A court decision ordering the Reagan administration to relax eligibility standards for elderly people to get health care at home could help thousands of Medicare recipients, according to a lawyer in the case.
U.S. District Judge Stanley Sporkin's decision overturning a Medicare regulation may encourage thousands of recipients to apply for benefits they thought they never had, said William Dombi, legal director of the National Association for Home Care, which brought the lawsuit.Sporkin overturned a 1986 regulation defining "part-time or intermittent" care as limiting eligibility to patients who received four or fewer home visits a week.
Sporkin said the four-day limit "produces absurd results."
"A beneficiary needing a total of five hours of care per week is denied coverage if the care is needed over the course of five or more days, while the person needing as many as 27 hours of care spread over only four days may qualify for coverage," the judge said in a 69-page opinion released Tuesday.
Dombi said the decision probably affects several thousand Medicare beneficiaries who were denied reimbursement for visits by nurses or health aides.