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
The Improvement Standard
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
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
Know Jimmo | Skilled Nursing Facility Policy
Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility ServicesSection 30Coverage of nursing care and/or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement … [Read more...] about Know Jimmo | Skilled Nursing Facility Policy
Know Jimmo | New CMS Implementation Activity!
CMS Joins the Center for Medicare Advocacy to Advance Access to Medicare-Covered Skilled Care to Maintain One’s Condition or Slow DeclineIn 2011, the Center for Medicare Advocacy and Vermont Legal Aid brought the Jimmo v. Sebelius class … [Read more...] about Know Jimmo | New CMS Implementation Activity!
Know Jimmo | Home Health Policy
Medicare Benefit Policy Manual, Chapter 7 – Home Health ServicesSection 20.1.2Coverage of skilled nursing or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement from the … [Read more...] about Know Jimmo | Home Health Policy
When Should Medicare Coverage be Available for Outpatient Therapy?
Physical, speech-language pathology, and occupational therapies can be covered by Medicare Part B if they meet the following criteria:Other Important Points: … [Read more...] about When Should Medicare Coverage be Available for Outpatient Therapy?
Know Jimmo | The Medicare Policy Manual
Outpatient Maintenance Physical Therapy, Occupational Therapy and Speech Language Pathology Services (Medicare Benefit Policy Manual Ch. 5, §220.2D)Outpatient Physical Therapy, Occupational Therapy and Speech Language Pathology Services “may be … [Read more...] about Know Jimmo | The Medicare Policy Manual
Know Jimmo | Right from the Medicare Agency
The Centers for Medicare & Medicaid Services (CMS) reminds the Medicare community of the Jimmo Settlement Agreement (January 2013), which clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | Right from the Medicare Agency
Know Jimmo | Share a Success Story
Have you or someone you know successfully argued for coverage of skilled care to maintain a condition, or slow decline, rather than being told there's a need to "improve?"Let us know! Share your story with us at … [Read more...] about Know Jimmo | Share a Success Story