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Insurance Company Halts Payments for Alzheimer Therapy

April 16, 1990

TOLDEO, Ohio (AP) _ An insurance company has rejected more than 40,000 claims totaling $1.1 million from an agency that provides services for Alzheimer’s patients.

Nationwide Insurance said it stopped the Medicare payments Oct. 1 because recreational and social activities were part of the therapy provided.

A group has formed to fight Nationwide’s denial of Medicare payments to Intergenerational Services Inc., a non-profit agency founded five years ago. The Toledo-based agency said it will have to close by the end of the month unless the company changes its position.

″Time is short since we’re facing a deadline which is less than three weeks away, but we’re determined to gather an impressive number of signatures,″ said Judith Messinger, chairwoman of Advocates for Alzheimer’s Victims.

The group was formed Friday to call attention to the fact that the agency will have to shut if the claims aren’t paid and to gather signatures to show support for their cause.

Intergenerational provides psychotherapy to Alzheimer’s patients at 66 nursing homes in 15 northwest Ohio counties.

William P. Ramsey, vice president of Nationwide’s Medicare operation, said in a statement last week, ″As a Medicare carrier under federal government contract, Nationwide is obligated to safeguard the proper use of Medicare money.″

Dr. Alice Faryna, medical director for Nationwide’s Medicare operations, said in the statement certain psychotherapeutic services that are medically necessary are payable under Medicare.

However, she also said that a review indicates that some of Intergenerational ’s activities do not fit the description of psychotherapy.

″They just feel that these older people don’t have much of a future, and that it’s not really worth the money to invest in making their quality of life a little bit better than it was before,″ said the Rev. A. Otto Baumann II, agency president.

The program, which began at the suggestion of a Toledo nursing home, is designed to help patients become more social and ease depression, program director Susan Lemle said. It also operates an Alzheimer’s day care center in Toledo.

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