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CMS: Guide for Schools on Medicaid Billing
The Centers for Medicare & Medicaid Services (CMS) recently published a guide that offers new flexibilities and combines existing guidance, making it easier for all schools, no matter their size or the resources available to them, to receive payment for delivering Medicaid-covered services.
Access to school-based health care services has been shown to improve health and academic outcomes, and Medicaid and CHIP provide health coverage for over half of all children in the U.S., making coverage of Medicaid and CHIP services in school an important tool to improve educational equity.
Examples of care that can be provided in schools include:
- Preventive care
- Behavioral health
- Physical and occupational therapy
- Disease management
The guide outlines important new billing flexibilities, like allowing states to provide higher fee schedule rates for services offered in schools. Providing services in schools can be more expensive than providing them in the general community, so allowing that flexibility will make it easier for schools to be able to provide services. It also covers best practices, including best practices to help states and schools enroll qualified health care providers to participate in Medicaid within school settings.
Along with the guide, CMS has released a fact sheet and an informational bulletin to help explain these new changes.
CMS: Linking Insuring Kids and Back-to-School
Connecting Kids to Coverage Campaign hosted a back-to-school webinar in June, “Back-to-School Planning: Enrollment, Retention, Vaccines, and Mental Health Services,” to discuss important topics to keep kids healthy throughout the upcoming school year. Check out the webinar recording and slides on InsureKidsNow.gov to learn more about the importance of immunizations, the integration of behavioral health services in schools, and how to help families maintain their coverage as states restart eligibility reviews.
The Campaign also has outreach tools and materials to support school-based outreach efforts. Below are outreach materials specifically tailored for Back-to-School and other school-based outreach. You can learn about how others have used these and other campaign materials in eNewsletters, webinars, and videos. Even more information and resources can be found at the campaign Outreach Tool Library.
**Connecting Kids to Coverage Campaign has options for free customized materials to meet the needs of your outreach. Click here to find out more.
Labor, Health and Treasury: Mental Health Parity Proposed Rule
The departments of Labor, Health and Human Services and the Treasury today announced an important step in addressing the nation’s mental health crisis by proposing rules to better ensure that people seeking coverage for mental health and substance use disorder care can access treatment as easily as people seeking coverage for medical treatments.
This proposed rule marks movement on the 2008 Mental Health Parity and Addiction Equity Act to make sure people seeking mental health and substance use disorder care do not face greater barriers to treatment than those faced by people seeking treatment for medical and surgical conditions. Generally, the act prohibits private health insurance companies from imposing copayments, prior authorization and other requirements on mental health or substance use disorder benefits that are more restrictive than those imposed on medical and surgical benefits.
The proposed rules seek to fully protect the rights of people seeking mental health and substance use disorder benefits and provide clear guidance to plans and issuers on how to comply with the law’s requirements. In developing their proposals, the departments drew from their combined and individual experiences in enforcing the act and in working with plans and issuers, and state regulators.
The Department of Labor, in consultation with the departments of Health and Human Services and the Treasury, also issued a technical release that requests public feedback on proposed new data requirements for limitations related to the composition of a health plan’s or issuer’s network.
The technical release seeks public comment to inform guidance for proposed data collection and evaluation requirements and requests input on the development of an enforcement safe harbor for plans and issuers that submit data indicating that their networks of mental health and substance use disorder providers are comparable to networks for medical/surgical providers.
The departments also released the second Mental Health Parity and Addiction Equity Act’s Comparative Analysis Report to Congress, as required by federal law. At the same time, the Department of Labor’s Employee Benefits Security Administration and Health and Human Services’ Centers for Medicare and Medicaid Services issued a joint fact sheet on the Mental Health Parity and Addiction Equity Act enforcement results for cases closed in fiscal year 2022.
With the proposed rules and technical release, the departments aim to promote changes in network composition and plans’ and issuers’ medical management techniques to make mental health and substance use disorder provider networks more accessible and create parity in treatment limitations, such as network composition standards and prior authorizations, for people seeking mental health and substance use disorder treatment.
HHS: Office of Long COVID Research and Practice
Health and Human Services (HHS) announced that the Office of Long COVID Research and Practice has officially been stood up, as called for in the National Research Action Plan on Long COVID published last year. This Office will continue current efforts to lead the whole-of-government response and work across the government to implement the National Research Action Plan on Long COVID. The Office will continue to work to ensure that research findings are rapidly translated into clinical practice guidelines; that services and supports are available; and that the public understands the risk of Long COVID and how to prevent it and to reduce disparities exacerbated by the pandemic.
NIH’s RECOVER Initiative will launch and offer open enrollment for Phase 2 clinical trials that will evaluate potential treatments for Long COVID, with additional clinical trials expected in the coming months. To make comments, content recommendations, or inquires, The Office can be reached at longcovid@hhs.gov.
CDC: New Air Quality Standards
The Centers for Disease Control and Prevention (CDC) updated its COVID-19 building ventilation standards to include a specific ventilation target, an update the disability community has been advocating for throughout the pandemic.
The new standards recommend at least five air changes per hour of clean air in occupied spaces. While this change won’t eliminate risk of transmission of the virus that causes COVID-19, it will do a lot to make indoor spaces safer for people at high risk from COVID-19 and other respiratory illnesses.
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