Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Search Results for: maintenance

Federal Case Settled for Vermont Plaintiff in Landmark Jimmo v. Sebelius Class Action − Medicare Coverage Finally Granted for Jimmo’s Skilled Maintenance Care

Twenty-one months after winning a national class action lawsuit that sought to overturn Medicare's practice of denying skilled maintenance care to patients who did not meet an "improvement standard," plaintiff Glenda Jimmo is finally … [Read more...] about Federal Case Settled for Vermont Plaintiff in Landmark Jimmo v. Sebelius Class Action − Medicare Coverage Finally Granted for Jimmo’s Skilled Maintenance Care

Improvement Standard Update: CMS Revises Medicare Policy to Ensure Coverage for Skilled Maintenance Care

December 9, 2013 – The Center for Medicare Advocacy is pleased to announce that the Medicare Policy Manuals have been revised pursuant to the Jimmo vs. Sebelius Settlement. The Manual revisions, which clarify that improvement is not required to … [Read more...] about Improvement Standard Update: CMS Revises Medicare Policy to Ensure Coverage for Skilled Maintenance Care

Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline

“Maintenance Therapy – Therapy services in connection with a maintenance program are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a qualified therapist. … [Read more...] about Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline

Know Jimmo | Outpatient Therapy to Maintain Function or Slow Decline Is Eligible for Medicare Coverage

The key to coverage is whether the individual requires a skilled provider to ensure the services are safe and effective, not whether improvement is expected. “Medicare coverage does not turn on the presence or absence of improvement from therapy, … [Read more...] about Know Jimmo | Outpatient Therapy to Maintain Function or Slow Decline Is Eligible for Medicare Coverage

Self-Help Packet for Skilled Nursing Facility Appeals Including “Improvement Standard” Denials

1. Introduction The Center for Medicare Advocacy has produced this packet to help you understand Medicare coverage and how to file an appeal if appropriate. Medicare is the national health insurance program to which many disabled individuals … [Read more...] about Self-Help Packet for Skilled Nursing Facility Appeals Including “Improvement Standard” Denials