Tag: Gill Deford

Medicare’s Coverage Of Therapy Services Again Is In Center Of Court Dispute

By Susan Jaffe  | Kaiser Health News | January 30, 2017 | This KHN story also ran on     

Four years after Medicare officials agreed in a landmark court settlement that seniors cannot be denied coverage for physical the
rapy and other skilled care simply because their condition is not improving, patients are still being turned away.

So federal officials and Medicare advocates have renewed their court battle, acknowledging that they cannot agree on a way to fix the problem. Earlier this month, each submitted ideas to the judge, who will decide — possibly within the next few months — what measures should be taken.

Several organizations report that the government’s initial education campaign following the settlement has failed. Many seniors have only been able to get coverage once their condition worsened. But once it improved, treatment would stop — until they got worse and were eligible again for coverage.

Every year thousands of Medicare patients receive physical therapy and other treatment to recover from a fall or medical procedure, as well as to help cope with disabilities or chronic conditions including multiple sclerosis, Alzheimer’s or Parkinson’s diseases, stroke, and spinal cord or brain injuries. [Continued at Kaiser Health News and NPR]

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$18 For A Baby Aspirin? Hospitals Hike Costs For Everyday Drugs For Some Patients

By Susan Jaffe | April 30, 2012 |  KAISER HEALTH NEWS produced in collaboration with usat 4sidebar

For the price Diane Zachor, 66, was charged for one pill to control high pressure during her 18 hour stay at St. Luke’s Hospital In Duluth, MinZachorn., she could have bought a three-week supply.  In South Florida, Pearl Beras, 85, of Boca Raton, Fla., said her hospital charged $71 for one blood pressure pill for which her neighborhood pharmacy charges 16 cents. Several other Medicare patients in Missouri were billed $18 for a single baby aspirin, said Ruth Dockins, a senior advocate at the Southeast Missouri Area Agency on Aging.

It’s no mistake: When Medicare patients are in hospitals for observation, they can be charged any amount for routine drugs to treat chronic conditions such as diabetes, high blood pressure or high cholesterol.  Medicare doesn’t cover these type of medications and doesn’t require hospitals to tell patients when they are in observation status or that they will be responsible for paying any non-Medicare-covered services.   

“I just couldn’t believe some of these prices they charge,” said Zachor (left). “It’s just atrocious.”  [More from USA Today or from Kaiser Health News]