Home Health & Hospice Week

A new Medicare website about the Jimmo settlement may lend some backup to your maintenance nursing and therapy services.

The Jimmo Settlement Agreement from January 2013 “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 beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met),” the Centers for Medicare & Medicaid Services explains in a notice of the new website.

“The Jimmo Settlement Agreement may reflect a change in practice for those providers, adjudicators, and contractors 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,” CMS says on the website.

Q&A: The Jimmo agreement applies to beneficiaries in Medicare Advantage plans too, CMS says in a new question-and-answer set on the site. “Medicare Advantage plans must cover the same Part A and Part B benefits as original Medicare, and must also apply the standards for coverage of skilled care as clarified by the Jimmo Settlement Agreement,” according to the Q&A.

For more information, including the 15 Q&As about the settlement, go to www.cms.gov/Center/Special-Topic/Jimmo-Center.html.