A health care provider recommends skilled services for a Medicare beneficiary – but will it be covered?

An enlightening article on the topic, Medicare ends improper ‘improvement standard’ for coverage of skilled care, was just published in fall 2014 issue of Doctor’s Life Magazine – Tampa Bay.

Gunster attorney Paula Bentley, also a licensed Health Care Risk Manager, wrote the article. Bentley is a member of the firm’s health care law practice, and is a former Registered Nurse.

In the article, Bentley indicates that the revised portions of the Medicare Benefit Policy Manual went into effect January 7, 2014. The revisions, she says, clarify when skilled care may be necessary, and distinguish between restorative or rehabilitative therapy and maintenance therapy. Only in limited cases under the new policy may a patient’s potential for improvement be considered when evaluating a claim for skilled health care services.

Read the online version of the magazine: Doctor’s Life Magazine (Vol. 2, Issue 4, 2014). Note: Bentley’s article appears on pages 14-15.


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