Skilled Maintenance Care is Covered
The Jimmo Court rulings and related policy changes specifically apply to Medicare coverage for home health care. The Medicare Home Health Benefit Policy Manual makes that very clear. It states: “Coverage of skilled nursing care or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement from the nursing care or therapy, but rather on the patient’s need for skilled care. Skilled care may be necessary to improve a patient’s condition, to maintain a patient’s condition, to prevent or slow further deterioration of the patient’s condition.” [Emphasis added.]
- Medicare Benefit Policy Manual, Chapter 7, Section 20.1.2