Q: Does Jimmo only apply to people with certain diseases, diagnoses, or conditions?
A: No. The Jimmo Settlement applies to anyone who requires skilled services to maintain or slow deterioration regardless of the individual’s underlying illness, disability, injury, or condition.
Q: Does the Jimmo Settlement apply to services provided at home or as an outpatient, or only to nursing home care?
A: Jimmo applies to coverage for skilled maintenance services (physical, occupational, speech therapy, and/or nursing) provided in all three levels of care: home health, outpatient, and skilled nursing facility.
Q: Does the Jimmo Settlement Agreement add to the number of days Medicare will cover in a skilled nursing facility (SNF)?
A: No. The Jimmo Settlement confirms that Medicare coverage is available for skilled nursing and therapy that is needed to maintain a person’s condition or slow deterioration in a SNF, but does not add to the number of days of SNF coverage.
Q. Does the Jimmo Settlement allow people to get physical therapy at home?
A. Yes. Therapy – physical, speech and occupational – is a covered service under the Medicare home health benefit. If the individual meets the other Medicare home health qualifying criteria Jimmo confirms that skilled “maintenance therapy” is coverable if a qualified therapist is required to ensure the care is safe and effective.