Sewickley, PA
A 53-year-old female asked:
Can a md. deny medicare-paid hospice end-stage dementia patient physical therapy if patient's family requests it to maintain movement with new law?
2 doctor answers • 6 doctors weighed in
Dr. Pamela Pappasanswered
Psychiatry 44 years experience
Hmmm . . . : Could there maybe be a disagreement between this physician and your family about what's in the patient's best interests? This is a deep discussion that involves much thought and consideration, and which deserves scheduled time with your relative's doctor to go over treatment plans, prognosis, etc. Maybe such a discussion can resolve these issues? Doctors want to help, not hurt or harm.
Created for people with ongoing healthcare needs but benefits everyone.
5.2k viewsReviewed >2 years ago
Dr. Charles Barnhart commented
undefined 50 years experience
The rules on treatments like physical therapy haven't changed with the Affordable Care Act. It's always been an issue of whether something is medically necessary vs. elective. In that regard Medicare is no different that commercial insurance; there's always the need to ensure a treatment is justified under particular circumstances. Like Dr. Pappas said, this is the sort of thing that probably requires a discussion with your doctor (who, by the way, probably doesn't have the last say).
Mar 23, 2013
Dr. Pamela Pappas commented
Psychiatry 44 years experience
Provided original answer
Absolutely, Dr. Barnhart. Thanks for your comment. Patients often don't realize that doctors aren't the arbiters of Medicare or other insurance paying for services or not.
Mar 23, 2013
Dr. Thomas Alfreda jranswered
16 years experience
Physical therapy: Only services under the hospice diagnosis are covered. Typically pt/ot are never covered. If the patient has a secondary insurance you possibly have the pcp order home pt/ot, if not in a facility.
Created for people with ongoing healthcare needs but benefits everyone.
5.2k viewsAnswered >2 years ago
Last updated Dec 10, 2013
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