Jennifer Rutberg, of the Families and Health Care Project United Hospital Fund, has shared the following information with regard to the case of Jimmo v. Sebelius, which required the Centers for Medicare and Medicaid Services (CMS) to revise portions of its program manuals.
Jennifer explains that it is important for caregivers to know that Medicare has now explicitly stated (as of January 7) that claims for rehabilitation services cannot be denied because a patient has failed to improve. In her words, “Because this Medicare policy is new, it is important for family caregivers to know about it and to be prepared to advocate for an individualized assessment of their family member to gain approval for the necessary skilled services. If necessary, denials can be appealed.”
For more information, please see the following:
• Center for Medicare Advocacy: http://www.nextstepincare.org/uploads/File/newsletter/NewsletterJanuary2014.html
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