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
Search Results for: improvement
Know Jimmo | Use the CMS Information
CMS says very clearly that "skilled nursing and skilled therapy services in the Skilled Nursing Facility (SNF), Home Health (HH), and Outpatient Therapy (OPT) settings does not turn on the presence or absence of a beneficiary’s potential for … [Read more...] about Know Jimmo | Use the CMS Information
Know Jimmo | You Do Not Have to Decline
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
A Model for Nursing Home Enforcement
Acting New Jersey Comptroller Kevin Walsh issued three reports identifying the worst-performing nursing facilities in the state and the millions of dollars these facilities receive in Medicaid funding, despite the poor care they provide to residents … [Read more...] about A Model for Nursing Home Enforcement
Know Jimmo | Why Skilled Maintenance Care Matters, In a Daughter’s Words
“These changes [from the Jimmo Settlement] are extremely meaningful, as my mother has repeatedly been denied the ability to continue the physical therapy she needs in order to prevent further deterioration of her condition. It has been … [Read more...] about Know Jimmo | Why Skilled Maintenance Care Matters, In a Daughter’s Words
Implementation of Medicare Drug Law Proceeds
Drug Industry Continues to Fight It; President Biden Proposes to Expand It The Inflation Reduction Act of 2022 (IRA), signed into law by President Biden on August 16, 2022, has already provided cost-savings for Medicare beneficiaries through … [Read more...] about Implementation of Medicare Drug Law Proceeds
Know Jimmo | CMS Reiterates that Medicare Coverage is Available to Maintain Function or Slow Decline
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
Know Jimmo | It’s Not About Care Setting
The Jimmo Settlement Agreement is consistent with the Medicare program’s regulations governing maintenance nursing and therapy in skilled nursing facilities, home health services, and outpatient therapy (physical, occupational, and speech) and … [Read more...] about Know Jimmo | It’s Not About Care Setting
Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
As discussed in a recent CMA Alert (Feb. 22, 2024), the Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025, comments to which are due March 1, 2024. MA plans are … [Read more...] about Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
Know Jimmo | CMS Reminder to MA Plans
In a February 2024 memo, the Centers for Medicare & Medicaid Services reminded Medicare Advantage organizations that the Jimmo Settlement ...clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | CMS Reminder to MA Plans