Vermont Court Settlement Means More Home Care Covered Under Medicare

A Vermont court today settled a case that stands to make in-home care more available to patients who need it.

The Medicare Improvement Standard case Jimmo v. Sebelius was approved today during a fairness hearing, marking a “critical” step for thousands of Medicare beneficiaries, according to the Center for Medicare Advocacy. The Centers for Medicare & Medicaid Services (CMS) will now look to revise policies regarding maintenance care for those suffering from chronic illness based on the court’s approval for an “improvement standard” settlement.

“With the settlement now officially approved, [CMS] is tasked with revising its Medicare Benefit Policy Manual and numerous other policies, guidelines and instructions to ensure that Medicare coverage is available for skilled maintenance services in the home health, nursing home and outpatients settings,” wrote the Center for Medicare Advocacy, in response to the settlement.


The changes will be designed to ensure Medicare coverage is available for skilled maintenance services—including services delivered through in-home care.

The Settlement Agreement standards for Medicare coverage are available now, while CMS works on policy revisions and its education campaign, according to the CMA.

The settlement was proposed October in response to a class action lawsuit filed by beneficiaries of Medicaid.


Written by Elizabeth Ecker

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