NAHC Praises Class Action Settlement That Protects Medicare Patients
October 23, 2012 05:57 PM
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Barbara D. Woolley
National Association for Home Care & Hospice
Washington, D.C. (October 23, 2012) – Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC) released the following statement about the settlement of a nationwide class-action lawsuit against Medicare.
“Medicare beneficiaries with chronic illnesses and deteriorating conditions at the end of life have had their rights to Medicare home health care coverage restored today!” said Val J. Halamandaris, President of the National Association for Home Care & Hospice. “The settlement of the class action lawsuit announced today will provide our vulnerable seniors and persons with disabilities the opportunity to receive therapy and nursing services essential to maintaining functional abilities and preventing avoidable decline in their condition.”
Medicare beneficiaries are entitled to coverage of home health services when they are homebound and in need of skilled nursing or therapy. The lawsuit challenged the application of an “improvement” standard in determining whether skilled care is needed. As part of a settlement of another class action in 1989 that established Medicare standards that allowed for coverage of chronically ill patients and those who required therapy to maintain function or prevent accelerated deterioration, the Medicare home health benefit was restructured to properly serve the whole Medicare patient population. Over time, Medicare contractors that administer the benefit improperly imposed a standard that limited coverage to only those patients who showed improvement in function or their clinical condition.
“Medicare beneficiaries are entitled to home health services that provide them with the skilled care that can improve their condition, but also care that prevents or slows a decline in function. We are very pleased that Medicare has recognized that some of our most vulnerable citizens were wrongly denied benefits,” said Halamandaris.
The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, and disabled. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC, visit www.nahc.org.