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Federal Court Orders a Corrective Action Plan for the Government’s Noncompliance with the Settlement in Jimmo v. Burwell

Feb 14, 2017

On February 2, 2017, the federal judge administering the Settlement Agreement in the Medicare “Improvement Standard” case (Jimmo v. Burwell) ordered the Secretary of Health & Human Services to carry out a Corrective Action Plan to remedy the department’s noncompliance with the settlement. In August 2016, Chief Judge Christina Reiss of the District of Vermont, held that the HHS Secretary had not accurately implemented the Jimmo Settlement’s required Educational Campaign. The Judge ruled that the Secretary failed to explain that a consideration of the need for skilled care, not the potential for improvement, should govern Medicare coverage determinations—for skilled nursing facility, home health, and outpatient therapy. The judge ruled that the corrective action plan will include a new CMS web page dedicated to Jimmo, a published corrective statement disavowing the improvement standard, a posting of frequently asked questions, and new training for contractors making coverage decisions. The ruling does not mention in-patient rehabilitation.

The Academy was an original-named party when the suit was first filed and coordinated with community partners and coalitions on various efforts in support of the case. Thank you to our Academy members—it's through your support that allows us to engage on these critical items to lead the specialty.