Who should pay
Who is responsible for health care costs is an ongoing debate and a recent lawsuit is challenging this from another angle.
In this particular suit, the plaintiffs claim that if a drug is deemed medically necessary for a patient, the government should pay for it, even if it falls outside the parameters of off-label uses that it will cover.
This lawsuit is being filed in federal district court by the Medicare Rights Center, a patient advocate, on behalf of Judith M. Layzer, an elderly widow who has been taking Cetrotide since 1999 to treat her ovarian cancer.
The drug is not FDA approved or indicated for this treatment.
According to the complaint, Layzer had never paid more than $40 a month out of her own pocket for the medication, but soon after enrolling in Medicare Part D in January 2006, she was denied coverage for her prescription and her monthly tab shot up to over $7,200.
What is interesting in this case is that in 2006, Layzer's former employer was the City of New York.
They moved all of its retiree members to the City of New York enhanced Medicare Part D Program, which is administered by GHI, and is the same company that used to cover her medications as a retiree.
The suit seeks reimbursement of Layzer's out-of-pocket costs, which have totaled more than $100,000.
What the patient’s net worth, income, benefits etc. were not disclosed.
Who should pay??
The legal answer will be watched closely
In this particular suit, the plaintiffs claim that if a drug is deemed medically necessary for a patient, the government should pay for it, even if it falls outside the parameters of off-label uses that it will cover.
This lawsuit is being filed in federal district court by the Medicare Rights Center, a patient advocate, on behalf of Judith M. Layzer, an elderly widow who has been taking Cetrotide since 1999 to treat her ovarian cancer.
The drug is not FDA approved or indicated for this treatment.
According to the complaint, Layzer had never paid more than $40 a month out of her own pocket for the medication, but soon after enrolling in Medicare Part D in January 2006, she was denied coverage for her prescription and her monthly tab shot up to over $7,200.
What is interesting in this case is that in 2006, Layzer's former employer was the City of New York.
They moved all of its retiree members to the City of New York enhanced Medicare Part D Program, which is administered by GHI, and is the same company that used to cover her medications as a retiree.
The suit seeks reimbursement of Layzer's out-of-pocket costs, which have totaled more than $100,000.
What the patient’s net worth, income, benefits etc. were not disclosed.
Who should pay??
The legal answer will be watched closely
Labels: healthcare, lawsuit
posted by Anonymous at 5:52 AM
1 Comments:
If you feel that the government is responsible for you from cradle to grave then I guess then you would say the government. However, if the government is your nanny in that case then if your having welfare kids that the government is supporting then the governnment should be able to use birth control over you because you are not an adult, the government is your parent. Bottom line is the USA was not drawn up by the forefathers with that purpose in mind, it was about personal liberty and thus responsiblity for oneself. So the answer is a resounding no.
Post a Comment
<< Home