Policy Manual Change Effective Today
Effective today, January 7, Medicare beneficiaries can no longer be denied coverage for physical, occupational, and speech-language therapy services solely for lack of improvement.
In 2011, the Parkinson's Action Network (PAN) joined a class action lawsuit against the Center for Medicare and Medicaid Services (CMS) over a standard for Medicare coverage that we believed discriminated against people with Parkinson's and other chronic degenerative diseases. The standard, commonly referred to as the Improvement Standard, required Medicare beneficiaries to show improvement to continue physical, occupational, and speech-language therapy services. For a degenerative disease like Parkinson's, therapy is not a cure, but it is a treatment option that can improve quality of life and help maintain independence.
The lawsuit reached a favorable settlement in January 2013, and CMS was given one year to update its policy manual as well as develop and implement a nationwide education campaign for all who make Medicare determinations. This will help ensure that beneficiaries with chronic conditions are not denied coverage for critical services because their underlying conditions will not improve.