RIPR News
7:22 pm
Tue January 18, 2011

RI resident part of Medicare lawsuit

Providence, RI – A Rhode Islander is among five Medicare recipients in a class action lawsuit filed against the federal government Tuesday.

The suit alleges that Mary Patricia Boitano was denied Medicare coverage for a stay in a skilled nursing facility because of a policy called the "improvement standard." That standard denies funding for services that don't clearly improve a patient's health.

Gil Deford with the Center for Medicare Advocacy says the improvement standard is in direct violation of federal regulations. "We're not asking congress to change the law," he says. "We're not asking the government to rewrite the regulations. We're saying your own law, your own regulations, require coverage for these people."

In general, Medicare only pays for services that are reasonable and medically necessary.

A spokeswoman for the Center for Medicare and Medicaid Services says the agency hasn't had a chance to review the complaint, so it can't comment on the lawsuit.

The lawsuit
Read the class action lawsuit here

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