Archive for the ‘Medicare / Medicaid’ Category

Recovery Works When Coverage Does: The Lifesaving Impact of Medicare’s IOP Expansion

Closing a Critical Coverage Gap in Medicare In 2024, following stalwart efforts by Congress, the Centers for Medicare & Medicaid Services, providers, advocacy organizations, and directly-impacted communities alike, Medicare closed a gap in its addiction treatment coverage by adding a benefit...

The NYSPA Report: Federal and State Coverage of Telehealth and Its Role in Expanding Access to Mental Health Care

Following the COVID-19 public health emergency, the federal Centers for Medicare and Medicaid Services (CMS) made permanent expansions to the coverage of telehealth under the Medicare program. CMS has greatly increased the number of services included on the permanent list of telehealth services and...

A National Call to Action: Protecting Medicaid for Individuals with Serious Mental Illness and Autism

Take Note: Members of the House Committee on Energy & Commerce are drafting a budget which is highly likely to propose severe cuts to Medicaid. Whatever form those cuts take, they are likely to disproportionately harm people with disabilities, including people living with serious mental illness...

Stretching Medicaid Dollars: How Behavioral Health Providers Can Stay Afloat

Many behavioral health providers around the country are trying to establish and implement alternative payment models in hopes of focusing on reducing costs and improving outcomes, especially for more acute patients. However, many states and health plans lag, creating a disincentive for already...

Nursing Home Initiated Discharges of Residents a Critical Issue for Patients with Mental Health Disorders

Nursing homes care for a growing number of adults with mental health disorders. In fact, mental health is sometimes a decisive factor that contributes to placement in a nursing home, causing nursing homes to become the de facto institution for persons with mental illness. Thus, there is increasing...

New York Health Equity Reform: A Transformative Shift in New York’s Medicaid Landscape

On January 9, 2024, New York’s Department of Health received its long-awaited amendment to our Medicaid 1115 demonstration, newly rebranded NYHER (NY Health Equity Reform). It’s not as flashy nor as generously funded as the special purpose DSRIP (Delivery System Reform Incentive Payment)...

New Medicaid Option Promotes Enhanced Mental Health, Substance Use Crisis Care

The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is working with states to promote access to Medicaid services for people with mental health and substance use disorder (SUD) crises. Authorized under President Biden’s American...

CEO to CEO: Navigating the 2021 Medicare and Medicaid Services Changes

Centers for Medicare and Medicaid Services (CMS) policies present an ever shifting landmine of standards and benchmarks that must be understood and adapted to year after year. While these changes are important in eventually achieving better budget-neutrality in healthcare, they do create additional...

Creating a Family Peer Support and Services Workforce

For the caregiver of a Medicaid-eligible child who has a behavioral diagnosis, or demonstrated loss of a physical health diagnosis, Children & Family Support & Services (CFTSS) provide unprecedented support, advocacy and resources. On July 1, 2019, the fourth CFTSS component, Family Peer...

Medicaid Redesign Will Help Children and Families Get the Right Services at the Right Time

New York State embarked on a large-scale effort in 2011 to restructure the State’s Medicaid program based on recommendations from the Governor-appointed Medicaid Redesign Team (MRT). The MRT was comprised of a wide variety of stakeholders, including State agencies, providers, advocates, consumers...