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Medicare to update reimbursement criteria for degenerative diseases such as Alzheimer’s, MS, Parkinson’s disease

Posted Oct 29 2012 10:53am

What Medicare Will Cover Even if You’re Not Likely to Get Better (The New York Times):

“Should the federal government cover the costs of many kinds of treatments for patients who aren’t going to get any better? It didn’t, for many years. But after the settlement of a landmark class-action this week, Medicare will soon begin paying more often for physical, occupational and other therapies for large numbers of people with certain disabilities and chronic conditions like Alzheimer’s disease, multiple sclerosis and Parkinson’s disease…

“The idea that you would have to show improvement when you have a degenerative disease is blatantly absurd,” said Amy Comstock Rick, chief executive of the Parkinson’s Action Network. In her world, holding steady or degenerating more slowly than you might otherwise is often the definition of success…

The biggest question mark may be for the large numbers of people who suffer from dementia. According to Robert Egge, vice president for public policy at the Alzheimer’s Association, there are many benefits that come from delaying the long-term progression of dementia. Leslie Fried, director of policy and progralawsuit ms at the National Council on Aging, said there had been a particular Medicare claims bias over the years in applying the improvement standard to people with dementia and other forms of cognitive impairment.”

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