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Planning for Medicaid Unwinding in 2023

Social Work Blog

When the COVID-19 PHE ends, which is expected in 2023, state agencies will begin the “unwinding” of continuous Medicaid and Children’s Health Insurance Program (CHIP) by going through the redetermination process for all enrollees. By Carrie Dorn, MPA, LMSW. NASW Senior Practice Associate.

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New Actuarial Analysis Estimates Medicaid Palliative Care Return on Investment

CAPC

At minimum, palliative care is cost neutral while improving quality of life. News Bites Payment and Program Financing

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Serious Illness Recommendations to the Center for Medicare and Medicaid Innovation

CAPC

CAPC and the National Coalition for Hospice and Palliative Care share actionable recommendations with CMMI staff and model participants. News Bites Policy

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CAPC Shares Equity Findings and Recommendations with the Center for Medicare and Medicaid Innovation (CMMI)

CAPC

Letter defines real opportunities to improve quality of care for Black patients with serious illness through CMMI payment models. News Bites Payment and Program Financing

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Medicaid Expansion and Palliative Care Use Among Patients Newly Diagnosed with Advanced Cancer

CAPC

Study shows an increase in palliative care usage amongst people living with stage IV cancer. News Bites

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CMS Updates Guidance for Nursing Home Visitation During the COVID-19 Pandemic

Social Work Blog

Recognizing the physical and emotional toll of these visitation restrictions, the Centers for Medicare & Medicaid Services (CMS) recently updated its guidance to nursing homes regarding visitation during COVID-19. Posted December 17, 2021. Two adults are interacting with an older person.

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National Report Addresses Nursing Home Quality & Promotes Value of Social Work

Social Work Blog

submission of comments to the Centers for Medicare & Medicaid Services in response to its Request for Information on Revising the Requirements for Long-Term Care Facilities to Establish Mandatory Minimum Staffing Levels.

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Update: Nursing Home Visitation During the COVID-19 Pandemic

Social Work Blog

On November 12, 2021, the Centers for Medicare & Medicaid Services (CMS) released updated guidance to Medicare- and Medicaid-certified long-term care (LTC) facilities (commonly known as nursing homes) regarding visitation during the COVID-19 pandemic.

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Federal Rule to Prevent Surprise Health Care Billing

Social Work Blog

Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). Find Centers for Medicare and Medicaid Services (CMS) resources , including templates that can be used to prepare good faith estimates and model language for informing patients of their rights to GFE.

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Update: CMS Guidance for Nursing Home Visitation During the COVID-19 Pandemic

Social Work Blog

On November 12, 2021, the Centers for Medicare & Medicaid Services (CMS) released updated guidance to Medicare- and Medicaid-certified long-term care (LTC) facilities (commonly known as nursing homes) regarding visitation during the COVID-19 pandemic. Posted January 28, 2022.

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CMS Creates Additional Place of Service Code for Telehealth

Social Work Blog

Following a recent update from the Centers for Medicare and Medicaid Services (CMS), NASW has received multiple inquiries regarding telehealth place of service codes (POS) for Medicare, Medicaid and private health insurance companies. A blog post written by NASW Senior Practice Associate Denise Johnson, CMS Creates Additional Place of Service Code for Telehealth , clarifies what POS codes clinical social workers should use when providing telehealth services.

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Calendar Year (CY) 2023 Proposed Rule for Medicare Physician Fee Schedule

Social Work Blog

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule of the Physician Fee Schedule that announced proposed policy and practice changes for Medicare Part B payments beginning January 1, 2023. You may mail written comments to the following address: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1770-P, P.O.

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NCCPR news and commentary round-up, week ending January 25, 2022

NCCPR Child Welfare Blog

Expand Medicaid: Less “neglect.” ● The Imprint has a good round-up of research documenting the confusion of poverty with neglect. Raise the minimum wage and you reduce what family policing agencies call “neglect.” Increase SNAP benefits: Less “neglect.”

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CMS Creates Additional Place of Service Code for Telehealth

Social Work Blog

Following a recent update from the Center for Medicare, and Medicaid Services (CMS), NASW has received multiple inquiries regarding telehealth place of service codes (POS) for Medicare, Medicaid, and private health insurance companies. June 2022. The purpose of this blog is to clarify what POS codes clinical social workers should use when providing telehealth services. POS codes are used on health insurance claim forms to indicate where patient services are rendered.

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CMS 2023 Home Health Final Rule: What Agencies Need To Know

Relias

The 2023 Home Health Final Payment Rule , which the Centers for Medicare and Medicaid Services (CMS) released in October, increases Medicare payments for home health agencies by 0.7%, or $125 million, compared to 2022.

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Social Workers: The Backbone of Reimagined 988 Emergency Crisis Services

Social Work Blog

W hen the National 988 Suicide Prevention Crisis Hotline goes into effect July 16, 2022, it will probably be the most significant public policy initiative impacting behavioral healthcare since the Medicaid expansion. By Mel Wilson, LCSW, MBA.

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Biden’s commitment to better mental health for all

MQ Mental Health

“Let’s take on mental health. Especially among our children whose lives and education have been turned upside-down.”. At President Biden’s first State of the Union address to congress last night he addressed many important topics, including a commitment to better mental health for the nation.

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CMS Seeks Feedback on Good Faith Estimates

Social Work Blog

The Center for Medicare and Medicaid Services (CMS) is seeking feedback from clinical social workers and other providers about how they should provide estimates for costs of services for patients who use their insurance to pay for health and mental health services. Attention Clinical Social Workers: CMS Seeking Feedback on Good Faith Estimates.

