Lerum v. Heckler

PELL, Senior Circuit Judge.

Plaintiff, Eileen Lerum, sued defendant, Margaret Heckler, Secretary of Health and Human Services, for reimbursement of hospital care costs incurred by her mother (decedent). Plaintiff is the executrix for the estate of decedent. The sole question presented is whether Medicare covers costs for services rendered in an acute care facility when, despite the patient’s need for continued reimbursable medical services, the attending physician and the hospital’s utilization review committee both certified that a skilled nursing facility could provide the required services.

T…