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The Improvement Standard

CMS Could Truly Put “Patients over Paperwork” By Fully Implementing the Jimmo Settlement

August 22, 2019

The Centers for Medicare & Medicaid Services (CMS) launched a “Patients over Paperwork” initiative in 2017 “to evaluate and streamline regulations with a goal to reduce unnecessary burden, to increase efficiencies, and to improve the beneficiary … [Read more...] about CMS Could Truly Put “Patients over Paperwork” By Fully Implementing the Jimmo Settlement

Filed Under: Article Tagged With: alert, The Improvement Standard, Weekly Alert

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

New Issue Brief: Implementing Jimmo v. Sebelius: An Overview

June 27, 2019

In 2013, a federal district court approved a settlement agreement in Jimmo v. Sebelius, No. 5:11-CV-17 (D. VT). The Jimmo Settlement confirmed that Medicare coverage should be determined based on a beneficiary’s need for skilled care (nursing or … [Read more...] about New Issue Brief: Implementing Jimmo v. Sebelius: An Overview

Filed Under: Article Tagged With: alert, The Improvement Standard, Weekly Alert

The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement

June 13, 2019

The National Association of Insurance Commissioners (NAIC) is a standard-setting and regulatory support organization governed by chief insurance regulators from across the country. NAIC’s website indicates that organizational members and its … [Read more...] about The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement

Filed Under: Article Tagged With: alert, The Improvement Standard, Weekly Alert

New Fact Sheet Available – Medicare Inpatient Rehabilitation Hospital/Facility Coverage In Light of Jimmo v. Sebelius

April 11, 2019

With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Fact Sheet to help Medicare beneficiaries and their families respond to unfair Medicare denials for care at inpatient rehabilitation … [Read more...] about New Fact Sheet Available – Medicare Inpatient Rehabilitation Hospital/Facility Coverage In Light of Jimmo v. Sebelius

Filed Under: Article Tagged With: alert, Rehab Hospital Care, The Improvement Standard, Weekly Alert

Jimmo Implementation Update: Where is CMS?

February 28, 2019

The Settlement Agreement in Jimmo v. Sebelius, No. 5:11-CV-17 (D. VT), was approved by a federal district court in January 2013. The Centers for Medicare & Medicaid Services (CMS) was required to confirm that Medicare coverage is determined by a … [Read more...] about Jimmo Implementation Update: Where is CMS?

Filed Under: Article Tagged With: alert, 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

Checklist for Medicare Nursing Home “Improvement Standard” Denials

October 25, 2018

With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Checklist to help Medicare beneficiaries and their families respond to unfair Medicare denials for skilled nursing facility care based on an … [Read more...] about Checklist for Medicare Nursing Home “Improvement Standard” Denials

Filed Under: Article, fact-sheet, Self Help Packet Tagged With: alert, Appeal Tips, Jimmo-practice-tip, Skilled Nursing Facility, snf, The Improvement Standard, Weekly Alert

Checklist for Medicare Home Health Care “Improvement Standard” Denials

October 18, 2018

With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Checklist to help Medicare beneficiaries and their families respond to unfair Medicare denials for home health care based on an erroneous … [Read more...] about Checklist for Medicare Home Health Care “Improvement Standard” Denials

Filed Under: Article, fact-sheet, Self Help Packet Tagged With: alert, Appeal Tips, Home Health, 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!

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