile children but not necessarily right for kids with autism.

So she came up with her own solution: The Safety Sleeper, which is an enclosed canopy bed that’s designed to work with twin, full, twin XL and full XL mattresses in the U.S.

Abram’s Nation products are sold across the U.S. as well as in Europe, Scandinavia, Australia and Canada. Prices range from $2,200 to $4,000.

After years of hearing repeatedly from customers about insurance denying their claims for the beds, however, and even accompanying families to their appeal hearings only to have claims denied again for entirely separate reasons, she launched the petition.

One person who signed is Aimee Robeson of Butler.

Her son has developmental delays and sensory issues resulting from hydrocephalus, and he was diagnosed with epilepsy at 7 months. It wasn’t until their third appeal that their insurance company agreed to pay for a SleepSafe bed.

“The third appeal they never even showed up to our hearing, and that’s how we ended up getting it,” she said. “I don’t know if they got tired of me appealing or what.”

For the first appeal, the family’s pediatrician completed a peer-to-peer review, but the company wouldn’t accept his recommendation that the bed was medically necessary, Robeson said.

In the interim, after her son had a craniotomy at the age of 2 and in desperation to keep him from re-opening the wound and further injuring himself in the night, they went to the store and bought an inflatable pool, put a spare twin size mattress inside then stuffed every pillow and blanket they had in the gaps, and that’s how he slept, Robeson said.

“During the appeal process, they said he didn’t need the bed because there were other alternatives, like putting up bed rails,” Robeson said. “I was like, ‘No, you don’t understand, right now he’s in an inflatable pool, and they were saying, ‘You can drape the bed sheets around and do this and that and the pool is suitable.’ They were actually defending us using an inflatable pool as his bed.”

Her biggest hope if the petition gains traction, Robeson said, is that ultimately insurance companies would be required to approve bedding for special needs children on the basis of a doctor’s prescription.

“If the doctor takes the time to do that or do a peer-to-peer review because they know the child best and have talked to the parents and, medically, they know the best fit for them, (insurance companies) should be able to cover this for families,” she said.

Morris launched the petition, using the title, “#InsuranceDeniedMe — Stand Up to Insurance Companies for Children with Special Needs,” at the beginning of October and within two weeks she’d gained more than 1,400 signatures.

“I’m hoping to find the village that can come together on this,” she said. “I need someone from, say, California to say, ‘I agree, I have strong connections, let’s get my friend from New York involved, too.’ It has to be from across the nation. It can’t just be me. I’m just a little guy. But little guys can band together and make a change.”