What is the Victor Rivera Foundation?
The Victor Rivera Foundation is named in honor of Dr. Victor Rivera, a leading expert and pioneer in the treatment of multiple sclerosis. The Foundation is a 501(c)(3) created in the state of Texas to provide MS care to those in need of access to neurologic and neuro-eye services. This includes individuals who are underinsured, may have a high deductible or lack health care benefits. The Victor Rivera Foundation strives to ensure that all people with MS receive the highest quality care regardless of their ability to pay.
How will the Victor Rivera Foundation achieve its mission?
The Victor River Foundation will reimburse health service providers who provide Foundation-approved care to people in need. The Foundation has three goal areas:
- To provide under resourced people of all ethnicities living with MS access to neurologic and neuro-eye services. This includes individuals who are underinsured, may have a high deductible or lack health care benefits.
- To ensure people with MS and similar diseases receive current and proven neurologic and neuro-eye protocols.
- To promote mentoring of bilingual MS healthcare professionals.
What type of care will the foundation support?
The Foundation strives to reduce financial barriers to care for underinsured patients with multiple sclerosis. It will reimburse health professionals for patients who have met the Foundation’s standards for inability to pay and no other funds for reimbursement can be found for needed services in these areas:
- Newly diagnosed consultations.
- Second opinion for patients requiring confirmation of the initial diagnosis and adequacy of ongoing treatment.
- Select tests where no other reimbursement can be found.
- Referral to clinical trials as appropriate.
- Standard MS ongoing care coordination provided in a physician’s office.
- Standard neuro-eye ongoing care provided in a physician’s office.
- Tests provided in a physician’s office.
- Eye exam and consultations.
What are examples of care will the foundation not support?
In general, services not billed through a health care provider are not covered by the Foundation, these include but are not limited to:
- Medications and pharmaceutical treatments
- Durable Medical Equipment
- Home health aide/care
- Care covered by insurance or other third-party coverage
- Tests provided outside a physician’s office or health care facility
- Co-pays for prescription drugs
- Health insurance premiums
- Deductibles
- Travel costs
- Non-medical expenses such as rent, electricity, or phone service
Partnerships with pharmaceutical companies and other avenues such as other foundations or government programs will be leveraged to ensure proper pharmaceutical treatment and access for all in need.
In all cases of Foundation support, all other options for funding patient care must be explored first. The Foundation will consider reimbursing under a reduced rate where no other options are possible.
Reimbursement is based on the Foundation’s available resources. Decisions related to what will be reimbursed can be adjusted by the board of the Foundation based on the Foundation’s resources and ability to reimburse for care. The Foundation board establishes the criteria to use for financial determination. The intent is for this to be a simple process. It includes asking patients to pay a portion of the cost based on their ability.
If a patient has a neurologist will the foundation reimburse their doctor?
The Foundation is structured to support neurological services delivered by qualified professionals.
Do patients need to have clinically definite or clinically suspected MS to qualify for foundation support?
Yes, those with suspected or established MS diagnosis would qualify to be evaluated as to eligibility for reimbursed services by the Victor Rivera Foundation. For patients suspected to have MS and who meet a certain set of criteria, support would be considered to provide a diagnosis.
What makes a person eligible for foundation support?
The Victor Rivera Foundation will conduct an intake process based on its criteria to determine patient care that qualifies for support. Pre-approval is needed for payment to medical professionals. The Foundation will provide support regardless of citizenship status.
How can patients explore support for medical care through the Victor Rivera Foundation?
The first step is for the patient to contact their medical professional or the National Multiple Sclerosis Society and begin to work with the Victor Rivera Foundation for an intake evaluation. This evaluation will review the patient’s ability to pay and qualification for Foundation support, what services might be needed by the patient. Reimbursement for some or all of the anticipated services must be pre- approved by the Victor Rivera Foundation. This is a simple process intended to ensure speedy attention to the patient’s needs.
This graph shows the process to follow to seek support from the Victor Rivera Foundation:
