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...
Jimmo guidance: Document whether therapy is for restoration or maintenance before providing care
By
Tim Mullaney
Dec 20, 2013
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...
CMS updates Medicare manual to reflect Jimmo settlement
By
Tim Mullaney
Dec 10, 2013
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...
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...