Medicare Benefit Policy Manual, Chapter 1, Section 110.2The patient can only be expected to benefit significantly from the intensive rehabilitation therapy program if … the patient can reasonably be expected to make measurable … [Read more...] about Know Jimmo | Inpatient Rehab Standards
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Know Jimmo | Watch our Symposium to hear from Jimmo Pros
This past September our virtual Jimmo Symposium brought together advocates, providers, beneficiaries, and others to discuss practical tips and strategies for obtaining medically necessary services pursuant to the Jimmo settlement, as well as ongoing … [Read more...] about Know Jimmo | Watch our Symposium to hear from Jimmo Pros
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 | You Do Not Have to Decline
You do not have to decline in order to receive Medicare coverage for care to maintain or slow declineToo often Medicare beneficiaries are told the care they are receiving to maintain their condition has to end and, if they decline, then they can … [Read more...] about Know Jimmo | You Do Not Have to Decline
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
Know Jimmo | CMS Reiterates that Medicare Coverage is Available to Maintain Function or Slow Decline
See MLN Connects Newsletter (2024-02-08-MLNC, 2/8/2024)“Medicare covers skilled nursing care and skilled therapy services under skilled nursing facility, home health, and outpatient therapy benefits when a beneficiary needs skilled care to … [Read more...] about Know Jimmo | CMS Reiterates that Medicare Coverage is Available to Maintain Function or Slow Decline
Know Jimmo | It’s Not About Care Setting
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
Know Jimmo | CMS Reminder to MA Plans
In a February 2024 memo, the Centers for Medicare & Medicaid Services reminded Medicare Advantage organizations that the Jimmo Settlement...clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | CMS Reminder to MA Plans
Know Jimmo | Skilled Nursing Facility Policy
Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility ServicesSection 30Coverage of nursing care and/or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement … [Read more...] about Know Jimmo | Skilled Nursing Facility Policy
Know Jimmo | New CMS Implementation Activity!
CMS Joins the Center for Medicare Advocacy to Advance Access to Medicare-Covered Skilled Care to Maintain One’s Condition or Slow DeclineIn 2011, the Center for Medicare Advocacy and Vermont Legal Aid brought the Jimmo v. Sebelius class … [Read more...] about Know Jimmo | New CMS Implementation Activity!