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Search Results for: maintenance

Know Jimmo | Medicare Has Never Supported an “Improvement Standard” Rule-Of-Thumb

July 18, 2024

"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

Filed Under: Article Tagged With: Jimmo-practice-tip, Weekly Alert

Know Jimmo | More Outpatient Therapy

June 13, 2024

The Center for Medicare Advocacy is often asked in what care settings the Jimmo Settlement applies. Jimmo applies to skilled care – nursing and therapy (physical, occupational and speech language pathology) – received in a skilled nursing facility, … [Read more...] about Know Jimmo | More Outpatient Therapy

Filed Under: Article Tagged With: Jimmo-practice-tip, Weekly Alert

Know Jimmo | Outpatient Therapy

June 6, 2024

Jimmo applies to outpatient therapy Services, too - Skilled therapy to maintain or slow decline is NOT limited, and the cap on outpatient therapy was repealed in 2018.  As CMS stated in its February 2024 reminders to Providers and Contractors: … [Read more...] about Know Jimmo | Outpatient Therapy

Filed Under: Article Tagged With: Jimmo-practice-tip, Weekly Alert

Know Jimmo | “‘Plateaued’ is not a medical description”

May 30, 2024

The following is an excerpt from a May 28, 2024 article in McKnight's Long Term Care by Jean Wendland Porter, Regional Director of Therapy Operations at Diversified Health Partners in Ohio. “I don’t want to risk my license by continuing therapy … [Read more...] about Know Jimmo | “‘Plateaued’ is not a medical description”

Filed Under: Article Tagged With: Jimmo-practice-tip, Weekly Alert

Nursing Home Roundup, May 2024

May 23, 2024

Congress is active in nursing home issues. H.J. Res 139, filed May 10, 2024 under the Congressional Review Act, disapproves the final minimum staffing rule for nursing homes. Nurse aide training rules are also under attack. On May 16, 2024, the … [Read more...] about Nursing Home Roundup, May 2024

Filed Under: Article Tagged With: Skilled Nursing Facility, Weekly Alert

Know Jimmo | You Do Not Have to Decline

March 28, 2024

You do not have to decline in order to receive Medicare coverage for care to maintain or slow decline Too often Medicare beneficiaries are told the care they are receiving to maintain their condition has to end and, if they decline, then they can … [Read more...] about Know Jimmo | You Do Not Have to Decline

Filed Under: Article Tagged With: Jimmo-practice-tip, The Improvement Standard, Weekly Alert

Know Jimmo | CMS Reiterates that Medicare Coverage is Available to Maintain Function or Slow Decline

March 14, 2024

See MLN Connects Newsletter (2024-02-08-MLNC, 2/8/2024) “Medicare covers skilled nursing care and skilled therapy services under skilled nursing facility, home health, and outpatient therapy benefits when a beneficiary needs skilled care to … [Read more...] about Know Jimmo | CMS Reiterates that Medicare Coverage is Available to Maintain Function or Slow Decline

Filed Under: Article Tagged With: Jimmo-practice-tip, The Improvement Standard, Weekly Alert

Know Jimmo | New CMS Implementation Activity!

February 15, 2024

CMS Joins the Center for Medicare Advocacy to Advance Access to Medicare-Covered Skilled Care to Maintain One’s Condition or Slow Decline In 2011, the Center for Medicare Advocacy and Vermont Legal Aid brought the Jimmo v. Sebelius class … [Read more...] about Know Jimmo | New CMS Implementation Activity!

Filed Under: Article Tagged With: Jimmo-practice-tip, The Improvement Standard, Weekly Alert

Know Jimmo | Priscilla’s Sister

December 21, 2023

The Jimmo Settlement Could Help Priscilla’s Sister Continue Therapy My sister, who has an Alzheimer’s diagnosis, has been refused continuation of PT by the home care provider…They have discharged my sister from PT saying they will tell caregivers … [Read more...] about Know Jimmo | Priscilla’s Sister

Filed Under: Article Tagged With: Jimmo-practice-tip, The Improvement Standard, Weekly Alert

Insurance Industry Group Issues Misleading Medicare Advantage Report

December 7, 2023

Report Suggests Medicare Could Save Money by Providing as Little Care as Private Medicare Advantage Plans Do, While Ignoring the Harm to Beneficiaries, Overpayments to the Private Plans, and Damage to Medicare’s Solvency On November 24, 2023, the … [Read more...] about Insurance Industry Group Issues Misleading Medicare Advantage Report

Filed Under: Article Tagged With: Medicare Advantage, Weekly Alert

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Jimmo v. Sebelius

Medicare covers skilled care to maintain or slow decline as well as to improve.

Improvement Isn’t Required. It’s the law!

Read more.

National Voices of Medicare Summit

With the many threats currently facing the Medicare program, now is the time to come together as allies and explore ways to advocate for comprehensive Medicare coverage, health equity, and quality health care. Drawing inspiration from real-life experiences and stories of beneficiaries and caregivers, we hope to share impactful discussions with you.

Learn more.

Center for Medicare Advocacy Follow 10,488 5,333

A national nonpartisan, nonprofit law organization working to advance access to comprehensive #Medicare coverage and quality #healthcare.

CMAorg
CMAorg avatar Center for Medicare Advocacy @CMAorg ·
11 Dec 1999172773487194169

📣Federal cuts are expected to carve a $100M hole in the Alameda Health System’s budget

@CMAorg called H.R. 1 “the largest rollback of federal support for health care in American history”

📝@DarwinBondGraha
via @Oaklandside

Learn more⬇️

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Federal cuts are expected to carve a $100M hole in the Alameda Health System’s budget 

Trump’s “Big Beautiful Bill” is forcing an unprecedented $1 trillion cut to Medicaid spending. At the East Bay...

oaklandside.org

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CMAorg avatar Center for Medicare Advocacy @CMAorg ·
9 Dec 1998412815393267757

You may be paying more than you need to. Medicare Savings Programs can help pay your Medicare premiums & other costs. Many people qualify and don’t know it. These programs could save you thousands each year.
👇

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Medicare Savings Programs

Get help from your state paying your Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) premiums through a Medicare Savings Program.

www.medicare.gov

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CMAorg avatar Center for Medicare Advocacy @CMAorg ·
8 Dec 1998087710842703960

We know this will lead to more unjustified denials. At CMA, we’re here to answer all of your questions, help you understand your rights - including your right to appeal - and guide you through the daunting appeals process.

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Medicare’s new AI experiment sparks alarm among doctors, lawmakers • Stateline

A Medicare pilot program will allow private companies to use artificial intelligence to review older Americans’ requ...

stateline.org

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Retweet on Twitter Center for Medicare Advocacy Retweeted
BoomerBenefits avatar Boomer Benefits Medicare Expert @BoomerBenefits ·
5 Dec 1996731569063551450

Lots of retirees hit the road before winter comes to go to a warmer state. However, it's important to know how your Medicare coverage works when traveling between two states.

Boomer Benefits We Speak Medicare® | 817-249-8600

#Medicare #Retirement

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What do Snowbirds do for Medicare Coverage? - Boomer Benefits

Each Medicare plan works differently when you're away from your permanent residence. Here's what you need to know ...

boomerbenefits.com

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