Therapy services at Dyer Nursing and Rehab
There has been an important change in the Medicare policy that affects individuals with chronic conditions such as Parkinson’s, multiple sclerosis, ALS, Alzheimer’s disease, heart disease, diabetes, and stroke. Until now, patients with chronic conditions had to show a likelihood of improvement in their condition or functioning in order to receive Medicare benefits. This policy has been revised because of a class action lawsuit that was recently settled. The new policy states that Medicare determinations will now be decided on the basis of the need for skilled care or therapy, not on the individual’s ability to improve.
The change applies to care for those in Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, Home Health care, and Outpatient Therapies. The updated policy clarifies that “coverage should never be denied because a patient cannot be expected to achieve complete independence in self-care or to return to his/her prior level of functioning.”
This change will have a big impact on patients who need some kind of skilled care in order to maintain their level of functioning, or to prevent further deterioration. The former policy left many individuals to pay for their own care, or to discontinue care if they couldn’t show that they were improving.
The new guidelines are now in effect, so coverage should be available immediately for people who require skilled maintenance care and meet other qualifying Medicare criteria. The Centers for Medicare and Medicaid Services are responsible for seeing that all who make Medicare eligibility determinations are using the new guidelines.