On September 27, 2023 the Center for Medicare Advocacy convened a symposium to discuss the Jimmo v. Sebelius "Improvement Standard" Settlement. This virtual meeting brought together advocates, providers, beneficiaries, and others to discuss practical … [Read more...] about Center Symposium on the Jimmo Settlement Calls for Sustainable Implementation
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Join Your CMA Community For A Jimmo Symposium
Jimmo v. Sebelius at 10 Years: A Call for Sustainable Implementation Make Your Voices Heard Wednesday, September 27 from 2:00 – 4:00 PM ET In 2013, the Center for Medicare Advocacy and Vermont Legal Aid along with additional counsel provided … [Read more...] about Join Your CMA Community For A Jimmo Symposium
Jimmo Update: CMS Reminds Providers and Contractors of Medicare Coverage to Maintain or Slow Decline
Skilled nursing care and skilled therapy services for beneficiaries who need skilled care to maintain function or to prevent or slow decline is covered by Medicare. That is the message of reminders issued by the Centers for Medicare & Medicaid … [Read more...] about Jimmo Update: CMS Reminds Providers and Contractors of Medicare Coverage to Maintain or Slow Decline
Guest Post: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed
By John Marmarou, DPT, MSCS - Executive Director, Total Rehab & Fitness For the last 15 years, all of my professional work and efforts have been devoted to keeping those with multiple sclerosis (MS) in their communities and out of the … [Read more...] about Guest Post: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed
Jimmo Implementation Council Meeting | June 16, 2021
The Center for Medicare Advocacy, with support from The John A. Hartford Foundation, brought together a multidisciplinary team of experts for the third Jimmo Council meeting on June 16, 2021. The meeting, led by the Center’s Executive Director Judy … [Read more...] about Jimmo Implementation Council Meeting | June 16, 2021
New Factsheet | Medicare Home Health Coverage and Jimmo v. Sebelius
Medicare home health coverage can be a crucial resource for individuals with long-term or chronic conditions who continue to reside in their homes. Beneficiaries who meet the qualifying criteria are eligible for home health coverage if the skilled … [Read more...] about New Factsheet | Medicare Home Health Coverage and Jimmo v. Sebelius
Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study
January 2020Download this Case Study I. Background - The Jimmo Settlement In 2013, a U.S. District Court approved the settlement agreement in Jimmo v. Sebelius,[1] requiring the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study
You Do Not Have to Improve! New Jimmo Resources for Appealing Medicare Denials in Nursing Homes
Medicare coverage of nursing home care depends on a resident’s need for skilled nursing and/or therapy, not the resident’s potential for improvement. However, too many nursing home residents continue to be denied skilled services on the basis of an … [Read more...] about You Do Not Have to Improve! New Jimmo Resources for Appealing Medicare Denials in Nursing Homes
Jimmo “Improvement Standard” Appeal Letter Template
[Date] [Attorney’s Name] [Address] Re: [Beneficiary’s Name], Medicare No. [XXXXX] To Whom It May Concern: I am writing on behalf of my client, [Full Name], to request an expedited reconsideration. The skilled nursing facility (SNF) … [Read more...] about Jimmo “Improvement Standard” Appeal Letter Template
Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *
Background The United States District Court for the District of Vermont approved a settlement agreement in Jimmo v. Sebelius[1] on January 23, 2013. The Jimmo Settlement required the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *