Does the Jimmo Settlement Agreement only apply to people with certain diseases, diagnoses, or conditions?
- No. The Settlement is not limited to particular conditions or diseases. It applies to anyone who requires skilled services to maintain or slow deterioration, regardless of the underlying illness, injury, or disability.
Does the Jimmo Settlement Agreement apply to services provided at home or as an outpatient, or only to nursing home coverage?
- The Settlement Agreement applies to Medicare coverage for skilled maintenance services provided in all three care settings: home health, outpatient therapy, and skilled nursing facility.
Does the Jimmo Settlement allow people to get physical therapy at home?
- Physical therapy (and speech language pathology and occupational therapy) is a covered service under the Medicare home health benefit. If the individual meets the other Medicare home health qualifying criteria. The Jimmo Settlement makes it clear that “maintenance only therapy” can be covered by Medicare if a qualified physical therapist is required to ensure the care is safe and effective.