Many times a year, MS Activists around the
country contact their legislators to urge support of policies and funding that
will benefit people living with multiple sclerosis (MS). Today, the Society is
pleased to announce that another type of activism—judicial action—has resulted
in a settlement that will help ensure that people with MS get the home health
care, skilled nursing home stays and outpatient therapy they need.
Just two years ago, the Society joined as an
original plaintiff in a class action lawsuit that challenged the Centers for
Medicare and Medicaid Services’ (CMS) inappropriate and illegal practice of
denying Medicare coverage to those who are unable to show that they are
improving from certain skilled care services, including therapy. This practice
has been particularly impactful for people with chronic, degenerative diseases
such as MS for which services such as therapy may be exactly what is needed to
help slow deterioration.
As a result of the lawsuit, the government has
agreed to take corrective action so that it will not happen in the future. The
government will revise relevant portions of its Medicare Benefit Policy Manual
and engage in a nationwide Educational Campaign about the corrected maintenance
coverage standards. Members of class will also be entitled to a re-review of
their denied claim within the next year.
We at the National MS Society are very pleased
with the progress which has been made in this case. Medicare beneficiaries
living with MS and other chronic illnesses will now definitively be able to
receive important needed health care services that prevent decline and maximize
independence. To learn more about this important settlement and about one of
its inspirational plaintiffs who lives with MS, click here.
The Society recognizes the work of the Center
for Medicare Advocacy, Inc. which has coordinated the legal proceedings for
plaintiffs in this case and acted as lead counsel. The other national
organizations that entered the case as plaintiffs are: Parkinson’s
Action Network, the Alzheimer’s Association, Paralyzed Veterans of America,
United Cerebral Palsy and the National Committee to Preserve Social Security
and Medicare.
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