Coverage does not turn on the presence or absence of potential for improvement but rather on the need for skilled care. Skilled maintenance therapies and nursing are covered by Medicare. Claims should never be denied because patient cannot achieve … [Read more...] about Know Jimmo | What It Means
Search Results for: maintenance
Know Jimmo | Jimmo is STILL in EFFECT, It’s the Law!
No matter who tells you differently, skilled maintenance care is covered by Medicare. “The Jimmo Settlement Agreement covers may reflect a change in practice for those…who may have erroneously believed that the Medicare program nursing and therapy … [Read more...] about Know Jimmo | Jimmo is STILL in EFFECT, It’s the Law!
Know Jimmo | Jimmo Applies to Home Health Care
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 … [Read more...] about Know Jimmo | Jimmo Applies to Home Health Care
Know Jimmo – Jimmo Can Open Doors to Necessary Care
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 … [Read more...] about Know Jimmo – Jimmo Can Open Doors to Necessary Care
Know Jimmo | Medicare Law and CMS Policy Spell It Out
The Code of Federal Regulations: “Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent … [Read more...] about Know Jimmo | Medicare Law and CMS Policy Spell It Out
Know Jimmo | CMS Reminded Providers & Contractors Back in 2021
“Skilled Nursing Care & Skilled Therapy Services to Maintain Function Or Prevent or Slow Decline: Reminder Medicare covers skilled nursing care and skilled therapy services under skilled nursing facility, home health, and outpatient therapy … [Read more...] about Know Jimmo | CMS Reminded Providers & Contractors Back in 2021
Know Jimmo | Improvement is Not Required for Medicare Home Health Coverage
The decision regarding coverage should turn on whether skill is needed, not whether the individual is expected to improve. Maintenance nursing is a Medicare-covered service if a nurse is needed to provide or supervise care. Example: … [Read more...] about Know Jimmo | Improvement is Not Required for Medicare Home Health Coverage
Know Jimmo | Documentation Tips
New Documentation Guidance was included in the Jimmo Manual revisions. Nurses and therapists should document what they do and why. IF improvement is occurring, note it. If the goal is, or includes maintenance or changes to maintenance, make sure … [Read more...] about Know Jimmo | Documentation Tips
Know Jimmo | Frequently Asked Questions
Does the Jimmo Settlement Agreement only apply to people with certain diseases, diagnoses, or conditions? Does the Jimmo Settlement Agreement apply to services provided at home or as an outpatient, or only to nursing home coverage? Does the … [Read more...] about Know Jimmo | Frequently Asked Questions
Know Jimmo | Medicare Has Never Supported an “Improvement Standard” Rule-Of-Thumb
"Medicare has never supported the imposition of an “Improvement Standard” rule-of-thumb in determining whether skilled care is required to prevent or slow deterioration in a patient’s condition. Thus, such coverage depends not on the beneficiary’s … [Read more...] about Know Jimmo | Medicare Has Never Supported an “Improvement Standard” Rule-Of-Thumb