Legal Question in Medical Malpractice in Virginia
Family member has become incapacitated and Dr's said they have done all they can do and the patient needs a higher level of care and requested her to be transferred to an LTAC (long term acute care) facility. Family member had a stroke, has COPD, Diabetes, high blood pressure, and a tracheostomy with ventilator support. Our request to transfer patient to INOVA acute care and rehab and any LTAC was rejected by our insurance provider Aetna Medicare and were told patient only needs SNF (skilled nursing facility) and they won't cover acute care. Who's liable if the SNF is unable to provide the proper care the Dr's are saying the patient needs?
1 Answer from Attorneys
Perhaps, no one, if both Aetna and the SNF are acting in full compliance with
their respective rules and regulations and the applicable law(s) which may be relevant
to the situation described. ( Have you attempted to appeal Aetna's decision as to coverage
to a higher level of the company for a possible reconsideration?)
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