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Jimmo-practice-tip

Guest Author – The Myth of the Medicare Improvement Standard

December 31, 2020

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

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

Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It

May 14, 2020

  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

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

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

January 28, 2020

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

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

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

January 15, 2020

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

Filed Under: Article, Self Help Packet Tagged With: Jimmo-practice-tip, The Improvement Standard

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

November 27, 2019

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

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

Jimmo “Improvement Standard” Appeal Letter Template

October 24, 2019

[Date] [Attorney’s Name] [Address] Re: [Beneficiary’s Name], Medicare No. [XXXXX] To Whom It May Concern: I am writing on behalf of my client, [Full Name], to request an expedited reconsideration. The skilled nursing facility (SNF) … [Read more...] about Jimmo “Improvement Standard” Appeal Letter Template

Filed Under: Self Help Packet Tagged With: Jimmo-practice-tip, The Improvement Standard

Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *

October 24, 2019

Background The United States District Court for the District of Vermont approved a settlement agreement in Jimmo v. Sebelius[1] on January 23, 2013. The Jimmo Settlement required the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *

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

Self-Help Resources for Improvement Standard Denials – August, 2019

August 1, 2019

Medicare coverage of skilled nursing and/or therapy services depends on a beneficiary’s need for the skilled care, not on the individual’s potential for improvement. The Settlement Agreement in Jimmo v. Sebelius, approved by a federal district court … [Read more...] about Self-Help Resources for Improvement Standard Denials – August, 2019

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

Medicare Coverage In Light of Jimmo v. Sebelius For Providers, Contractors, and Adjudicators

December 10, 2018

With support from The John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Fact Sheet to help Medicare providers, contractors, and adjudicators apply the correct legal standard to Medicare coverage and payment … [Read more...] about Medicare Coverage In Light of Jimmo v. Sebelius For Providers, Contractors, and Adjudicators

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

Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy

November 8, 2018

Despite the Jimmo case’s confirmation that Medicare coverage of a stay in a skilled nursing facility (SNF) is appropriate to maintain a resident’s functional status, when the nursing or therapy services must be provided by a professional … [Read more...] about Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy

Filed Under: Article Tagged With: alert, Jimmo-practice-tip, The Improvement Standard, 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.

Medicare: Build Back Better

By prioritizing Medicare beneficiaries and the health systems that serve them, we can avoid drastic national consequences. The Center for Medicare Advocacy proposes a five-part plan that will make Medicare a bulwark against the worsening health and economic challenges facing the American people.

learn more.

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