KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Notable Medicare Lawsuit Settlement Could Aid Patients Needing Skilled Nursing Care, Other Types Of Therapy

News outlets explain how a recent Medicare settlement could have an important impact on people who need physical, occupational and other therapies for certain disabilities and chronic conditions.

Reuters: Landmark Medicare Settlement Could Change Lives 
Under the settlement of the lawsuit, Jimmo v. Sebelius, the U.S. Department of Health and Human Services has agreed to relax Medicare's requirements for coverage of skilled nursing and therapy services in institutional or home care settings.The key criterion for coverage will be a demonstrated need for skilled care - regardless of whether there is a recovery prognosis. That means patients already enrolled in Medicare Part A (hospitalization) who need care to maintain their current condition but aren't likely to improve will qualify for Medicare's standard benefits (Miller, 10/27).

The New York Times: What Medicare Will Cover Even If You're Not Likely To Get Better
But after the settlement of a landmark class-action lawsuit this week, Medicare will soon begin paying more often for physical, occupational and other therapies for large numbers of people with certain disabilities and chronic conditions like Alzheimer's disease, multiple sclerosis and Parkinson's disease. The two questions patient advocates were left with this week were just how many people may benefit from the clarification of the regulations and how quickly (Lieber, 10/26).

Related, earlier news summary: Obama Administration To Relax Medicare Benefit Rules (10/24)

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