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Change to Medicare Subsidy Arrangement for Psychological Services

Psychological Health Care

Medicare subsidised visits to psychologists have been reduced from 1 January 2023. This means the number of Medicare subsidised psychology sessions you can claim has dropped from 20 to 10, per calendar year.

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Growing Numbers of Medicare Providers and Beneficiaries in Accountable Care Models

CAPC

Medicare estimates 13.2 million beneficiaries in one of three models. News Bites

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Future Medicare Models Expected to Take Lessons from Medicare Care Choices Model (MCCM)

CAPC

MCCM shines in its results compared to other Medicare models. News Bites

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Extension of Medicare Telehealth Billing Flexibilities

CAPC

Congress extends the existing Medicare waivers for 151 days after the PHE expires. News Bites Payment and Program Financing Policy

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(CY) 2022 Medicare Physician Fee Schedule Proposed Rule: Key Provisions Impacting Clinical Social Workers

Social Work Blog

The Centers for Medicare and Medicaid Services (CMS) proposed CY 2022 Physician Fee Schedule (PFS) issued on July 16 includes a variety of provisions that are relevant to clinical social workers (CSWs) who are participating providers in Medicare.

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Medicare Launches New Enhancing Oncology Model

CAPC

Emphasizes health equity, symptom management, and psychosocial health, and encourages care partners. News Bites Payment and Program Financing

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Medicare Open Enrollment: What’s New for 2022 and How You Can Help Your Clients

Social Work Blog

Each fall, Medicare beneficiaries can review, compare, and change their coverage options during the Medicare Open Enrollment Period (OEP). The Medicare OEP is distinct from Health Insurance Marketplace Open Enrollment , which occurs November 1 through December 15.). Medicare is integral to the economic security and health of people with disabilities and older adults. Each fact sheet also includes Medicare open enrollment dates and resources.

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How Medicare Advantage Could Address Pain Inequities for Black Patients Living With Serious Illness

CAPC

Health Affairs Forefront article offers five recommendations for MA plans to redress pain inequities. News Bites Payment and Program Financing

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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. The proposed changes may impact social work practice and reimbursement in various settings and that of other Medicare providers.

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The Seriously Ill Population (SIP) Medicare Payment Model Terminated

CAPC

Commitment to the population with serious illness remains. News Bites Payment and Program Financing

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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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CY 2022 Medicare Quality Payment Program for Clinical Social Workers: Frequently Asked Questions

Social Work Blog

Beginning January 1, 2022, clinical social workers (CSWs) will become eligible to participate in Medicare’s Quality Payment Program (QPP). CSWs may participate in the QPP by earning a payment adjustment for Medicare Part B covered professional services based on a performance evaluation across different categories that focus on the quality of care provided to a patient. Medicare has identified 15 measures that CSWs may use to report quality services. December 2021.

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Omnibus Enacted with Many Health Care Provisions

CAPC

Medicare cuts reduced and telehealth flexibilities remain. News Bites Payment and Program Financing Policy

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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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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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Seriously Ill Individuals—A Canary in the Coal Mine for Medicare’s Transition to Accountable Health Care?

CAPC

Palliative care leader calls for quality measures and accountability for those living with serious illness. News Bites

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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. Center for Medicare Advocacy.

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The Center for Medicare and Medicaid Innovation Releases Its New Strategy

CAPC

New strategy notes palliative care across models. News Bites Payment and Program Financing

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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. Center for Medicare Advocacy.

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Hospice Social Workers

Famcare

Many are surprised to learn that the Hospice Medicare Benefit, a primary payer of hospice services, allows for hospice care in assisted living facilities (ALFs) and skilled nursing facilities (SNFs), the latter of which are commonly referred to as nursing homes.

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Home Health CoPs Update: New Opportunities for OTs

Relias

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). Under previous rules, an OT was not authorized by Medicare to conduct an initial assessment in home health.

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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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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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2023 Healthcare Trends: Are You Ready?

Relias

This estimate is based on a survey of physicians who primarily serve Medicare fee-for-service and Medicare Advantage patients and represents up to a fourfold increase in the cost of care delivered at home today.

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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. For some health insurance companies, the code changes became effective on January 1, 2022, while Medicare implemented the changes on April 1, 2022. June 2022.

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What You Need To Know About Value-Based Payment Models

Relias

For example, less than 20% of Medicare spending is currently value-based. 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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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 act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020.

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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). Medicare has identified 10 target areas as risky for proper payments. We all love free tools that help our organizations perform better.

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Highlights of CMS 2023 Proposed Physician Fee Schedule

Social Work Blog

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule of the Physician Fee Schedule (PFS) that announced proposed policy and practice changes for Medicare Part B payments beginning January 1, 2023. The proposed changes may impact social workers and other Medicare providers in various settings. CMS is proposing several policy changes to Medicare telehealth services.

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Home Health Specializations Boost Performance, Bottom Line

Relias

Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023.

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American Dementia: Brain Health in an Unhealthy Society

inSocialWork

Soon, Medicare will issue a decision about whether they will cover Aduhelm (Aducanumab) – the new Alzheimer’s Disease (AD) treatment – the expensive and controversial medication approved by the FDA last June with mixed support from the scientific and Alzheimer’s community.

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Hospice Billing Compliance: The Latest PEPPER Updates

Relias

The provider-specific PEPPER analyzes Medicare data and statistics from discharges and services compared with every hospice nationwide. PEPPER provides each hospice organization’s paid Medicare claims for the last three fiscal years.

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A course of therapy

Prosper Health Collective

However, it is important to note that if you are using Medicare, they will now subsidize 10 sessions per year. Prior to seeing a psychologist there are some key pieces of information that it is good to know. First and foremost, psychology should ALWAYS be collaborative.

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New Legislative Action Happening in East Lansing and Washington DC

Michigan Social Work

In Washington, new legislation to increase Medicare reimbursement rates for clinical social workers has been introduced in both chambers of Congress.

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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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Home Health Referrals: Grow Your Network

Relias

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes.

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When and How to Consult a Psychologist

Psychological Health Care

Medicare rebates are also available for patients who have been referred by a GP and who have a mental health treatment plan. If you have a treatment plan, you are entitled to Medicare rebates for up to 20 individual psychological appointments per calendar year, until 30 June 2022.

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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.