The Jimmo Settlement, approved by the federal district court in 2013, confirmed Medicare coverage should be determined by a beneficiary’s need for skilled care, not the individual’s potential for improvement; and that Medicare covers skilled care to … [Read more...] about Know Jimmo | No Improvement Needed
Search Results for: improvement
Updated 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 Updated Factsheet: Medicare Skilled Nursing Facility Coverage Does Not Require Improvement
Congress Sets the Stage for Important Medicare Improvements
Earlier this week, the Senate passed a $1 trillion bipartisan infrastructure bill, followed by a party-line approval of a $3.5 trillion budget blueprint for a reconciliation bill. According to Politico, the budget blueprint, or framework, … [Read more...] about Congress Sets the Stage for Important Medicare Improvements
Changes to Health Coverage Must Include Medicare Improvements
In his national address before a joint session of Congress last night, President Biden outlined his vision for “rebuilding our nation” in the midst of both “crisis” and “opportunity”. His vision included both health care broadly, and Medicare … [Read more...] about Changes to Health Coverage Must Include Medicare Improvements
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
Center for Medicare Advocacy Issues Transition Memorandum: Medicare Improvements for the Biden Administration
The Center for Medicare Advocacy (the Center) looks forward to working with the incoming Biden Administration. In a Memorandum, submitted to Transition leaders on December 18, we recommend a number of measures that the new Department of Health and … [Read more...] about Center for Medicare Advocacy Issues Transition Memorandum: Medicare Improvements for the Biden Administration
Center for Medicare Advocacy Submits Memorandum: Medicare Improvements Biden Administration Can Make Immediately
For Immediate ReleaseDecember 18, 2020 Contact: Matthew Shepard: 202-293-5760, MShepard@MedicareAdvocacy.org The incoming Biden administration has vowed to improve health care, especially in light of the COVID-19 pandemic, which has taken a … [Read more...] about Center for Medicare Advocacy Submits Memorandum: Medicare Improvements Biden Administration Can Make Immediately
Jimmo “Improvement Standard” Appeal Letter Template
[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
Medicare & You 2020 – Better Than Draft, But Room for Improvement
The Centers for Medicare & Medicaid Services (CMS) recently posted the Medicare & You 2020 handbook on their website. The Center for Medicare Advocacy (the Center) reviewed the new handbook with an eye toward assessing the balance of … [Read more...] about Medicare & You 2020 – Better Than Draft, But Room for Improvement
Self-Help Resources for Improvement Standard Denials – August, 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