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  • APTA Clarifies Key Points of Medicare 'Improvement Standard'

    APTA's issue brief on the final settlement in the class action "Improvement Standard" lawsuit (Jimmo vs Kathleen Sebelius), which upheld the right of patients to continue to receive reasonable and necessary care to maintain their condition and prevent or slow decline, contains key points for physical therapists regarding compliance with this Medicare regulation.    

    In the brief, APTA notes that there is "clear and convincing evidence embedded within the provisions of the current Medicare regulations that providers may use to justify the current practice of providing skilled therapy to patients to maintain their current level of function or to prevent decline or deterioration." Thus, the final settlement seeks to clarify the regulations; it does not expand the Medicare benefit. "Therefore, we expect that only patients who were unfairly denied services based on this arbitrary standard will now have access to care," says the brief. 

    APTA members can access the issue brief on the Medicare Coverage Issues webpage under the subtitle Improvement Standard. 


    • Very helpful information shared here, thanks for this info.

      Posted by Anton Martin on 7/26/2013 8:17 AM

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