“I’m too sick for therapy today.” “Come back later.” “Leave me alone.” If you’ve worked in long-term care (or hospitals or LTACHs or acute rehab hospitals), you’ve heard...
Jimmo v. Sebelius, 10 years later
By
Renee Kinder
Sep 14, 2023
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,...
Advocating for those who need us
By
Kristy Wikum
Feb 25, 2015
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...
Determining medically necessary Medicare coverage
By
Colleen Toebe
Dec 05, 2014
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...
Pay for performance, medical necessity and Jimmo
By
Shelly Mesure, MS, OTR/L
Jun 04, 2014
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...