Dear CSWA,
As you know, CSWA has been involved in the development of a Compact which would allow clinical social workers to practice in all states that join the Compact without having to become licensed in individual states. For the past 8 months, Laura Groshong, CSWA Director of Policy and Practice, and I have attended the Social Work Compact Technical Advisory Committee meetings monthly, sponsored by the Department of Defense and Council of State Governments.
A document for the Compact has been created which is now available for review by the public, including CSWA members. I encourage all CSWA members to attend one of the two webinars which will be held on July 30 at noon ET and September 8 at 3 pm ET for more detailed information on the Compact. Keith Buckhout and Matt Shafer of the Council of State Governments will be available to explain the process and answer your questions. Registration for these webinars will be on the website shortly.
Among the issues that will be addressed are:
To review the document before the webinars, go to https://compacts.csg.org/compact-updates/social-work/
To submit comments or feedback on the draft, please fill out the online survey at https://www.surveymonkey.com/r/socialworkcompact
Please let Laura know if you have any questions and watch for an email later this week from our new Administrator, Angela Katona, regarding how to sign up for one of the two webinars.
Kendra Roberson, PhD, LICSW
CSWA President
president@clinicalsocialworkassociation.org
Laura Groshong, LICSW
CSWA Director, Policy and Practice
lwgroshong@clinicalsocialworkassociation.org
CSWA members have expressed concerns about the way that companies like Betterhelp are providing a kind of mental health treatment based on texting. The lack of direct contact is cause for concern. The asynchronous nature of Betterhelp limits emotional communication.
A new article from California Healthline written by award-winning journalist Harris Meyer, has just come out and has echoed some of these concerns. The article, “Digital Mental Health Companies Draw Scrutiny and Growing Concerns”, can be found at https://californiahealthline.org/news/article/digital-mental-health-companies-scrutiny-concerns/.
Both Marlene Maheu, PhD, who presented a webinar on telemental health for CSWA, and Laura Groshong, CSWA Director, Policy and Practice, are quoted in the article.
Below is a Letter to Congress on gun violence that CSWA signed on to with 9 other national organizations which was published in USA Today this morning. ~Laura Groshong, LICSW, Director, Policy and Practice, lwgroshong@clinicalsocialworkassociation.org, 6/7/22
The Clinical Social Work Journal (CSWJ) is pleased to announce a call for papers for a special issue called: Life After the MSW. This special issue will be co-edited by the Editor in Chief of the journal, Melissa D. Grady, PhD and Kendra C. Roberson, PhD, the President of the Clinical Social Work Association (CSWA). In this issue we will be seeking manuscripts that offer readers a mix of historical/scholarly information about the topic, as well as concrete and practical information for soon to be and/or recent MSW graduates. The aim of this special issue is to offer practical advice to newer professionals in the field. We hope that the articles within this special issue can be used by faculty members and supervisors who are helping to train new social work practitioners, as well as by the graduates/students themselves.
Some examples of topics for this special issue could include, but are not limited to issues related to post-masters education, clinical supervision considerations, navigating and/or preparing for the licensure process, practicing clinical social work with a social justice lens, and potential career paths as a clinical social worker.
Interested authors should submit an abstract of no more than 750 words describing the proposed manuscript. Those that are chosen will then be invited to submit full manuscripts that will be between 10-15 pages in length.
Each abstract should include the following:
In addition to the above, full manuscripts will also require
Deadlines for process:
I have received a deluge of emails from you about the use of POS “10” for Medicare and other insurers. This guidance that Medicare has provided about this policy is complicated.
The current guidance from CMS is that:
Be sure to check with EACH private insurer for a patient to find out what combination of POS and Modifier are being requested so that claims will not be denied.
I hope this resolves the confusion about POS codes. Let me know if there are any other questions.
POS Codes as of 4/1/22 – Medicare
There has been some confusion about what Point of Service (POS) Codes should be used for Medicare and other insurers as of April 1, 2022.
As you know, there were changes to POS codes that were announced as of January 1, 2022 to be “available” for Medicare as of April 1, 2022. POS “10”, a new POS code for telemental health services that are provided when the patient is in their home, and the LCSW is in their office or elsewhere. Other POS Codes are “2” which is used when a patient is not in their own home and receiving telemental health services from an LCSW or “11” which is used when seeing a patient in the LCSW’s office.
The Medicare modifier is 95 for any of the above codes.
It appears that the POS 10 is now being used instead of POS 2 for Medicare for reimbursement. All other insurers, public and private, should be contacted about the POS codes that are required for reimbursement of claims. The same goes for which modifier is being used – check with the individual insurer.
For more information, go to https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set If you have other question, contact me at lwgroshong@clinicalsocialworkassociation.org.
Transgender children have been in the crosshairs of conservative groups in the legislature and elsewhere for the past decade. Amongst legislative attempts to discriminate against them, there have been attempts to ban them from gender-specific bathrooms or from participating in sports consistent with their gender identity. Support for transphobic attitudes and actions has grown. Now there is an attempt in Texas to lay blame on parents who affirm their child’s gender identity. This bill is one of the most harmful to trans children, but is the tip of the iceberg; there have been over 235 state-based bills that limit the rights of trans children in 2022 (https://www.msn.com/en-us/news/us/nearly-240-anti-lgbtq-bills-filed-in-2022-so-far-with-most-targeting-trans-people/ar-AAVhMSa) . The current law that has passed in Texas, abhorrently describes parental support of trans children as child abuse; though, for now, it has been placed on hold by a Texas appeals court.
