Transcription of —Toolkit - Medicare Advocacy
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—Toolkit - Medicare Advocacy
Toolkit . Medicare Skilled Nursing Facility Coverage And Jimmo v. Sebelius _____. 1. Introduction Jimmo v. Sebelius, No. 11-cv-17 (D. VT), is a nationwide class-action lawsuit brought on behalf of Medicare beneficiaries who received care in skilled nursing facilities, home health care , and outpatient therapy and who were denied Medicare coverage on the basis that they were not improving or did not demonstrate a potential for improvement (known as the Improvement Standard). On January 24, 2013, the District Court for the District of Vermont approved a Settlement in Jimmo between attorneys for the Jimmo plaintiffs (the Center for Medicare Advocacy and Vermont Legal Aid) and the Centers for Medicare & Medicaid Services (CMS). The Jimmo Settlement required CMS to undertake the following to remedy the practice of erroneously denying Medicare coverage based on an Improvement Standard.
3 4. Medicare’s Skilled Nursing Facility Benefit Policy Manual Chapter 8 of the Medicare – Benefit Policy Manual (“Coverage of Extended Care …
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