Friday, February 15, 2008

Federal Update: Targeted Case Management CMS Update

On February 4th we posted an action alert regarding the Center for Medicare and Medicaid Services rule changes for case management services. The proposed rules will drastically cut Medicaid funding for case management services that provide adults and children with long term supports, social, medical, educational and other services. The rules would change current CMS policy in the following ways:

*Transition case management services would be limited to 60 days. Current policy allows for up to 180 days. It often takes up to 180 days to secure housing and necessary support services for a person to transfer into a community independent living environment.

*Providers will only be paid for transitional case management services when the person successfully transitions into the community. This rule can be a financial hardship on service providers who do not have a financial capacity to wait for a reimbursement. Sometimes a transition is not successful for various reasons such as the availability of appropriate support services. In this case if the persons transition is not successful the provider will not receive reimbursement, again creating a financial hardship for the provider.

Advocates and legislators have been working on legislation to place a moratorium on these CMS rules. Currently the CMS regulations will go into effect on March 3, 2008.

On Thursday February 14th Senator Norm Coleman (R-MN), Barbara Mikulski (D-MD), and Amy Kobuchar (D-MN) introduced an amendment to the Indian Health Services Act reauthorization bill. This amendment will impose a moratorium on the targeted case management interim final rule until April 1, 2009. The Senate approved the amendment to this reauthorization bill. The Senate will be back in session on February 24th. The clock is ticking on the new CMS rules which are set to go into effect on March 3, 2008.

We will continue to track this legislation and bring you updates as we receive them. We will also bring you action alerts as they are issued.

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Special thanks to DPC for the information.

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