Jimmo V. Sebelius

In 2013, the Center for Medicare Advocacy and Vermont Legal Aid, along with additional counsel provided by Wilson Sonsini Goodrich & Rosati, settled a lawsuit with the Medicare program (the named defendant,...

Providing the best care for our therapy patients has evolved and expanded over the past year. Our roles as therapists have broadened to include advocating for patients as well as providing services for...

Accurate and thorough nursing documentation is the crucial factor in determining medical necessity. As nursing leaders in long-term care, we are obligated to ensure that Medicare documentation standards...

Why would anyone mention value-based reimbursement, medical necessity and the Jimmo lawsuit in the same sentence? I feel they are all related, but it will be difficult to find the perfect balancing act...

In seeking Medicare reimbursement, skilled nursing facilities should not claim that therapy was to maintain a patient’s condition if documentation reflected only an improvement goal, according to...

The Centers for Medicare & Medicaid Services has revised the Medicare Benefit Policy manual to clarify that skilled care and skilled therapy may be covered even for conditions that will not improve, per...

Marking another step toward guaranteeing Medicare coverage for nursing home residents needing skilled services, a federal judge on Thursday approved the October 2012 settlement agreement in Jimmo v. Sebelius.

Federal health officials have agreed to changes in Medicare coverage rules that would make it easier for beneficiaries with chronic conditions to qualify for nursing home stays, outpatient therapy and...