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
Search Results for: maintenance
Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It
The Center for Medicare & Medicaid Services issued MLN Matters # MM-11721 on May 1, 2020. Effective January 1, 2020, the MLN, reconfirms that therapy to maintain an individual’s function is a Medicare-covered service. Further, the MLN authorizes … [Read more...] about Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It
The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement
The National Association of Insurance Commissioners (NAIC) is a standard-setting and regulatory support organization governed by chief insurance regulators from across the country. NAIC’s website indicates that organizational members and its … [Read more...] about The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement
Successful Advocacy for Home Health Beneficiary in Need of Maintenance Physical Therapy
Mrs. R contacted the Center for Medicare Advocacy about her husband, who has ALS, and was told his home health physical therapy was about to be terminated. While receiving physical therapy, Mr. R had reduced pain, allowing him to decrease pain … [Read more...] about Successful Advocacy for Home Health Beneficiary in Need of Maintenance Physical Therapy
Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy
Despite the Jimmo case’s confirmation that Medicare coverage of a stay in a skilled nursing facility (SNF) is appropriate to maintain a resident’s functional status, when the nursing or therapy services must be provided by a professional … [Read more...] about Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy
Practice Tip: Orders Needed for Maintenance Skilled Care
Based on recent experience, the Center for Medicare Advocacy provides this Practice Tip for providers and advocates for patients who need to change from an improvement mode to maintenance mode for nursing or therapy. The Center is seeing decisions … [Read more...] about Practice Tip: Orders Needed for Maintenance Skilled Care
Federal Case Settled for Vermont Plaintiff in Landmark Jimmo v. Sebelius Class Action − Medicare Coverage Finally Granted for Jimmo’s Skilled Maintenance Care
Twenty-one months after winning a national class action lawsuit that sought to overturn Medicare's practice of denying skilled maintenance care to patients who did not meet an "improvement standard," plaintiff Glenda Jimmo is finally … [Read more...] about Federal Case Settled for Vermont Plaintiff in Landmark Jimmo v. Sebelius Class Action − Medicare Coverage Finally Granted for Jimmo’s Skilled Maintenance Care
Improvement Standard Update: CMS Revises Medicare Policy to Ensure Coverage for Skilled Maintenance Care
December 9, 2013 – The Center for Medicare Advocacy is pleased to announce that the Medicare Policy Manuals have been revised pursuant to the Jimmo vs. Sebelius Settlement. The Manual revisions, which clarify that improvement is not required to … [Read more...] about Improvement Standard Update: CMS Revises Medicare Policy to Ensure Coverage for Skilled Maintenance Care
Know Jimmo | Medicare Law and CMS Policy Spell It Out
The Code of Federal Regulations: “Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent … [Read more...] about Know Jimmo | Medicare Law and CMS Policy Spell It Out
Know Jimmo – Jimmo Can Open Doors to Necessary Care
The Jimmo case was settled in 2013, with an agreement, approved by the court, confirming that improvement potential is not the deciding factor to determine Medicare coverage for nursing home care, home health care, and outpatient therapy. The Jimmo … [Read more...] about Know Jimmo – Jimmo Can Open Doors to Necessary Care