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Thread: A lawsuit settlement will end a Medicare policy that deprives chronically ill people

  1. #1
    Distinguished Community Member tic chick's Avatar
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    Default A lawsuit settlement will end a Medicare policy that deprives chronically ill people

    hello everyone!

    recently i was asked by the social worker at the nursing home where my mom is, to sign some papers agreeing with the decision to end physical therapy for my mom. they said she was no longer benefitting from the therapy and medicare wasn't going to pay for it. so, i signed the papers half-heartedly, because i know my mom will not recover from alzheimer's disease. however, i felt that the process was at least keeping her moving and allowing her to have interaction with the staff and other's. she always liked the attention she got when she went to physical therapy and i think even that is beneficial.

    today i read a story on msnnews on the internet saying that a lawsuit had been settled that says,
    'Medicare would not deny skilled nursing care and various forms of therapy for beneficiaries, regardless of their prognosis.'
    the story further stated that,
    "Under the agreement, which amounts to a significant change in Medicare coverage rules, Medicare will pay for such services if they are needed to 'maintain the patient's current condition or prevent or slow further deterioration,' regardless of whether the patient's condition is expected to improve."
    for further info from this story and how it might impact those with ms, parkinson's disease, alzheimer's, chronic lung disease and even the elderly who are getting weaker and young people with disabilities, please click on this link: http://money.msn.com/health-and-life...5-fb16fe92aec4

    i hope those of you who have been denied access to maintain your current physical status will be able to once more get help.

    ...jeannie
    Here's to good women. May we know them. May we be them. May we raise them.
    "The world is a better place when you're barefoot." Mark
    "Don't go there unless you know the way back." TC
    "...there will be an answer. Let it be." Paul McCartney

  2. #2

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    not sure what this is about since my condition is slowly becoming worse.. but I am now on "special needs" medicaide insurance due to a development brain defect. I get better care with this then medicare alone. MN has a 'special needs" insurance law of sorts for those with medicare and medicaide who also have a developmental disability. I LOVE my ucare connect! :) they understand my needs and are always happy to help me with transportation issues. this is excellent considering my specialists are either in the twin cities or way up north and I see them regular.

  3. #3

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    OK I just reread that link the third time.. STUPID ACC :( thats my brain disorder. But I have recnetly been diagnosed with dysuatonomia and a 'failing central nervous system" so if they want me in a nursing home.. tough luck? is that what this means? Right now my Mother is my PCA and medicaide covers her salary( I am 37 and severely disabled.. near bedridden) they don't know HOW long I will live or even if I will ever get better! one test after another.. HOW horrible of the government to do this to us!

  4. #4
    Distinguished Community Member tic chick's Avatar
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    hello acc_gal and welcome !

    from what i understand about this new law, it means that if you are covered by medicare and your condition is deteriorating, you cannot be denied any services even though you have a terminal illness. it means that if physical therapy, or some other kind of therapy is maintaining your condition or keeping you from getting worse, you cannot be denied that treatment or therapy even if you have a terminal illness.

    it doesn't mean you have to go to a nursing home . if you are already in a nursing home, however and you are getting physical therapy or respiratory therapy or occupational therapy, you cannot be denied that therapy even if you are not expected to get better from the therapy and you have a terminal illness diagnosis.

    how wonderful that you live in a state where you are getting such good care! it seems your mom knows what to do to get you the best care possible!

    acc_gal, have you posted in the child neurology forum? yes, i know at 37 that you are NOT a child , but there are moms there that are taking care of their adult children who have medical, physical and mental disabilities. these moms know SO much about how the medical system works that even i read their posts, because i am always trying to learn ! your posts are understandable and thoughtful, i'm sorry your brain disorder causes you such frustration!

    i hope you find a little home of support here in the braintalk communities .
    jeannie
    Last edited by tic chick; 03-02-2013 at 01:34 PM.
    Here's to good women. May we know them. May we be them. May we raise them.
    "The world is a better place when you're barefoot." Mark
    "Don't go there unless you know the way back." TC
    "...there will be an answer. Let it be." Paul McCartney

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