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Improvement Standard Fairness Hearing Scheduled: Next Step to Eliminating Harmful Standard for Good

January 22, 2013

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January 16, 2013 – Mansfield, Ct. – The Center for Medicare Advocacy, along with its co-counsel Vermont Legal Aid and the law firm of Wilson Sonsini Goodrich & Rosati, marks a critical next step toward finalizing its class action lawsuit against the federal government this week. With the recent close to the comment period for the proposed settlement in the Medicare Improvement Standard case [Jimmo v. Sebelius, No. 5:11-cv-00017 (D.Vt.)], the plaintiffs’ counsel are encouraged that only one written objection has been recorded (and even that was based on a misunderstanding of the settlement). The plaintiffs joined with the named defendant, Secretary of Health and Human Services Kathleen Sebelius, in asking a federal judge to approve the settlement of the case in October 2012.

The next step in the adjudication process is a Fairness Hearing, which is scheduled for January 24 in federal district court in Vermont, where the case was filed. In the event that the settlement is approved, the Centers for Medicare & Medicaid Services will be required to rewrite numerous parts of the Medicare Benefit Policy Manual stating that Medicare coverage is available for maintenance services, and begin a nationwide education campaign to ensure that beneficiaries will not be denied coverage for critical services in the future.

"As this legal challenge takes a critical next step, we are pleased that a final and complete resolution is in sight for those who live with chronic conditions and rely on Medicare to maintain their health and well-being," said Gill Deford, plaintiffs' lead counsel on the case. "The time has come for this unjust rule of thumb to end, and we look forward to the day when all beneficiaries have the coverage that they need and are entitled to under the Medicare statute."

To speak with a representative of the Center for Medicare Advocacy, please contact Lauren Weybrew at lweybrew@douglasgould.com or 914-833-7093. Learn more about the Center for Medicare Advocacy at www.medicareadvocacy.org

________________________

The Center for Medicare Advocacy, Inc., established in 1986, is a national nonprofit, nonpartisan organization that provides education, advocacy and legal assistance to help older people and people with disabilities obtain fair access to Medicare and necessary health care. We focus on the needs of Medicare beneficiaries, people with chronic conditions, and those in need of long-term care. The organization is involved in writing, education, and advocacy activities of importance to Medicare beneficiaries nationwide.

Filed Under: Press Release Tagged With: The Improvement Standard

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Jimmo v. Sebelius

Medicare covers skilled care to maintain or slow decline as well as to improve.

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