Home Health Care is Available for Medicare Beneficiaries with Long Term, Chronic, and Terminal ConditionsThe key to coverage is whether the individual requires skilled nursing or therapy and whether care would be safe and effective if skilled … [Read more...] about Know Jimmo | Home Health Care for Chronic Conditions
Archives for October 2025
Dangerous, Expensive Risks for Falls Identified in Skilled Nursing Facility Assessments
A recent CMA Alert discussed a recent report by the HHS Office of Inspector General (OIG) finding that skilled nursing facilities fail to report 43% of residents’ falls in a 1-year period reviewed by OIG. In an accompanying Data Snapshot, Serious … [Read more...] about Dangerous, Expensive Risks for Falls Identified in Skilled Nursing Facility Assessments
Report Examines Role Agents & Brokers Play in Medicare Enrollment
A recent report from Senate Finance Committee Ranking Member Ron Wyden found that MA insurers spent a combined $6.9 billion on agent and broker commissions in 2023. An Urban Institute report published in September 2025 explores how agents and brokers … [Read more...] about Report Examines Role Agents & Brokers Play in Medicare Enrollment
CMA Founder Judith Stein Presents Award Named in Her Honor
AgingCT, a statewide network of coordinated information, supports, and services to help Connecticut residents navigate their aging journey based on their care setting, preferences, and needs, recently held their 2025 AgingCT Summit. The Summit … [Read more...] about CMA Founder Judith Stein Presents Award Named in Her Honor
Medicare Telehealth in Limbo
As of the time of this alert, the federal government remains shut down due to a spending impasse in Congress over extending Affordable Care Act subsidies and restoring Medicaid cuts in H.R.1, the reconciliation bill passed in July.An overlooked … [Read more...] about Medicare Telehealth in Limbo
Know Jimmo | CMS “Clarified” that Skilled Maintenance is Covered
In November 2010, CMS revised its regulations to clarify Medicare coverage principles for skilled services. Most importantly, the revisions “clarified” that skilled care does include services intended to maintain a person's condition and that no … [Read more...] about Know Jimmo | CMS “Clarified” that Skilled Maintenance is Covered
As Government Shuts Down, Administration of the Medicare Program Largely Continues
As of midnight October 1, 2025, the federal government is shutdown due to a spending impasse in Congress over extending Affordable Care Act subsidies and restoring Medicaid cuts in H.R.1, the reconciliation bill passed in July. It is unclear how long … [Read more...] about As Government Shuts Down, Administration of the Medicare Program Largely Continues
Getting Repeated Termination Notices from Your MA Plan? You’re Entitled to an Explanation
Earlier this year, the Center for Medicare Advocacy highlighted updated CMS appeals guidance to Medicare Advantage plans. Effective January 1, 2025, if an MA plan’s decision to terminate coverage with a Notice of Medicare Non-Coverage (NOMNC)[1] is … [Read more...] about Getting Repeated Termination Notices from Your MA Plan? You’re Entitled to an Explanation
Report Highlights Limited Access to Opioid Treatment
A recent Health Affairs report, “Trends In The Availability Of Buprenorphine At US Retail Pharmacies, 2017–23,” cited data to highlight the need for expanded access to medication for opioid use disorder in pharmacies, particularly in high minority … [Read more...] about Report Highlights Limited Access to Opioid Treatment
Know Jimmo | Share a Success Story
Have you or someone you know successfully argued for Medicare coverage of skilled care to maintain a condition, or slow decline, rather than being told there's a need to "improve?"Let us know! Share your story with us at … [Read more...] about Know Jimmo | Share a Success Story