Maintenance Therapy Update

February 14, 2017
Rick Gawenda

On February 2, 2017, a federal judge ruling has ordered the Secretary of Health & Human Services to carry out a Corrective Action Plan to remedy the Department’s noncompliance with the Jimmo vs Sebelius Settlement agreement concerning the coverage and payment for maintenance therapy under the Medicare program. Per the Center for Medicare Advocacy, the judge ruled that the Corrective Action Plan will include a new CMS webpage dedicated to Jimmo, a published Corrective Statement disavowing the improvement standard, a posting of Frequently Asked Questions (FAQs), and new training for contractors making coverage decisions.  In addition, and significantly, the Court largely adopted the Corrective Statement drafted by plaintiffs, and ordered the Secretary to conduct a new National Call to explain the correct policy.

If you did not know that the Medicare program covers maintenance therapy and/or do not know what maintenance therapy is, consider purchasing my recent webinar I did concerning maintenance therapy under the Medicare program. For additional information on this webinar, click HERE. I also have a dedicated page on maintenance therapy FAQs with answers. Click HERE to access the FAQs.

For additional information on the recent ruling, click

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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