On January 24, 2022, Medicare Administrative Contractor NGS announced that it would retire a local coverage determination (LCD) that barred coverage of certain central sleep apnea devices effective January 27, 2022. Central sleep apnea occurs when the signaling between the brain and diaphragm is insufficient to stimulate regular breathing when a person is sleeping. Transvenous […]
On October 27, 2020, the Centers for Medicare and Medicaid Services proposed expanding coverage of continuous glucose monitors (CGMs) for individuals with diabetes. This proposal is open to comment. See the proposal here. https://www.federalregister.gov/documents/2020/11/04/2020-24194/medicare-program-durable-medical-equipment-prosthetics-orthotics-and-supplies-dmepos-policy-issues As conceded in the proposed rule, the Secretary’s proposal to extend Medicare coverage of CGMs is the result of loses in […]
Second Circuit Rules Medicare Beneficiaries Can Combine Claims for Judicial Review; Fourth District Court Rules for Glucose Monitors On September 23, 2020, the United States Second Circuit Court of Appeals found that Medicare beneficiaries can combine claims denied by Medicare to meet the dollar amount necessary for judicial review. See Bloom v. Azar. Medicare had […]
On December 9, 2019, Parrish Law Offices scored another victory for Medicare beneficiaries when a United States District Court ruled that Medicare Advantage Plan participants (i.e., Part C cases) have the same hearing rights as Original Medicare participants. Parrish Law Offices routinely represents individuals and companies at all stages of the Medicare appeals process. In […]
Medicare coverage policies are supposed to be based on: 1) peer-reviewed literature; 2) the consensus of experts; and 3) whether a technology has been accepted by the relevant medical community. In the absence of a National Coverage Determination, Medicare contractors are free to develop a Local Coverage Determination policy. There are seven different Medicare contractor […]
In October 2017, Parrish Law Offices won a District Court case where the Court found that Medicare’s denial of a CGM was arbitrary and capricious and not supported by substantial evidence. See Whitcomb v. Burwell, No. 2:17-CV-14 (E.D. Wis. Oct. 26, 2017) The Medicare Appeals Council/Secretary had argued that a CGM is simply precautionary because […]
Since 2014, Parrish Law Offices has been representing beneficiaries seeking Medicare coverage for Continuous Glucose Monitors (CGMs). Many Medicare beneficiaries had their claims for CGM coverage denied because Medicare claimed that CGMs were not durable medical equipment (DME). These denials forced many Medicare beneficiaries to either forego this life-saving technology or pay for it themselves while navigating […]
Our firm represents many Medicare beneficiaries seeking access to medical treatments and technologies. This year we are honored to be recognized by the American Bar Association for our work. The ABA’s Standing Committee on Pro Bono and Public Service works to ensure access to justice through the expansion and enhancement of the delivery of legal […]
Yesterday, the Supreme Court heard oral arguments in TC Heartland v. Kraft Foods Group Brands LLC concerning venue in patent litigation. As with most arguments at the Supreme Court, the arguments themselves are merely a window into what the Court is interested in and are not a reliable guide as to how the Court will […]
On March 27, 2017, the Supreme Court will hear arguments in TC Heartland v. Kraft Foods Group Brands LLC. The case concerns venue for patent litigation and has the potential to be one of the most significant procedural cases related to patents of the last twenty years. By way of background, prior to the late […]