Center for Medicare Advocacy

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Medicare Coverage of Home Health Care Has Not Changed Under the New Payment System (PDGM)

Background.  On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began implementing a new Medicare payment system—“Patient Driven Groupings Model” (PDGM)—for home health services. Under PDGM, home health agencies have a new set … [Read more...] about Medicare Coverage of Home Health Care Has Not Changed Under the New Payment System (PDGM)

Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study

January 2020Download this Case Study I. Background - The Jimmo Settlement In 2013, a U.S. District Court approved the settlement agreement in Jimmo v. Sebelius,[1] requiring the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study

Issue Brief – November 2019 – Medicare Enrollment Period Updates & Other Issues

(The views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy.) I. ENROLLMENT PERIOD UPDATES Overview The Annual Coordinated Election Period (ACEP) – the period during which … [Read more...] about Issue Brief – November 2019 – Medicare Enrollment Period Updates & Other Issues

Potential Impacts of New Medicare Payment Models On Skilled Nursing Facility and Home Health Care

The Centers for Medicare & Medicaid Services will be implementing revised payment systems for both skilled nursing facility care (effective October 2019) and home health care (effective January 2020). The Center for Medicare Advocacy has written … [Read more...] about Potential Impacts of New Medicare Payment Models On Skilled Nursing Facility and Home Health Care

Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *

Background The United States District Court for the District of Vermont approved a settlement agreement in Jimmo v. Sebelius[1] on January 23, 2013. The Jimmo Settlement required the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *

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