http://www.newhavenadvocate.com/featured-news/health-care-coverage-denied-why-is-the-federal-government-telling-the-chronically-ill-they-deserve-no-helpWhy is the federal government telling the chronically ill they deserve no help?
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Almost every week for several years, Anne Marie Maffuid received a yellow piece of paper saying that the Medicaid-provided care for her mother would be terminated.
The reason: Maffuid’s mother has ALS and her condition wasn’t improving. ALS is a chronic disease, which, almost by definition, means that her condition is not expected to improve. There is no cure for ALS. Wheelchair-bound, Maffuid’s mother needed help showering and feeding herself, among other things; Medicare paid for a visiting nurse and therapy.
“The whole thing was very upsetting,†Maffuid says.
Maffuid is just one of many people who’ve received similar termination notices, says Gill Deford, an attorney with the Connecticut-based Center for Medicare Advocacy, a group that represents Medicare patients and lobbies to improve Medicare policies.
Deford wants to know why Medicare has been using the so-called “Improvement Standard†— which seems to require a patient to be improving to continue receiving certain benefits — to stop giving people Medicare-provided therapy (they’d still receive Medicare coverage for things like routine hospital or doctors visits).
However, there is no such thing as the “improvement standard,†Medicare regulations dictate that improvement is “not the deciding factor in determining whether skilled services are needed.â€
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