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

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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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

(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.

Medicare Physician Fee Schedule Final Rule for CY 2022

Social Work Blog

On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the CY 2022 Medicare Physician Fee Schedule (PFS) final rule. percent reimbursement cuts to Medicare providers , including CSWs. Implications for Clinical Social Workers. December 2021.

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.

The Seriously Ill Population (SIP) Medicare Payment Model Terminated

CAPC

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

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.

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.

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

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.

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

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

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Hospice Care Considerations for People With Dementia

Relias

The percentage of Medicare hospice beneficiaries dying with a diagnosis of dementia or Parkinson’s disease, some of whom have dementia, has increased from 9% in 2002 to almost 21% in 2019, according to the National Hospice and Palliative Care Organization’s Facts and Figure Report 2021 Edition.

Home Health Agencies Face Growing Competition as Value-Based Purchasing Expands Nationally

Relias

With the successes reaped during the pilot of the Home Health Value-Based Purchasing (HHVBP) program, the Centers for Medicare and Medicaid Services (CMS) aims to accelerate the results nationwide.

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.

What can EAP do for me?

Prosper Health Collective

However most likely you would be able to access a mental health care plan via your GP to assist with the costs via a Medicare rebate.

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.

The Payoff of Wound Care Education: Get a Return on Your Investment

Relias

Medicare payment models in skilled nursing and home health provide incentives for clinicians to be well versed in specialty areas such as skin and wound care. Chronic wounds affect about 15% of Medicare beneficiaries each year.

Nursing Home Compliance: Prepare for Focused Inspections

Relias

During the 2022 State of the Union (SOTU) address, President Biden referenced reforms targeting nursing homes and their owners/operators, saying that Medicare will provide stricter oversight of nursing homes.

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.

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.

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.

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.

Grow Your Own Home Health Aides To Capture New Business

Relias

Medicare and other payers also encourage home-based care when appropriate to keep the cost of care low compared with skilled nursing facilities and hospitals.

Successful Lobbying Requires Building Relationships, Finding Common Ground – Your Social Work Advocates Digital Edition is Now Available

Social Work Blog

From lobbying for voting rights to more social work-specific legislation—like social worker safety, social work reinvestment, Medicare reimbursement and student loan forgiveness—NASW continues to fight for social workers and their clients.

Religious chauvinism in hospice

Hospice Social Work

While most hospice agencies are private corporations, the fact that most hospice revenue comes from Medicare makes hospice workers agents of a government funded institution. Imagine you are sitting with a beloved family member who has only a few days or a few hours left to live.