Jimmo vs. Sebelius Training

Thank you for your partnership with MHS Health Wisconsin Medicare Advantage.  We value our relationship with you, as well as the excellent care you provide to our members. 

CMS has issued a requirement related to the settlement of the 2013 Jimmo v. Sebelius class action lawsuit. The settlement addresses the delivery of skilled nursing services to Medicare beneficiaries and applies to nursing facilities, home health, and outpatient therapy benefits when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met). 

All Medicare providers are required to review this training in order to ensure that services are provided and coverage determinations are adjudicated accurately and appropriately in accordance with existing Medicare policy.

Please don’t hesitate to reach out to Provider Services at 1-877-935-8024 with any questions you may have.

•  Jimmo vs. Sebelius Training (PDF)
•  Jimmo vs. Sebelius FAQs (PDF)