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The Center for Medicare Advocacy recently completed a survey of Jimmo v. Sebelius stakeholders to analyze the effectiveness of the Centers for Medicare & Medicaid Services’ education efforts regarding the Jimmo Settlement, which clarified that Medicare must cover skilled maintenance care in the home health, skilled nursing facility and outpatient therapy settings. Unfortunately, the results were not encouraging.

The survey was sent to over 400 providers and advocates across multiple disciplines. There was about a 20% response rate. Of those respondents, almost 40% still had not heard about the Jimmo Settlement, and almost 30% remained unaware that Medicare coverage depends on the need for skilled care, regardless of a beneficiary’s potential for improvement, and that Medicare covers skilled care to maintain a condition or slow deterioration.

Most tellingly, over 70% of respondents were completely unaware of the Jimmo Education Campaign that CMS was required to provide in 2013.  Further, even some of those were aware did not participate, as over 85% of respondents indicated that they did not participate.  CMS materials continue to lag as source of information as well, as over 60% of respondents have not accessed CMS’ Jimmo webpage.

The Center for Medicare Advocacy and our allies will continue our own efforts to educate providers, decision-makers, and beneficiaries about Jimmo, but true systemic change that will ensure beneficiaries get the coverage they are legally entitled to must involve a real, ongoing effort by CMS.

For more information, contact Improvement@MedicareAdvocacy.org

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