“Need for skilled care” is the Medicare standard for rehab payment
We are seeing an uptick in the number of fragile elderly patients whose post-hospital subacute Medicare benefits are being prematurely terminated due to lack of improvement. Before 2013, the insurance companies that were processing the post-hospital skilled care benefits under Medicare Part A were often using a “rule of thumb” whereby they would terminate benefits if the patient...
Despite the JIMMO settlement, Medicare benefits are being prematurely terminated
Back in January 2013 the Centers for Medicare and Medicaid Services (CMS) settled a class action lawsuit called Jimmo v Sebelius concerning premature cutoffs of skilled care benefits under Medicare Part A. The problem was that patients in skilled care facilities after hospitalizations, who were placed there for skilled nursing and rehabilitation, were finding that their benefits were being cut...