Five of thousands of Medicare patients with “chronic” medical conditions not receiving coverage, together with five national organizations serving patients with multiple illnesses, filed a lawsuit recently in an effort to provide better care for these patients, said a NY Probate Lawyer. Patients in New York City and Long Island have been made aware of these conditions and the efforts to change things.
“It is illegal and unfair and an inappropriate application of the Medicare law,” said the founder and executive director of the Medicare Advocacy Center, a Washington, D.C.-based nonprofit organization that filed the lawsuit in Vermont federal court. “It is a major barrier to access to medical care and access to necessary care.”
The lawsuit basically says that coverage is being denied because of “an improvement standard,” which basically means that patients are denied treatment for occupational therapy and other physical remedies in situations that seem helpless. Examples include debilitating conditions like Multiple Sclerosis, Alzheimer’s and Parkinson’s disease.
“This is not just a theoretic problem but one that affects patients every day,” the executive director went on to say and added that the practice of denying coverage has been going on for much too long.
Many therapies that can be given at home are being denied and could strongly improve these patient’s conditions, said a NY Probate Lawyer. He added that the goal of this lawsuit is mainly to change the language in Medicare laws so that coverage will no longer be denied based on “the improvement standard.”
A representative from Medicare could not be reached for comment but one patient speculates the company will come forward in the next few weeks with a statement.
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