Watch the 2023 Jimmo Symposium | Jimmo v. Sebelius at 10 Years: A Call for Sustainable Implementation Originally held September 27, 2023, this virtual meeting brought together advocates, providers, beneficiaries, and others to discuss practical … [Read more...] about Improvement Standard and Jimmo News
Search Results for: improvement
CMA Alert: Medicare Home Health Regs: Improvement NOT Required; Also Extender Act and More
CMA ALERT, DECEMBER 12, 2010 New Medicare Home Health Regulations: Improvement is NOT Required to Maintain Coverage! Congress Passes the Medicare and Medicaid Extenders Act of 2010 CMS Issues Corrected "Choosers" … [Read more...] about CMA Alert: Medicare Home Health Regs: Improvement NOT Required; Also Extender Act and More
Two Federal Courts Reject "Improvement Standard" for Denying Medicare Coverage
Within a month of each other, two federal district courts have rejected the Center for Medicare & Medicaid Services' (CMS) beleaguered Medicare "Improvement Standard," thereby adding to the chorus of federal judges who have found the standard … [Read more...] about Two Federal Courts Reject "Improvement Standard" for Denying Medicare Coverage
The Medicare Improvement Standard: A Barrier to Necessary Care
Mrs. P, 68 years old, was diagnosed with Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's Disease) five years ago. She now needs a wheelchair, cannot stand on her own, needs assistance to move from bed to wheelchair, and is … [Read more...] about The Medicare Improvement Standard: A Barrier to Necessary Care
How the 'Improvement Standard' Improperly Denies Coverage to Medicare Patients with Chronic Conditions – text of article printed in Clearinghouse Review, Vol. 43, No. 9-10, Jan-Feb. 2010
By Gill Deford, Margaret Murphy, and Judith Stein Diagnosed three years earlier with Amyotrophic Lateral Sclerosis ("ALS," or otherwise known as "Lou Gehrig’s Disease"), 68-year-old Eileen Prendergast was suddenly informed by her home health agency … [Read more...] about How the 'Improvement Standard' Improperly Denies Coverage to Medicare Patients with Chronic Conditions – text of article printed in Clearinghouse Review, Vol. 43, No. 9-10, Jan-Feb. 2010
The "Improvement Standard" is a Barrier to Necessary Care
Mrs. P, 68 years old, was diagnosed with Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's Disease) five years ago. She now needs a wheelchair, cannot stand on her own, needs assistance to move from bed to wheelchair, and is losing … [Read more...] about The "Improvement Standard" is a Barrier to Necessary Care
Illegal “Improvement Standard” for SNF Coverage Terminated
Over the years, contractors that review Medicare claims have denied coverage for Medicare services inappropriately on the grounds that the beneficiary's condition will not improve. The Center for Medicare Advocacy, through individual appeals and … [Read more...] about Illegal “Improvement Standard” for SNF Coverage Terminated
Know Jimmo | Provider Education is Key
"I am a private nurse care manager who has advocated for my clients regarding the application of Jimmo decision for the last several years... without success. The therapists and nurses in the room continue to repeat 'Must discharge because of lack of … [Read more...] about Know Jimmo | Provider Education is Key
Know Jimmo | Inpatient Rehab Standards
Medicare Benefit Policy Manual, Chapter 1, Section 110.2 The patient can only be expected to benefit significantly from the intensive rehabilitation therapy program if … the patient can reasonably be expected to make measurable … [Read more...] about Know Jimmo | Inpatient Rehab Standards
Know Jimmo | Watch our Symposium to hear from Jimmo Pros
This past September our virtual Jimmo Symposium brought together advocates, providers, beneficiaries, and others to discuss practical tips and strategies for obtaining medically necessary services pursuant to the Jimmo settlement, as well as ongoing … [Read more...] about Know Jimmo | Watch our Symposium to hear from Jimmo Pros