On July 26th, 1990, the Americans with Disabilities Act was signed into law. In the thirty-one years since, that day has come to mark a recognition of “disability pride”, defined by the publication AmeriDisability as “accepting and honoring each person’s uniqueness and seeing it as a natural and beautiful part of human diversity,” rather than seeing disability as stigmatizing classification of a physical or mental impairment.[1] Since New York Mayor Bill de Blasio’s announcement of Disability Pride Month in July 2015,[2] cities nationwide have been holding parades and celebrations in honor of disabled Americans everywhere.
According to the Centers for Disease Control and Prevention (CDC), 61 million adults in the United States have some type of disability,[3] and over half are aged 65 and older.[4]
In recognizing and celebrating the strength and empowerment that comes from understanding that an individual living with a disability is much more than a diagnosis, it is also critical that the health care needs of that individual are respected and met. Access to the Medicare coverage to which disabled Americans are entitled is a fundamental part of the Center for Medicare Advocacy’s mission.
Medicare is not just for Americans who are 65 and over. The same Medicare coverage available to older Americans is available to those under 65 who meet the criteria for Social Security Disability benefits. (Click here for more specific details about Medicare Coverage for People with Disabilities.) Furthermore, as confirmed by the 2013 settlement in Jimmo v. Sebelius,[5] Medicare covers skilled nursing care and skilled therapy services in nursing homes, home health care settings, and outpatient therapy when skilled care is needed to maintain function or prevent or slow further deterioration.[6] Unfortunately, those with disabilities, along with other Medicare beneficiaries, often face significant challenges in receiving coverage for this necessary care based on a long-standing myth that coverage is only available for people who will improve (known as the “Improvement Standard”).[7]
To address the widespread and unfounded denials of coverage that Americans with disabilities and other Medicare recipients have faced, the Center for Medicare Advocacy and Vermont Legal Aid filed a class action lawsuit (Jimmo v. Sebelius) with the goal of eliminating the myth that Medicare covers care and services only if a beneficiary is expected to improve. In 2013, the Court approved a settlement that required the Centers for Medicare & Medicaid Services (CMS) to issue clarifications to existing program guidance and create new educational material. These important materials aim to inform providers of “skilled” care that Medicare beneficiaries in need of ongoing support to maintain function or slow deterioration will continue to receive coverage for these services. (Click here to access the Jimmo Settlement information page on CMS’s website.)
There remains much work to be done, however. The Center for Medicare Advocacy continues to fight for Americans with disabilities and other Medicare beneficiaries who are still being denied their rightful coverage to access critical skilled care. We remain committed to ensuring Jimmo is properly implemented.
July 15, 2021 – C. St. John
[1] AmeriDisability. What is Disability Pride… And How to Display It. (n.d.). Available at: https://www.ameridisability.com/post/how-to-display-disability-pride
[2] The official website of the City of New York. Mayor Bill de Blasio Designates July “Disability Pride Month” in Honor of Twenty-Fifth Anniversary of ADA (July 2, 2015). Available at: https://www1.nyc.gov/office-of-the-mayor/news/468-15/mayor-bill-de-blasio-designates-july-disability-pride-month-honor-twenty-fifth-anniversary
[3] Centers for Disease Control and Prevention. Disability Impacts All of Us Infographic. (Sept. 16, 2020). Available at: https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
[4] U.S. Bureau of Labor Statistics. Persons with a Disability: Labor Force Characteristics Summary. (Feb. 24, 2021). Available at: https://www.bls.gov/news.release/disabl.nr0.htm
[5] No. 5:11-cv17 (D. Vt. Jan. 24, 2013). Available at: https://www.medicareadvocacy.org/wp-content/uploads/2013/01/Order-Granting-Final-Approval.012413.pdf
[6] Centers for Medicare & Medicaid Services. Jimmo Settlement. (n.d.). Available at: https://www.cms.gov/Center/Special-Topic/Jimmo-Center
[7] Center for Medicare Advocacy. Transition Memorandum for Biden Administration Department of Health & Human Services (HHS). (Dec. 21, 2020). Available at: https://medicareadvocacy.org/transition-memo-2020/?emci=311b3b1f-1fe0-eb11-a7ad-501ac57b8fa7&emdi=f571f5da-30e0-eb11-a7ad-501ac57b8fa7&ceid=9511848