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May/1/2014

Health Law Update

Download May 14 Health.pdf

One development of particular importance attorneys representing providers servicing the chronically ill Medicare population was the January amendment, by the Centers for Medicare and Medicaid Services (“CMS”), to the Medicare Benefit Policy Manual (“MBPM”) clarifying coverage for therapy and skilled nursing care in the wake of the January 2013 settlement in the Jimmo v. Sebelius1 case. The Jimmo case was a class action lawsuit against CMS’s parent agency, the U.S. Department of Health and Human Services (“HHS”), challenging the denial of services provided to maintain the condition of chronically ill patients, who demonstrated little potential for improvement, let alone recovery. Although CMS agreed, in the Jimmo settlement, to recognize such maintenance care, the MBPM amendments contain fresh documentation requirements necessary to demonstrate coverage. Attorneys can play a key role in assisting providers, and even beneficiaries, to understand and comply with these requirements in order to demonstrate coverage.






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September 2014 NEWSLETTER


Albany County Bar Association
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