According to long term care experts, skilled nursing providers remain confused about Medicare changes related to Jimmo v. Sebelius, and beneficiaries are not aware that their therapy may be eligible for coverage.
Under the Jimmo settlement, the CMS were required to distribute educational materials to skilled nursing providers. The CMS has recently posted online resources and updated the Medicare manual.
The Jimmo settlement requires Medicare to reimburse for medically necessary skilled care, even if it is only to maintain a patient’s condition. Before the settlement, Medicare only covered skilled care if it could lead to the improvement of a beneficiary’s condition.
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