Thursday, February 3, 2011

Class Action Lawsuit Challenges Medicare's "Improvement Standard"

Last fall I posted this entry discussing Medicare's misapplication of a "improvement standard" in determining a whether a person using Medicare days in a nursing home should continue to receive Medicare coverage for the duration of the 100-day maximum Medicare period for each "spell of illness."

On January 18, a number of advocacy groups joined forces and filed a class action lawsuit against the U.S. Department of Health and Human Services alleging that HHS has improperly applied the improvement standard to deny Medicare participants care to which they were entitled.   The lawsuit, Jimmo v. Sebelius, was filed in the United States District Court for the District of Vermont.

A copy of the complaint can be read here.

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