On
July 26th, 1990, the Americans with Disabilities Act was signed
into law. In the thirty-one years since, that day has come to mark a
recognition of “disability pride”, defined by the publication AmeriDisability
as “accepting and honoring each person's uniqueness and seeing it as a natural
and beautiful part of human diversity,” rather than seeing disability as
stigmatizing classification of a physical or mental impairment.[1] Since New York Mayor Bill de Blasio’s
announcement of Disability Pride Month in July 2015,[2] cities nationwide have been holding
parades and celebrations in honor of disabled Americans everywhere.
According
to the Centers for Disease Control and Prevention (CDC), 61 million adults in
the United States have some type of disability,[3] and over half are aged 65 and older.[4]
In
recognizing and celebrating the strength and empowerment that comes from
understanding that an individual living with a disability is much more than a
diagnosis, it is also critical that the health care needs of that individual
are respected and met. Access to the Medicare coverage to which disabled
Americans are entitled is a fundamental part of the Center for Medicare
Advocacy’s mission.
Medicare
is not just for Americans who are 65 and over. The same Medicare coverage
available to older Americans is available to those under 65 who meet the
criteria for Social Security Disability benefits. (Click here for more specific details about Medicare
Coverage for People with Disabilities.) Furthermore, as confirmed by the 2013
settlement in Jimmo v.
Sebelius,[5]
Medicare covers skilled nursing care and skilled therapy services in nursing
homes, home health care settings, and outpatient therapy when skilled care is
needed to maintain function or prevent or slow further deterioration.[6] Unfortunately, those
with disabilities, along with other Medicare beneficiaries, often face
significant challenges in receiving coverage for this necessary care based on a
long-standing myth that coverage is only available for people who will improve
(known as the “Improvement Standard”).[7]
To
address the widespread and unfounded denials of coverage that Americans with
disabilities and other Medicare recipients have faced, the Center for Medicare
Advocacy and Vermont Legal Aid filed a class action lawsuit (Jimmo v. Sebelius) with the
goal of eliminating the myth that Medicare covers care and services only if a
beneficiary is expected to improve. In 2013, the Court approved a settlement
that required the Centers for Medicare & Medicaid Services (CMS) to issue
clarifications to existing program guidance and create new educational
material. These important materials aim to inform providers of “skilled” care
that Medicare beneficiaries in need of ongoing support to maintain function or
slow deterioration will continue to receive coverage for these services. (Click
here to access the Jimmo Settlement information page on CMS’s
website.)
There
remains much work to be done, however. The Center for Medicare Advocacy
continues to fight for Americans with disabilities and other Medicare
beneficiaries who are still being denied their rightful coverage to access
critical skilled care. We remain committed to ensuring Jimmo is properly
implemented.
__________________
[1] AmeriDisability. What is Disability Pride... And How to
Display It. (n.d.). Available at: https://www.ameridisability.com/post/how-to-display-disability-pride
[2] The official
website of the City of New York.
Mayor Bill de Blasio Designates July “Disability Pride Month” in Honor of
Twenty-Fifth Anniversary of ADA (July 2, 2015). Available at:
https://www1.nyc.gov/office-of-the-mayor/news/468-15/mayor-bill-de-blasio-designates-july-disability-pride-month-honor-twenty-fifth-anniversary
[3] Centers for
Disease Control and Prevention. Disability
Impacts All of Us Infographic. (Sept. 16, 2020). Available at: https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
[4] U.S. Bureau of
Labor Statistics. Persons with
a Disability: Labor Force Characteristics Summary. (Feb. 24, 2021).
Available at: https://www.bls.gov/news.release/disabl.nr0.htm
[5] No. 5:11-cv17
(D. Vt. Jan. 24, 2013). Available at: https://www.medicareadvocacy.org/wp-content/uploads/2013/01/Order-Granting-Final-Approval.012413.pdf
[6] Centers for
Medicare & Medicaid Services. Jimmo
Settlement. (n.d.). Available at: https://www.cms.gov/Center/Special-Topic/Jimmo-Center
[7] Center for
Medicare Advocacy. Transition
Memorandum for Biden Administration Department of Health & Human Services
(HHS). (Dec. 21, 2020). Available at: https://medicareadvocacy.org/transition-memo-2020/?emci=311b3b1f-1fe0-eb11-a7ad-501ac57b8fa7&emdi=f571f5da-30e0-eb11-a7ad-501ac57b8fa7&ceid=9511848
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