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
The Improvement Standard
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
Jimmo Implementation Council Meeting | June 16, 2021
The Center for Medicare Advocacy, with support from The John A. Hartford Foundation, brought together a multidisciplinary team of experts for the third Jimmo Council meeting on June 16, 2021. The meeting, led by the Center’s Executive Director Judy … [Read more...] about Jimmo Implementation Council Meeting | June 16, 2021
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 Home Health Case Settled with Full Coverage for Beneficiary with Chronic Conditions
Vermont Legal Aid and the Center for Medicare Advocacy are pleased to announce the settlement of McKee v. Azar, a case that was brought in federal court to ensure proper coverage of home health care services for a Medicare beneficiary with multiple … [Read more...] about Medicare Home Health Case Settled with Full Coverage for Beneficiary with Chronic Conditions
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
Issue Brief: Medicare Payment vs. Coverage for Home Health & Skilled Nursing Facility Care
New Issue Brief: Medicare Payment vs. Coverage for Home Health & Skilled Nursing Facility Care The Centers for Medicare & Medicaid Services (CMS) — the federal agency responsible for administering the Medicare program — has begun … [Read more...] about Issue Brief: Medicare Payment vs. Coverage for Home Health & Skilled Nursing Facility Care
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