A settlement filed in federal court this week will dramatically change what Medicare covers. Until now, interventions and treatments had to demonstrate that the patient improved. With the new ruling, Medicare will be required to cover care that enables a patient to maintain his or her function, or to prevent decline. This means that tens of thousands of beneficiaries will now have access to home health services and supports for which Medicare had previously denied coverage. We cannot overstate how important this change is, and what a dramatic effect if will have on the lives of millions of beneficiaries. The ruling opens up new possibilities for care–and opportunities for community-based improvements and quality measurement. For years, health care providers and families have struggled with–and suffered because of–Medicare’s refusal to pay for many services that people could use. This ruling changes all of that. It is a red-letter day for patients everywhere.
You can read the full text of the ruling here, at Medicaring. And watch here in coming days for updates and analyses.
You can read the full text of the proposed settlement for Case 5:11-CV-17-CR.