Courts: Some Medicare Standards Too Strict

Two federal courts, in Pennsylvania and Vermont, recently ruled that the current Medicare standards  used for deciding whether a patient is eligible for skilled nursing facility or home health care are too strict.

The courts found in favor of an 81-year-old Pennsylvania woman whose skilled nursing care, physical therapy and occupational therapy were discontinued following a hip replacement because Medicare alleged she hadn't improved and wasn't likely to. In Vermont, the court sided with a 66-year-old woman who was improperly denied coverage for home therapy that she needed to keep her condition from worsening after she suffered two strokes.

After the rulings, 17 House Democrats drafted a letter to President Obama asking for more relaxed standards, pointing out that many chronic conditions require regular therapy to prevent further deterioration.

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