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 Settlement confirmed that skilled care in all these settings is coverable to maintain an individual’s condition or slow decline when a professional is necessary to provide or supervise the care to ensure it is safe and effective.
Unfortunately, implementation of the Jimmo settlement, rulings, and revised policies has been inconsistent, at best. Too often the Medicare coverage rights affirmed by Jimmo are unknown or ignored by providers, Medicare contractors, and Medicare Advantage plans – leaving beneficiaries without access to Medicare and necessary care.
Jimmo can open doors to necessary care. John Marmarou, DPT, MSCS, recorded this video about providing physical therapy in his clinics for people with Multiple Sclerosis. It speaks clearly to the great value of on-going “maintenance therapy”. Help us implement Jimmo to open doors for necessary care!