Obama administration to relax Medicare benefit rules

As part of a proposed settlement in a national class-action lawsuit, the federal government would expand benefits for skilled nursing and home health care to the chronically ill.

The Associated Press/Washington Post: Proposed Medicare Change To Allow Disabled And Chronically Ill To Keep Getting Rehab Services
Thousands of Medicare patients with severe chronic illnesses such as Alzheimer's would get continuing access to rehab and other services under a change agreed to by the Obama administration, advocates said Tuesday (10/23).

Los Angeles Times: Settlement Proposed To Broaden Medicare Coverage
Sick and disabled Americans who rely on Medicare may gain new access to care with the proposed settlement of a lawsuit that challenged the government's practice of denying some coverage to patients whose condition was not improving. Under the terms of the settlement -; expected to be approved by a federal judge in Vermont in coming months -; Medicare would not deny skilled nursing care and various forms of therapy for beneficiaries, regardless of their prognosis (Levey, 10/23).

Kaiser Health News: Capsules: Industry Likes Medicare Home Care Expansion, But Cost Is Unknown
Patient advocacy and industry groups are cheering Medicare's move to start paying nursing home, home care and physical therapy bills for some patients who were previously denied coverage. But how much extra it will cost the government is far from clear (Hancock, 10/24).

Reuters: Obama Administration Agrees To Ease In Medicare Benefit Rules
The Obama administration has agreed to relax Medicare's requirements for skilled nursing and home health care, allowing beneficiaries to qualify for benefits even if their conditions are not expected to improve, according to court documents. A proposed settlement of a national class-action lawsuit, filed October 16 in U.S. District Court in Vermont, says the government will revise its Medicare manual to make benefits available when care would only "maintain the patient's current condition or ... prevent or slow further deterioration" (Morgan, 10/23).

Modern Healthcare: Class-Action Settlement Would Widen Medicare Chronic-Care Benefits
A federal judge in Vermont may approve a proposed legal settlement intended to guarantee Medicare benefits for people with chronic health conditions who need nursing and therapy services at home or in skilled-nursing and outpatient facilities. The settlement would resolve (PDF) a national class-action lawsuit that alleges HHS, Medicare contractors and administrative review boards across the country have rolled out a "clandestine" policy to limit Medicare coverage for nursing and therapy services even though official CMS rules say those benefits should be covered (Carlson, 10/23).

In other Medicare news -

USA Today: House Members Want Medicare To Change ID Card Numbers
A recent inspector general report, first highlighted in USA TODAY, has brought another call to disconnect Social Security numbers from Medicare identification cards because of the risk of identity theft and fraud (Kennedy, 10/23).