Medicare's quiet 'sea change' on therapy for the elderly

http://www.advisory.com/daily-briefing/2014/03/26/medicares-quiet-sea-change-on-therapy-for-the-elderly

March 26, 2014

Medicare has "quietly" expanded its coverage policy to pay for physical therapy, nursing care, and other services that aim to prevent the decline of patients with chronic conditions like multiple sclerosis, Parkinson's, or Alzheimer's disease—even if they show no signs of improvement.

In January, Medicare officials updated the agency's policy manual to remove any indication that improvement is necessary to receive payment for skilled care. "Coverage depends not on the beneficiary's restoration potential, but on whether skilled care is necessary," the policy states.

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Though coverage cannot be denied for lack of improvement or stalled progression, it can still be denied or coverage can be limited for other reasons: