Does Jimmo Settlement Agreement of 2013 also apply to Medicaid?

Question

The Jimmo Settlement Agreement was passed in 2013. This is under the Center for Medicare & Medicaid. In laymen's terms, this allows a patient to receive help with skilled therapy/nursing services (ie: exercising aka range of motion is a common one) if they are unable to do it themselves, among other things.

https://www.cms.gov/medicare/settlements/jimmo

Does this law cover Medicare patients only? Or does this law cover Medicare AND Medicaid patients?

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Further research:

Because Medicaid is a state-run program, the federal government does not have to answer questions about this program.

I called Medicaid (at my state level) and they have two departments that answer questions about benefits--Member Services and Provider Services. They said members (patients) are not allowed to ask questions about their specific benefits (what is covered and what is not covered). Provider Services can answer those benefit coverage questions. Only providers (doctors, managed care organizations, etc.) can call Provider Services.

Answer 1

The Jimmo Settlement Agreement (2013) is a consent decree reached in a federal class action court case, not a statute. It applies only to Medicare. It does not apply to Medicaid.

This makes sense because the Jimmo Settlement pertains to what Medicare does and does not cover. But the package of benefits that are part of Medicare (which the settlement helps define) and the package of benefits that goes with various Medicaid subprograms in say, Ohio, are not the same. Medicaid benefits aren't even exactly the same from state to state.

To give a fake example that illustrates the issue, suppose that Medicare covers "medical care", and that Medicaid in Ohio covers "health care". The Jimmo Settlement helps define what "medical care" means, which doesn't help you determine what "health care" means for purposes of Medicaid in Ohio.

They said members (patients) are not allowed to ask questions about their specific benefits (what is covered and what is not covered). Provider Services can answer those benefit coverage questions. Only providers can call Provider Services.

This isn't entirely true, but it may be the practical reality.