Industry Notes:
Take These Steps Now To Address Clarification Of 'Im-provement' Coverage Criteria
Published on Thu Nov 01, 2012
You can implement changes now in re-action to a proposed class action lawsuit eliminating the improvement criteria for Medicare home care coverage.Background: In a proposed settlement of a nationwide class-action lawsuit filed last year, the Obama administration has agreed to scrap the practice of requiring many beneficiaries to show a likelihood of medical or functional improvement before Medicare would pay for home care and other post acute services (see Eli's HCW, Vol. XX, No. 37).If the federal court judge approves the settlement some time in the next few months, as ex-pected, the Centers for Medicare & Medicaid Ser-vices then will revise Medicare manuals and educate contractors, providers, and others on the clarification, says the Center for Medicare Advocacy, which is representing the plaintiffs in the lawsuit.What now? "The settlement does not change the underlying law and regulations governing the Medicare program," CMA says in a release. "Accordingly, since the Medicare [...]