The 2013 Settlement in Jimmo v. Sebelius confirmed that Medicare coverage should be determined based on a beneficiary’s need for skilled care (nursing or therapy), not on the individual’s potential for improvement.

Unfortunately, more than six years after the Settlement’s approval, Medicare beneficiaries and providers across the country are still having significant problems with the implementation of the Settlement. The Center for Medicare Advocacy with support form the John A. Hartford Foundation, has compiled an Issue Brief to provide Medicare stakeholders with an overview of the Jimmo Settlement, what it means in different care settings, some of the Center’s key implementation work, and links and references to helpful resource materials. 

Jerry Rothkoff was honored to serve on the Jimmo Implementation Council which convened in Washington, DC in June 2015 in order to discuss implementation in the various care-settings, identified specific barriers to implementation, and considered effective methods to implement the Settlement.      

Please click on the link below to access the issue brief.

Implementing Jimmo v. Sebelius: An Overview