Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

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Jimmo Update: CMS Reminds Providers and Contractors of Medicare Coverage to Maintain or Slow Decline

Skilled nursing care and skilled therapy services for beneficiaries who need skilled care to maintain function or to prevent or slow decline is covered by Medicare. That is the message of reminders issued by the Centers for Medicare & Medicaid … [Read more...] about Jimmo Update: CMS Reminds Providers and Contractors of Medicare Coverage to Maintain or Slow Decline

Guest Post: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed

By John Marmarou, DPT, MSCS - Executive Director, Total Rehab & Fitness For the last 15 years, all of my professional work and efforts have been devoted to keeping those with multiple sclerosis (MS) in their communities and out of the … [Read more...] about Guest Post: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed

New Factsheet | Medicare Home Health Coverage and Jimmo v. Sebelius

Medicare home health coverage can be a crucial resource for individuals with long-term or chronic conditions who continue to reside in their homes. Beneficiaries who meet the qualifying criteria are eligible for home health coverage if the skilled … [Read more...] about New Factsheet | Medicare Home Health Coverage and Jimmo v. Sebelius

Jimmo v. Sebelius Factsheet: Medicare Skilled Nursing Facility Coverage Does Not Require Improvement

In 2013, a federal district court approved a settlement agreement in the case of Jimmo v. Sebelius that confirmed Medicare coverage should be determined by a beneficiary’s need for skilled care, not the individual’s potential for improvement. The … [Read more...] about Jimmo v. Sebelius Factsheet: Medicare Skilled Nursing Facility Coverage Does Not Require Improvement

Guest Author – The Myth of the Medicare Improvement Standard

The Issue Brief linked below is posted and reprinted with permission of the author, Catherine G. Hopper, Esq. The Center for Medicare Advocacy is grateful to Ms. Hopper not only for permission to reprint, but for her diligence in understanding and … [Read more...] about Guest Author – The Myth of the Medicare Improvement Standard

Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It

  The Center for Medicare & Medicaid Services issued MLN Matters # MM-11721 on May 1, 2020. Effective January 1, 2020, the MLN, reconfirms that therapy to maintain an individual’s function is a Medicare-covered service. Further, the MLN … [Read more...] about Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It

Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study

January 2020 Download this Case Study I. Background - The Jimmo Settlement In 2013, a U.S. District Court approved the settlement agreement in Jimmo v. Sebelius,[1] requiring the Centers for Medicare & Medicaid Services (CMS) to … [Read more...] about Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study

The Jimmo v. Sebelius Settlement Agreement: An Issue Brief for Medicare Providers

January 2020 Download this Brief Table of Contents What is the Jimmo Settlement Agreement? Does Jimmo Apply to My Practice? What Does Jimmo Mean for My Patients? Are Providers Implementing Jimmo? How Do PDPM and … [Read more...] about The Jimmo v. Sebelius Settlement Agreement: An Issue Brief for Medicare Providers

Jimmo Implementation Council Meets to Discuss the State of Skilled Maintenance Care

On November 20, the Center for Medicare Advocacy, with support from the John A. Hartford Foundation, convened an online gathering of members of the Jimmo Implementation Council and other stakeholders in the effort to remove barriers to care for … [Read more...] about Jimmo Implementation Council Meets to Discuss the State of Skilled Maintenance Care

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