Per CMS: “This is long-standing criteria, consistent with regulations” See cms.gov/medicare/settlements/jimmo … [Read more...] about Know Jimmo | A Summary
Search Results for: Jimmo
Know Jimmo | Use the CMS Information
CMS says very clearly that "skilled nursing and skilled therapy services in the Skilled Nursing Facility (SNF), Home Health (HH), and Outpatient Therapy (OPT) settings does not turn on the presence or absence of a beneficiary’s potential for … [Read more...] about Know Jimmo | Use the CMS Information
Know Jimmo | Important Message about the Settlement
“The Jimmo Settlement Agreement may reflect a change in practice for those…who may have erroneously believed that the Medicare program covers nursing and therapy services under these benefits only when a beneficiary is expected to improve. The Jimmo … [Read more...] about Know Jimmo | Important Message about the Settlement
Know Jimmo | Provider Education is Key
"I am a private nurse care manager who has advocated for my clients regarding the application of Jimmo decision for the last several years... without success. The therapists and nurses in the room continue to repeat 'Must discharge because of lack of … [Read more...] about Know Jimmo | Provider Education is Key
Know Jimmo | What Care Settings?
The Jimmo Settlement applies to: See www.cms.gov/medicare/settlements/jimmo … [Read more...] about Know Jimmo | What Care Settings?
Know Jimmo | Home Health Coverage Requires Individual Review
Medicare regulations set out coverage rules for home health care, including physical therapy, occupational therapy, and speech-language pathology services. Significantly, especially for people with longer term and chronic conditions, the regulations … [Read more...] about Know Jimmo | Home Health Coverage Requires Individual Review
Know Jimmo | Frequently Asked Questions (FAQs) Regarding Jimmo Settlement
(CMS.gov, Sept 10, 2024. Last visited 2/28/2025.) Q1: What is the Jimmo Settlement Agreement (January 2013)? A1: The Jimmo Settlement Agreement clarified that when a beneficiary needs skilled nursing or therapy services under Medicare’s skilled … [Read more...] about Know Jimmo | Frequently Asked Questions (FAQs) Regarding Jimmo Settlement
Know Jimmo | The Medicare Policy Manual
Provisions from Medicare’s Policy Manual Support SNF Coverage for Patients Receiving Skilled Maintenance Care (See, Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility Services) Section 30 Coverage of nursing care and/or … [Read more...] about Know Jimmo | The Medicare Policy Manual
Know Jimmo | Skilled Care & Individual Assessments, Not “Improvement”
In 2013, the Center for Medicare Advocacy reached a settlement with the Centers for Medicare & Medicaid Services (CMS) in the national class action case, Jimmo v. Sebelius. The Settlement, reaffirmed in 2017, confirmed that beneficiaries do not … [Read more...] about Know Jimmo | Skilled Care & Individual Assessments, Not “Improvement”
Know Jimmo | Home Health Care is Available for Medicare Beneficiaries with Long Term, Chronic, and Terminal Conditions
The key to coverage is whether the individual requires skilled nursing or therapy and whether care would be safe and effective if skilled care was not provided. (And the individual meets other qualifying criteria: is homebound and has proper provider … [Read more...] about Know Jimmo | Home Health Care is Available for Medicare Beneficiaries with Long Term, Chronic, and Terminal Conditions