Medicare beneficiaries and public interest groups are seeking a court order to force the Centers for Medicare and Medicaid Services to establish an appeals process for beneficiaries denied a vision therapy known as Visudyne for age-related macular degeneration. Time is short for many beneficiaries because the disease is so aggressive, said the plaintiffs' attorney, Grant Bagley, of the Washington office of Arnold & Porter. Under a 2000 law, the CMS was supposed to have an appeals process for national coverage decisions in place by last October, but the agency has yet to do so. Earlier this year, the CMS reversed a previous decision to cover Visudyne and has since refused to hear an appeal by beneficiaries. The lawsuit was filed in U.S. District Court for the District of Columbia by three beneficiaries, the American Association of People with Disabilities, the American Council of the Blind and the Gray Panthers. A CMS spokesman said the agency is committed to decisionmaking that reflects the best scientific and medical information available on new technology. "While we have not yet reviewed the lawsuit in question, we are always disappointed when certain paid special interest groups decide to sue us rather than work with us to create benefits and processes that best serve the interests of Medicare beneficiaries and the Medicare program," the spokesman said. -- by Susanna Duff
Interest groups sue CMS over vision therapy ruling
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.