As the result of a successful lawsuit filed in Vermont, Medicare can no longer deny coverage for skilled services care because a patient’s progress is not likely to improve. Medicare officials have updated the agency’s policy manual to clarify that continuing improvement is not necessary to receive coverage for skilled care.
Medicare will now pay for physical therapy, nursing care and other services for beneficiaries with chronic diseases like multiple sclerosis, Parkinson’s or Alzheimer’s disease in order to maintain their condition and prevent deterioration. Medicare officials were required to inform health care providers, bill processors, auditors, Medicare Advantage plans, and appeals judges. However, Medicare was not required to notify actual beneficiaries or otherwise publicize this change.
To learn more, below is the link to the New York Times article: A Quiet "Sea Change" in Medicare