Medicare Class Action Lawsuit

"In a proposed settlement of a nationwide class-action lawsuit, the administration has agreed to scrap a decades-old practice that required many beneficiaries to show a likelihood of medical or functional improvement before Medicare would pay for skilled nursing and therapy services.

Under the agreement, which amounts to a significant change in Medicare coverage rules, Medicare will pay for such services if they are needed to “maintain the patient’s current condition or prevent or slow further deterioration,” regardless of whether the patient’s condition is expected to improve." NY Times, Oct. 22, 2012

 

Wonderful news for those of who are caregivers for someone with dementia.  Dwane had benefited so much from PT (physical therapy) services, which were helping him with his posture and, therefore, with his back pain; but these services had to be terminated in September because he had met the upper limit allowed by Medicare.  Now I can get him scheduled in again.  I am grateful to the Center for Medicare Advocacy which brought the lawsuit forward on behalf of us all.  If the person for whom you are caregiver would benefit from either skilled nursing or therapy services, check into having these paid for by Medicare under these new agreements parameters.