{"id":23645,"date":"2023-12-14T12:09:05","date_gmt":"2023-12-14T17:09:05","guid":{"rendered":"https:\/\/medicareadvocacy.org\/?p=23645"},"modified":"2023-12-14T12:10:18","modified_gmt":"2023-12-14T17:10:18","slug":"know-jimmo-help-open-doors-to-necessary-care","status":"publish","type":"post","link":"https:\/\/medicareadvocacy.org\/know-jimmo-help-open-doors-to-necessary-care\/","title":{"rendered":"Know Jimmo | Help Open Doors to Necessary Care"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<p><strong>Jimmo Summary:<\/strong><\/p>\n\n\n\n<ul>\n<li>Coverage turns on whether skilled care is required, not improvement\u00a0(This is key to <em>Jimmo<\/em>)<\/li>\n\n\n\n<li>Restoration potential is not the deciding factor<\/li>\n\n\n\n<li>Medicare should not be denied because the beneficiary has a chronic condition or needs services to maintain his\/her condition<\/li>\n\n\n\n<li>\u00a7n \u201cIndividualized Assessment\u201d of each claim is\u00a0 required<\/li>\n\n\n\n<li>Rules of thumb should not be used<\/li>\n<\/ul>\n\n\n\n<p><strong>Per CMS: \u201cThis is long-standing criteria,<\/strong> <strong>consistent with regulations\u201d<\/strong><\/p>\n\n\n\n<p><strong>Questions to Ask:<\/strong><\/p>\n\n\n\n<ul>\n<li>Is a skilled professional needed to ensure nursing or therapy is safe and effective?\u00a0 Yes \u2192 Medicare coverable.<\/li>\n\n\n\n<li>Is a qualified nurse or therapist needed to provide <em>or<\/em> supervise the care?\u00a0 Yes \u2192 Medicare coverable.<\/li>\n<\/ul>\n\n\n\n<p><strong>Regardless of whether the skilled care is needed to improve, or maintain, or slow deterioration of the condition. Or if condition is \u201cchronic\u201d or \u201cstable\u201d or has \u201cplateaued.\u201d<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong>Help Open Doors to Necessary Care!<\/strong><br>Search for <em>Jimmo<\/em> and <em>Important Message about Jimmo <\/em>at CMS.gov<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n\n<div class=\"wp-block-uagb-info-box uagb-block-d557259b uagb-infobox__content-wrap  uagb-infobox-icon-above-title uagb-infobox-image-valign-top\"><div class=\"uagb-ifb-content\"><div class=\"uagb-ifb-icon-wrap\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path d=\"M0 256C0 114.6 114.6 0 256 0C397.4 0 512 114.6 512 256C512 397.4 397.4 512 256 512C114.6 512 0 397.4 0 256zM371.8 211.8C382.7 200.9 382.7 183.1 371.8 172.2C360.9 161.3 343.1 161.3 332.2 172.2L224 280.4L179.8 236.2C168.9 225.3 151.1 225.3 140.2 236.2C129.3 247.1 129.3 264.9 140.2 275.8L204.2 339.8C215.1 350.7 232.9 350.7 243.8 339.8L371.8 211.8z\"><\/path><\/svg><\/div><div class=\"uagb-ifb-title-wrap\"><h3 class=\"uagb-ifb-title\">Learn More<\/h3><\/div><p class=\"uagb-ifb-desc\">To learn more about the historic&nbsp;<em>Jimmo&nbsp;<\/em>Settlement, including watching a recording of CMA\u2019s recent&nbsp;<em>Jimmo<\/em>&nbsp;Symposium \u2013&nbsp;<em>Jimmo v. Sebelius<\/em>&nbsp;at 10 Years: A Call for Sustainable Implementation <a href=\"https:\/\/medicareadvocacy.org\/medicare-info\/improvement-standard\/\"><strong>please visit the&nbsp;<em>Jimmo<\/em>&nbsp;section of our website by clicking here<\/strong><\/a>.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n","protected":false},"excerpt":{"rendered":"<p>Medicare coverage turns on whether skilled care is required, not improvement.<\/p>\n","protected":false},"author":2,"featured_media":17569,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[3],"tags":[54],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Know Jimmo | Help Open Doors to Necessary Care - Center for Medicare Advocacy<\/title>\n<meta name=\"description\" content=\"Medicare coverage turns on whether skilled care is required, not 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