Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients

(By Susan Jaffe for KFF Health News)

Judith Sullivan was recovering from major surgery at a Connecticut nursing home in March when she got surprising news from her Medicare Advantage plan: It would no longer pay for her care because she was well enough to go home.

At the time, she could not walk more than a few feet, even with assistance — let alone manage the stairs to her front door, she said. She still needed help using a colostomy bag following major surgery.

“How could they make a decision like that without ever coming and seeing me?” said Sullivan, 76. “I still couldn’t walk without one physical therapist behind me and another next to me. Were they all coming home with me?” Continue reading here…

Kaiser Health News is a nonprofit national health policy news service that is part of the nonpartisan Henry J Kaiser Family Foundation.

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