Challenge to Medicare coverage denial: your stories are needed

[Guest guest]

CHALLENGE TO MEDICARE:

DON'T REQUIRE PEOPLE TO GET BETTERTO GET COVERAGE AND CARE

Jimmo vs. Sebelius, No. 5:11-cv-17 (D.Vt.)

On January 18, 2011 the Center for Medicare Advocacy, with co-counsel Vermont Legal Aid, filed a national class action law suit in federal district court to eliminate Medicare's long-standing practice of denying coverage and access to care for people who are not going to improve, or improve sufficiently, or improve quickly enough.

This inappropriate "Improvement Standard" keeps people with long-term and chronic conditions from obtaining medically necessary health care and therapeutic services such as nursing, physical, occupational, and speech therapy. That is what happened to Glenda Jimmo, the lead plaintiff in the law suit.

Ms. Jimmo, a 71-year-old resident of Vermont, was denied Medicare coverage for home health nursing and aide services on the grounds that she was stable, despite the fact that she has diabetes, peripheral vascular disease, on-going circulatory problems, skin lesions, and is legally blind and has a below-the-knee amputation.

The lawsuit, Jimmo vs. Sebelius, was filed in Vermont federal court on behalf of five individual Medicare beneficiaries from Vermont, Connecticut, Rhode Island and Maine, and five organizations, National Multiple Sclerosis Society, Parkinson's Action Network, Paralyzed Veterans of America, National Committee to Preserve Social Security and Medicare, and American Academy of Physical Medicine and Rehabilitation. The federal government has 60 days to file its Answer to the lawsuit.

Improvement is NOT a legal standard upon which to determine eligibility for Medicare coverage. The Center for Medicare Advocacy hopes the Jimmo case will eliminate this harmful policy and practice once and for all.

MEDICARE DOES NOT REQUIRE "IMPROVEMENT" FOR COVERAGE

The Center for Medicare Advocacy has launched a campaign to end this unfair standard. We need your stories!If you or someone you know has been denied Medicare coverage because the person's condition is not showing improvement, Medicare coverage is being unfairly denied.If Medicare coverage is denied because "your underlying condition will not improve," "you have plateaued," "you are not likely to improve," "you are chronic and stable" or "you need maintenance services only,"share your story now or contact us at (860) 456-7790 or improvement@....