As CMS states in its Jimmo Frequently Asked Questions, Medicare Advantage plans are required to cover care to maintain or slow deterioration just as in traditional Medicare. This is clearly reiterated in FAQ 15 on CMS’s website:See … [Read more...] about Know Jimmo | Jimmo Applies to Medicare Advantage!
Search Results for: Jimmo
Know Jimmo | It’s the Law
If you, or someone you are helping are informed that Medicare coverage is not available for necessary care because improvement isn’t possible or sufficient, remember – that’s not true. Quote and direct them to the Medicare agency’s own website, … [Read more...] about Know Jimmo | It’s the Law
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
Know Jimmo | CMS Reminder to MA Plans
In a February 2024 memo, the Centers for Medicare & Medicaid Services reminded Medicare Advantage organizations that Jimmo applies to them, saying that the Jimmo Settlement...clarified that the Medicare program covers skilled nursing care … [Read more...] about Know Jimmo | CMS Reminder to MA Plans
Know Jimmo | Maintenance Care is Covered if it Requires Skilled Personnel for Safe Delivery – Ask CMS!
Frequently Asked Question #5:Q5: When are skilled nursing or therapy services to maintain a patient’s current condition or prevent or slow further deterioration covered under the SNF, HH, and OPT benefits, assuming all other coverage criteria are … [Read more...] about Know Jimmo | Maintenance Care is Covered if it Requires Skilled Personnel for Safe Delivery – Ask CMS!
Know Jimmo | You do NOT Have to Decline
From Frequently Asked Questions – CMS.gov/Jimmo:Q11: If a patient is not improving or is not expected to return to his or her prior level of function from skilled nursing or therapy, does Medicare coverage for skilled nursing or skilled therapy … [Read more...] about Know Jimmo | You do NOT Have to Decline
Know Jimmo | Help Open Doors to Care
Medicare Opens Doors to Health Care for 68 million Americans. Jimmo provides the key for thousands of beneficiaries who have longer-term and chronic conditions. The Jimmo case settlement reiterates that Medicare should not be denied … [Read more...] about Know Jimmo | Help Open Doors to Care
Know Jimmo | When Should Medicare Coverage be Available for Home Health Care
Home health care can be covered by Medicare if it meets the following criteria:For more information see our Home Health Quick Screen for Medicare Coverage … [Read more...] about Know Jimmo | When Should Medicare Coverage be Available for Home Health Care
Know Jimmo | Home Health Care for Chronic Conditions
Home Health Care is Available for Medicare Beneficiaries with Long Term, Chronic, and Terminal ConditionsThe key to coverage is whether the individual requires skilled nursing or therapy and whether care would be safe and effective if skilled … [Read more...] about Know Jimmo | Home Health Care for Chronic Conditions
Know Jimmo | CMS “Clarified” that Skilled Maintenance is Covered
In November 2010, CMS revised its regulations to clarify Medicare coverage principles for skilled services. Most importantly, the revisions “clarified” that skilled care does include services intended to maintain a person's condition and that no … [Read more...] about Know Jimmo | CMS “Clarified” that Skilled Maintenance is Covered