The Jimmo Settlement Agreement is consistent with the Medicare program’s regulations governing maintenance nursing and therapy in skilled nursing facilities, home health services, and outpatient therapy (physical, occupational, and speech) and … [Read more...] about Know Jimmo | It’s Not About Care Setting
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Know Jimmo | Medicare Home Health Coverage Does Not Require Improvement
Medicare home health coverage is misunderstood and too often denied. This is particularly true for people with longer-term and chronic conditions who are unable to obtain Medicare coverage although they meet the benefit’s criteria – are homebound and … [Read more...] about Know Jimmo | Medicare Home Health Coverage Does Not Require Improvement
Know Jimmo | What It Means
Coverage does not turn on the presence or absence of potential for improvement but rather on the need for skilled care. Skilled maintenance therapies and nursing are covered by Medicare. Claims should never be denied because patient cannot achieve … [Read more...] about Know Jimmo | What It Means
Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law
Medicare IS available for skilled care to maintain or slow decline of an individual’s condition. “Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not … [Read more...] about Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law
Know Jimmo | Medicare Home Health Coverage Available for People with Ongoing Conditions
Medicare home health coverage offers the promise of allowing eligible individuals (legally homebound and in need of skilled care), to remain at home with the care they need. According to Medicare law, regulations, and policy, home health coverage … [Read more...] about Know Jimmo | Medicare Home Health Coverage Available for People with Ongoing Conditions
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 | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline
“Maintenance Therapy – Therapy services in connection with a maintenance program are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a qualified therapist. … [Read more...] about Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline
Know Jimmo | Jimmo Applies to Many Care Settings
The standards established by Jimmo v Sebelius apply to four health care settings. They include: 1. Skilled Nursing Facility,2. Home Health, and,3. Outpatient Therapy (PT, SLP/ST, OT)4. Inpatient Rehabilitation Hospital (Facility) (IRF) Skilled … [Read more...] about Know Jimmo | Jimmo Applies to Many Care Settings
Know Jimmo | Medicare Home Health Coverage is Available for People with On-Going Needs
Contrary to regular misunderstanding and misstatements, Medicare coverage is available for home health coverage with no duration of time limit. In fact, Medicare home health coverage is available under the law “so long as skilled care is received” … [Read more...] about Know Jimmo | Medicare Home Health Coverage is Available for People with On-Going Needs
Know Jimmo | As CMS Reiterates, Jimmo is the Law
Skilled Nursing and therapy to maintain an individual's condition are covered by Medicare. Improvement is not required. This applies to Medicare Advantage as well as traditional Medicare. A CMS wrote on 2/13/2024: "The Centers for Medicare … [Read more...] about Know Jimmo | As CMS Reiterates, Jimmo is the Law