By Laura Groshong, LICSW, Director, Policy and Practice
Here are two issues which I hope you will all address with your members of Congress and your state legislature.
For Members of Congress:

• H.R. 2474 is a bill which would improve Medicare reimbursement rates by using the rate of inflation as the way to adjust reimbursement each year instead of the Physician Fee Schedule (PFS) which does not use inflation as a factor. 
• H.R. 2474 would also tie reimbursement to the Medicare Economic Index which is based on provider expenses and other economic trends.
• Medicare rates have not increased since 2001, making payments 26% lower today than they were then, when adjusting for inflation. This is one of the major reasons that LCSWs are opting out as Medicare providers. There is a freeze on updated reimbursement until 2026.
• Though this is a House bill, please let your Senators know as well.  You can contact them all at https://www.congress.gov/contact-us .  Here is a message you can use or change it to use your own words: “I am a Licensed Clinical Social Worker and a constituent. Please support H.R. 2474 which will make Medicare reimbursement more equitable for mental health services. Reimbursement rates have not increased since 2001 and are therefore 26% less when adjusted for inflation. LCSWs are opting out as Medicare providers, leaving vulnerable beneficiaries without adequate mental health services. Thank you for your support.”

For State Legislatures:

• The Social Work Compact is now available to be passed by state legislatures. There are 10 states which have begun the process of getting the bill passed; Missouri has already passed the bill. We need six more states to create the Commission to oversee the Compact. 
• Here is a map of the 26 states that have passed the Counselor Compact, https://counselingcompact.org/map/. These states should be open to passing the Social Work Compact as well.
• For more information on how to make your state legislators aware of the Social Work Compact, go to the CSWA website at https://www.clinicalsocialworkassociation.org/Announcements/13212620.

Please let me know when you have sent messages to Congress and members of your state legislatures. Thanks for your help.

Contact:
Laura Groshong, LICSW, CSWA Director of Policy and Practice
[email protected]

​BREAKING NEWSII  WE HAVE A NEW COMMISSIONER FOR THE DEPARTMENT FOR
BEHAVIORAL HEALTH, DEVELOPMENTAL AND INTELLECTUAL DISABILITIES (BHDID)
Please see Acting Commissioner Stephanie Craycraft’s note below and extend a welcome to Dr. Katie Marks
 
Please join me in welcoming Dr. Katherine Marks to the position of Commissioner of the Department.  I know that Dr. Marks will bring the same energy, enthusiasm, collaborative spirit, and dedication to the role of Commissioner as she has her previous role as the Project Director for the Kentucky Opioid Response Effort (KORE).   Her efforts have been key to the expansion of a comprehensive, recovery-oriented system of care which has changed the lives of countless individuals in the Commonwealth who have been affected by the opioid epidemic. 
The Department’s efforts to facilitate recovery for Kentuckians affected by substance use and mental illness and to support those with intellectual or other developmental disabilities will undoubtedly be strengthened under Dr. Marks’ leadership. 
It has been a privilege to serve in the role as acting Commissioner for the past several months and to collaborate with our dedicated partners who are committed to meeting the needs of the people we serve.  I look forward to continuing to our collaboration as I revert to my role as Deputy Commissioner. 
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As of May 31st, the first round of required Medicaid renewals is in the books…and the results so far are very bad.  Despite the best efforts of KY DMS, providers, the MCOs and advocates, only 50% of the 74,004 individuals who needed to renew their Medicaid coverage by the end of May actually did so.  There were terminations of Medicaid coverage for 34,124 Kentuckians.  Of nearly 6,000 Kentuckians who then became eligible for a Qualified Health Plan on kynect, only 460 have enrolled!  24,521 individuals on Medicaid have not responded at all to letters, calls or other communications to return the required paperwork...but they still have time!! 
DMS and the MCOs will continue to reach out to those 24,000+ Kentuckians who can still easily respond and keep their coverage retroactive to May 31st.  After 90 days, they can still respond, but will need to reapply for Medicaid which will become active with their application.
We must ALL reach out to every Kentuckians we know, work with or serve to urge them to respond to their letter from DMS or to contact a DCBS office or a kynector who can help them get their Medicaid coverage and benefits going again!  

On May 11, 2023, the World Health Organization announced the end of the federal COVID-19 PHE declaration.
Unfortunately, this does not mean that coronavirus does not exist anymore, rather that Covid-realated deaths
have substantially decreased. The U.S. government’s approach to coronavirus will change, but how does this
impact social workers?
The end of the PHE has caused concern for LCSWs who work via telehealth with clients on Medicare (CMS).
Firstly, the coverage of telehealth has begun to be limited by some insurers. This is concerning because
telehealth increases access to healthcare providers, and limiting access to that may cause clients to stop
receiving the care they need. Fortunately, The Consolidated Appropriations Act of 2023 extended Medicare
coverage of telemental health until December 31, 2024 but many commercial insurers did/do not follow CMS
guidance. Secondly, after the December 31, 2024 date, clients will be required to be seen in-person at least
once a year. Due to health risks, transportation issues or more, this could be virtually impossible for some
clients. Audio-only telehealth appointments will not be covered following the The Consolidated
Appropriations Act of 2023 further alienating some clients from care.
LCSW’s who use platforms such as Skype will need to change mediums. According to the Office of Civil Rights
(OCR), using such platforms was not seen as a violation of HIPAA rules during the PHR. Now, LCSW’s will be
required to use a HIPAA compliant platform, such as ZoomPro, Doxy.me, and other platforms offer a Business
Associate Agreement (BAA).
Finally, there are changes to codes and modifiers for Medicare:
● New for CY 2023: Describes general BHI that a clinical psychologist (CP) or clinical social worker
(CSW) performs to account for monthly care integration
● A CP or CSW, serving as the focal point of care integration furnishes the mental health services
● At least 20 minutes of CP or CSW time per calendar month
○ Additionally, the modifier for Medicare claims is “GT” though “95” can be used for other
claims.

More information can be found on the Clinical Social Work Association website.
Info: https://www.clinicalsocialworkassociation.org/Announcements/13134039
https://www.clinicalsocialworkassociation.org/Announcements