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CMS Finally Develops a Jimmo Settlement Agreement Webpage

In the Aug. 24th MLN Connects newsletter, the Centers for Medicare & Medicaid Services (CMS) posted information on an educational webpage that had been mandated as part of the federal government's settlement of the Jimmo case. As we have reported since 2013, this case clarified that the Medicare program covers skilled nursing care and skilled therapy services under Medicare’s skilled nursing facility, home health, and outpatient therapy benefits when a patient needs skilled care to maintain function or to prevent or slow decline or deterioration.

The Jimmo settlement changed practice for providers and contractors who may have incorrectly believed that the Medicare program covers nursing and therapy services under these benefits only when a patient is expected to improve. The settlement 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 nursing and therapy in inpatient rehabilitation hospitals for beneficiaries who need the level of care that such hospitals provide.

As we shared, a court ruling last summer found that CMS did not do enough to explain maintenance coverage.

Now that the new Jimmo Settlement Agreement webpage has been launched, you can find:

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871