Whether you call it a "change" or a "clarification," the fact is this: the Centers for Medicare and Medicaid Services (CMS) is providing more details on skilled maintenance care in the wake of the landmark Jimmo v Sebelius settlement. An article in the April edition of PT in Motion, APTA's monthly member magazine, helps to explain the explanations.
In this month's "Compliance Matters" column, APTA Director of Regulatory Affairs Roshunda Drummond-Dye, JD, writes that the CMS manual updates "shatter the longstanding myth that skilled therapy services can be provided to Medicare beneficiaries only if material improvement in the patient's condition can be proven." The column outlines the history of the settlement and the ways in which CMS has revised Medicare manuals to shed light on exactly how maintenance care will be evaluated.
The PT in Motion article touches on CMS distinctions between restorative care and maintenance therapy, and addresses requirements for documentation in home health settings. The CMS clarifications also were the subject of a recent article in the New York Times that characterized the new language as "a quiet sea change" in coverage.
Hardcopy versions of PT in Motion are mailed to all members who have not opted out; digital versions are available online to members.
Learn more about the impacts of the Jimmo v Sebelius settlement agreement—download a recent APTA podcast that explores what it means for physical therapists.
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