Whither the “Improvement Standard”? Coverage for Severe Brain Injury after Jimmo v. Sebelius

Journal of Law, Medicine and Ethics 44 (1):182-193 (2016)
  Copy   BIBTEX

Abstract

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions.

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 76,442

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Mosaic Decisionmaking and Reemergent Agency after Severe Brain Injury.Joseph J. Fins - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):163-174.
Two Kinds of Brain Injury in Sport.P. Fry Jeffrey - 2017 - Sport, Ethics and Philosophy 11 (3):294-306.
Minding and Caring about Ethics in Brain Injury.Grant Gillett - 2016 - Hastings Center Report 46 (3):44-45.
Brain Injury and the Culture of Neglect: Musings on an Uncertain Future.Joseph Fins & Alexandra Suppes - 2011 - Social Research: An International Quarterly 78 (4):731-746.
Neurotrauma and the rule of rescue.S. Honeybul, G. R. Gillett, K. M. Ho & C. R. P. Lind - 2011 - Journal of Medical Ethics 37 (12):707-710.
Brain Injury and the culture of Neglect: musings on an uncertain Future.Joseph J. Fins & Alexandra Suppes - 2011 - Social Research: An International Quarterly 78 (3):731-746.

Analytics

Added to PP
2017-12-14

Downloads
17 (#641,995)

6 months
1 (#454,876)

Historical graph of downloads
How can I increase my downloads?