• DHHS Agrees To Proposed Settlement: The Improvement Standard
  • December 3, 2012 | Author: Lynn M. Barrett
  • Law Firm: Jones Walker LLP - Miami Office
  • On October 16, 2012, the Department of Health and Human Services ("DHHS") agreed to a proposed settlement of a lawsuit that was filed in January 2011 by the Center for Medicare Advocacy ("CMA") and the Vermont Legal Aid ("VLA"). The lawsuit, Jimmo v. Sebelius, No. 5:11-cv-00017 (D.C.Vt. Jan. 18, 2011), which was filed on behalf of a nationwide class of Medicare beneficiaries, involved the alleged application by the Centers for Medicare & Medicaid Services ("CMS") of the "Improvement Standard," which the plaintiffs alleged resulted in the denial of coverage of certain skilled nursing and therapy services provided to Medicare beneficiaries who had medical conditions that were not expected to improve. The proposed settlement, which, if approved by the U.S. District Court for the District of Vermont, could potentially affect thousands of beneficiaries, as more specifically discussed below.