From left: Aaron Claxton, ’17; Rick Lebherz, ’15; and Kimberly Van Spronsen, ’16. 20 SUMMER / FAL L 20 1 5 S T E V E Y E AT E R Elder & Health Law Clinic Wins Major Denial of Care Case JUDGE RELIES ON STUDENTS’ FINDINGS AND EXPERTISE TO REACH FAVORABLE DETERMINATION Elder & Health Law Clinic students Aaron Claxton, ’17; Rick Lebherz, ’15; and Kimberly Van Spronsen, ’16, worked on a case that resulted in the estate of their deceased client receiving an order for Kaiser Permanente to reimburse the family for more than $100,000 in out-of-plan services. The issue was whether the specialized surgery and treatment for a grade IV glioblastoma brain tumor qualified for out-of-plan services under the Medicare HMO plan through Kaiser. The judge heard testimony from McGeorge M.S.L. student Patrick Browning, M.D., who was qualified as a medical expert, which contributed to the favorable decision. Extensive research, a detailed brief, production of evidence, and the presentation of lay and expert witnesses at the adversary hearing persuaded the Medicare administrative law judge to reverse the denials of care. The clinic, supervised by Professor Melissa Brown, has won each of its Medicare denial of care cases and is one of the few California sources of legal representation for Medicare patients and their families.
University of the Pacific, McGeorge School of Law - Summer2015
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