tci Part B Insider - 2003 Issue 11

Coverage: Beneficiary Rage Leads to Likely Coverage

Taking the Centers for Medicare & Medicaid Services to court proved a worthwhile strategy for beneficiaries struggling with the agency's refusal to cover the treatment they needed.The plaintiffs in Jalbert v. Thompson (CA No. 02-01536) received most of what they asked for, and they trumpeted the victory as a complete one. Thanks to their settlement, an independent panel of the Medicare Coverage Advisory Committee will review whether CMS should cover verteprofin, a treatment for age-related macular degeneration, an eye disease.The original complaint filed by Lois Jalbert and a host of plaintiffs including the Gray Panthers and the...

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