WNYT.com

Schumer and Columbia County man challenge Medicare law

Posted at: 02/20/2013 5:56 PM
Updated at: 02/20/2013 7:26 PM
By: Beth Wurtmann

ALBANY - "I was shocked, outraged. I couldn't believe it, really," said Ike Cassuto.

That was the 88-year-old Spencertown man's reaction to a six-thousand-dollar medical bill he wasn't expecting.

It was a bill that Medicare refused to cover for rehabilitation in a Great Barrington nursing home, after Ike broke his pelvis.

Medicare denied the payment because Ike had been put on "observation status" when he was first taken to St. Peter's hospital for his injuries.

"A patient may find that they are denied Medicare coverage at a nursing home or other post hospital setting because they did not have the required three day inpatient stay," said James Reed, President and CEO of St. Peter's Health Partners.

The Army Airforce veteran, who flew 35 missions as a navigator in WWII, was incensed that his government would stick him with the bill.

He and his wife Thalia went on a crusade to change the Medicare rule, along with New York Senator Chuck Schumer.

"It's unconscionable that so many elderly people are being denied Medicare coverage for a technical loophole that Medicare is pushing," Schumer said at a press conference Wednesday.

Schumer is proposing legislation that that would make Medicare pay for rehabilitation for patients put on observation status.  Ike said he hopes it will save thousands of elderly patients from health care bills they can't afford.

"I would love to have my money back but really I think it's more important that the law be changed," Cassuto said.

St. Peter's also wants the regulations changed, saying that Medicare has been questioning short term hospital stays in order to find cost savings.

As a result, the number of patients put on observation status doubled at the hospital between 2009 and 2012.