Frequently Asked Question #5: Q5: When are skilled nursing or therapy services to maintain a patient’s current condition or prevent or slow further deterioration covered under the SNF, HH, and OPT benefits, assuming all other coverage criteria are … [Read more...] about Know Jimmo | Maintenance Care is Covered if it Requires Skilled Personnel for Safe Delivery – Ask CMS!
Search Results for: maintenance
Know Jimmo | CMS “Clarified” that Skilled Maintenance is Covered
In November 2010, CMS revised its regulations to clarify Medicare coverage principles for skilled services. Most importantly, the revisions “clarified” that skilled care does include services intended to maintain a person's condition and that no … [Read more...] about Know Jimmo | CMS “Clarified” that Skilled Maintenance is Covered
Know Jimmo | Skilled Outpatient Maintenance Therapy IS Available
The Center for Medicare Advocacy is often asked in what care settings the Jimmo Settlement applies. Jimmo applies to skilled care – nursing and therapy (physical, occupational and speech language pathology) – received in a skilled nursing facility, … [Read more...] about Know Jimmo | Skilled Outpatient Maintenance Therapy IS Available
Know Jimmo | Why Skilled Maintenance Care Matters, In a Daughter’s Words
“These changes [from the Jimmo Settlement] are extremely meaningful, as my mother has repeatedly been denied the ability to continue the physical therapy she needs in order to prevent further deterioration of her condition. It has been … [Read more...] about Know Jimmo | Why Skilled Maintenance Care Matters, In a Daughter’s Words
Guest Post: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed
By John Marmarou, DPT, MSCS - Executive Director, Total Rehab & Fitness For the last 15 years, all of my professional work and efforts have been devoted to keeping those with multiple sclerosis (MS) in their communities and out of the … [Read more...] about Guest Post: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed
Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It
The Center for Medicare & Medicaid Services issued MLN Matters # MM-11721 on May 1, 2020. Effective January 1, 2020, the MLN, reconfirms that therapy to maintain an individual’s function is a Medicare-covered service. Further, the MLN authorizes … [Read more...] about Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It
The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement
The National Association of Insurance Commissioners (NAIC) is a standard-setting and regulatory support organization governed by chief insurance regulators from across the country. NAIC’s website indicates that organizational members and its … [Read more...] about The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement
Successful Advocacy for Home Health Beneficiary in Need of Maintenance Physical Therapy
Mrs. R contacted the Center for Medicare Advocacy about her husband, who has ALS, and was told his home health physical therapy was about to be terminated. While receiving physical therapy, Mr. R had reduced pain, allowing him to decrease pain … [Read more...] about Successful Advocacy for Home Health Beneficiary in Need of Maintenance Physical Therapy
Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy
Despite the Jimmo case’s confirmation that Medicare coverage of a stay in a skilled nursing facility (SNF) is appropriate to maintain a resident’s functional status, when the nursing or therapy services must be provided by a professional nurse or … [Read more...] about Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy
Practice Tip: Orders Needed for Maintenance Skilled Care
Based on recent experience, the Center for Medicare Advocacy provides this Practice Tip for providers and advocates for patients who need to change from an improvement mode to maintenance mode for nursing or therapy. The Center is seeing decisions … [Read more...] about Practice Tip: Orders Needed for Maintenance Skilled Care