Medicare coverage for skilled nursing or therapy services can no longer be denied to beneficiaries who can’t show a likelihood of improvement.
The settlement in the Medicare Improvement Standard case, Jimmo v. Sebelius, was approved on January 24, 2013, marking a critical step forward for thousands of beneficiaries nationwide who require skilled nursing and therapy services to maintain their condition.
Coverage should be available now for people who need skilled maintenance care and meet any other qualifying Medicare criteria. People are encouraged to appeal should they be denied Medicare for skilled maintenance nursing or therapy because they are not improving.
The settlement is especially beneficial for patients with chronic conditions like Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, stroke, spinal cord injuries and traumatic brain injury, as they will qualify for services more easily than before. Read more