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Behind the Poor Pay and High Turnover Rates of Direct Support Professionals

Relias

The State of Medicaid Programs and the Need for Grassroots Advocacy. Commercial insurance and private pay revenue sources rarely cover services for people with IDD, leaving Medicaid as essentially the sole payer for these services.

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2023 Healthcare Trends: Are You Ready?

Relias

The Centers for Medicare and Medicaid Services (CMS) will expand its enforcement actions against poorly-performing facilities. From the growth of home-based care and telehealth to regulation changes, post-acute care leaders need to be aware of this year’s industry trends.

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New Peripartum Depression Study Shows Gap Between Screening and Outcomes

Relias

Research cited in our study showed that screening occurred in less than two-thirds of mothers, with considerable variation depending on race, income-level, and Medicaid/Medicare status.

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What You Need To Know About Value-Based Payment Models

Relias

But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030.

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Practice Alert: Affordable Care Act Health Insurance Marketplace Open Enrollment November 1 to January 15

Social Work Blog

Open Enrollment for the health insurance marketplace is November 1 to January 15, 2023. For coverage to begin on January 1 , enrollment must be completed by midnight on December 15.

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Social Workers: The Backbone of Reimagined 988 Emergency Crisis Services

Social Work Blog

When the National 988 Suicide Prevention Crisis Hotline goes into effect July 16, 2022, it will probably be the most significant public policy initiative impacting behavioral healthcare since the Medicaid expansion. By Mel Wilson.

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Home Health Agencies Face Financial Burden of Proposed CMS Payment Cut

Relias

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% The U.S. next year. CMS estimates that this move would decrease reimbursements by about $810 million compared to 2022 projected reimbursements.

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Guest Post: Interview with Author of Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry

Bipolar Bandit

The states primarily funded these hospitals through taxes until the Medicaid program was created in 1965. What inspired you to write the book, Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry , that got published in October of 2018? .

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Types of Therapy and Mental Health Providers

Stop Abuse Campaign

MHCs and CSWs often work in community mental health clinics, which are more likely to accept a wider variety of insurance, including Medicaid. . ← How to Choose a Therapist: Tips and Fits.

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Remembering the Children

Beyond Advocacy

According to the Peterson Foundation, federal spending on children in 2020 amounted to seven percent of the federal budget compared to 33 percent for adults 18 years and older through Social Security, Medicare, and Medicaid.

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Does Anyone Care? Shocking Barriers Killing Our Mental Health

Stop Abuse Campaign

If your needs are less urgent, you may qualify for Medicaid to get mental health help. Medicaid can help you receive mental health care at a low cost if your income is below certain state limits. ← Thoughts on suicide prevention from a survivor.

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Federal Rule to Prevent Surprise Health Care Billing

Social Work Blog

Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). Application to Clinical Social Work Services.

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Understanding the PEPPER Can Reduce Home Health and Skilled Nursing Audit Risks

Relias

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). We all love free tools that help our organizations perform better.

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How you can save babies whose mothers have substance use disorders

Stop Abuse Campaign

In traditional foster care, a trained stranger raises the baby with some monitoring from the local Child Protective Services and financial supports such as SNAP (food stamps), Medicaid, and a cash per diem. ← Incest the Unforgivable.

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What is MIECHV? Overview and Importance of Maternal Home Visiting Programs

Stop Abuse Campaign

78 percent of participating adults and children relied on Medicaid or CHIP. . ← How you can save babies whose mothers have substance use disorders. “ A young mom met her home visitor when she was 16 and pregnant.

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Nursing Home Compliance: Prepare for Focused Inspections

Relias

CMS will be tasked with holding nursing homes accountable for the care they provide their residents and terminating underperforming facilities from Medicare or Medicaid programs.

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Be Prepared for Dobbs Decision Impact on Maternal Mortality

Relias

The Commonwealth Fund reported that organizations are already gearing up to request additional federal funding for supplemental coverage for Medicaid patients to help alleviate the impact on low-income patients, people of color, and other underserved populations and help them get the care they need.

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Home Health CoPs Update: New Opportunities for OTs

Relias

There’s a new opportunity for occupational therapists practicing in home health settings. OTs working in home health can initiate the start of care in more situations beginning in 2022 under changes to the Medicare conditions of participation (CoPs).

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New Frequently Asked Questions on the No Surprises Act: Good Faith Estimates

Social Work Blog

The Centers for Medicare and Medicaid Services (CMS) has released clarifying information about Part 2 of the No Surprise Act, Good Faith Estimates (GFEs). April 18, 2022.

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Invest in Wound Care Education To Avoid Legal Risks

Relias

Because the Centers for Medicare and Medicaid Services will not reimburse healthcare organizations for costs associated with hospital- or facility-acquired pressure injuries, appropriate assessment at the time of admission is vital.

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Survey Readiness: Post-Acute Care Compliance Checkup

Relias

Recently, the Centers for Medicare and Medicaid Services’ (CMS) Special Focus Facility Program report listed nursing homes that have not met the CMS’ health care or fire safety standards. Federal and state agencies’ routine surveys of healthcare organizations can be stressful.

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How to choose a good hospice (whether you’re looking for a job or signing up a relative)

Hospice Social Work

When I heard from a nursing home social worker that a recently admitted patient neither qualified for Medicaid nor received enough income to pay privately, I called the patient care manager for our team in that area and described the situation.

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