CSWA believes that gender identity is an integral aspect of our intersectional identities and that children’s rights to express their identities, and to participate in everyday activities of childhood, regardless of this expression, should be protected. LCSWs work with trans-children and adults who have been harmed because their trans identities. To our affiliated colleagues in the Texas Society for Clinical Social Work, we send our support and encouragement to stand strong. No law can persuade us to ignore our ethical stance on respecting the identity of any individual child, and for parents that support and affirm their children. Also notable, the Texas law does nothing to prevent the violence directed toward trans BIPOC youth for being themselves. This violence has increased at alarming rates in the last few years.
As reported by Forbes, 30 trans youth were killed in 2020, including 23 that were BIPOC youth. (Forbes, “Transgender America: 30 Killed And Fatally Shot Already In 2020”, 10/2/20, https://www.forbes.com/sites/jamiewareham/2020/10/02/30-trans-woman-have-now-been-violently-murdered-in-america-in-2020/?sh=296cb38564a4). The work of groups like GLAAD (glaad.org), the Trans Youth Equality Foundation (http://www.transyouthequality.org/), and the Transgender Law Center (https://transgenderlawcenter.org/) are crucial to educating the public and advocating across multiple domains to prevent transphobic violence and discrimination against trans youth and their parents. CSWA supports the work of these groups in preventing harm and protecting trans children.
President Biden’s State of the Union address tonight will have a major focus on the need for more mental health funding and services. A few of the areas he will discuss are:
To see a complete summary of what the President will discuss regarding mental health go to: https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/
CSWA will provide a message to send to Congress, who will have to approve the funding and policy measures regarding mental health, on the issues that most affect clinical social workers following the State of the Union speech.
Laura Groshong, LICSW, Director, Policy and Practice Clinical Social Work Association lwgroshong@clinicalsocialworkassociation.org
In the rush to figure out the Good Faith Estimate, another important issue has been on the back burner.
As you know, the No Surprises Act also had a provision that we see every patient at least once every 12 months. This was extended from the previous rule which required this provision every 6 months.
With recent guidance from CMS, it is now clear that this requirement will go into effect after the end of the Public Health Emergency (PHE). That is not likely to be before the end of 2022 at the earliest.
CSWA is hoping to work with many other mental health groups to eliminate this rule. We will keep you posted.
Laura Groshong, LICSW Clinical Social Work Association Director, Policy and Practice lwgroshong@clinicalsocialworkassociation.org
The Aware Advocate: Focus on 2022 Medicare Changes
December, 2021 Laura Groshong, LICSW, CSWA Director, Policy and Practice
There are a number of issues that are affecting LCSW practices in the waning days of 2021, particularly in the area of Medicare (which we know affects commercial insurance heavily). These issues are: 1) giving patients a “Good Faith Estimate” of what the treatment we provide will cost; 2) elimination of 2022 cuts to Medicare reimbursement; 3) telemental health coverage; and 4) DCEs. Discussion of each of these follows.
Good Faith Estimates
This rule requires us to give a “good faith estimate” (GFE) to a patient of what our services will cost and how long they may last. While this policy is part of most of our informed consent forms, signed by the patient already, it is prudent to review what the GFE is more formally requesting we include in our information to the patient. The main difference about past practices and the GFE is that it applies to private pay patients as well as insured patients and uninsured patients.
For more information and a template of what belongs in a GFE, go to the CSWA website under “Templates” in the Members Only section.
Medicare Cuts Stopped
LCSWs can take a deep breath as Congress has acted to prevent the trio of Medicare payment cuts that were set to take effect at the beginning of 2022—a 3.75% cut due to scheduled changes in the Medicare Physician Fee Schedule (“PFS”), a 2% cut for Medicare sequestration, and a 4% Statutory Pay-As-You-Go Act (“PAYGO”). These Act cuts would have slashed Medicare payments by nearly 10% during a tumultuous time for healthcare. Instead, tThe Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) was approved by the U.S. House of Representatives on December 7 and passed the U.S. Senate on December 9, 2021. The bill has been sent to President Biden’s desk for his signature.
The Protecting Medicare and American Farmers from Sequester Cuts Act includes:
This is the second year that a last-minute change stopped a substantial reimbursement cut for LCSWs. CSWA will be encouraging CMS and Congress to stop these attempts to balance the Medicare budget on the backs of clinicians moving forward.
Telemental Health Coverage
As you know, CMS issued a new rule last month to expand telemental health and audio only psychotherapy through 2023. You also know we are still unable to practice across state lines unless we are licensed in the state where the patient resides and/or there is still increased reciprocity in the state where the patient resides. CSWA is still working with Department of Defense and the Council of State Governments to create a “Compact” that will make it much easier to work across state lines; it should be ready to begin implementing in early 2023.
The requirement that LCSWs see patients in person every 6 months has been extended to every 12 months. This is a still a hardship for some patients and LCSWs who have given up a physical office. CSWA will be working to eliminate this requirement.
For more information go to the CSWA website under “Legislative Alerts”.
Medicare Direct Contracting Entity
Over the past decade, over 50 models of delivering health care through Medicare have been explored, with the goals of lowering costs for dual-eligibles; eliminating access to care, based on economic disparities; and, moving away from a fee for service (FFS) payment model. The last goal has an impact on LCSWs in private practice who have used the FFS model for some time.
A new model has been emerging called the Medicare Direct Contracting Entity (MDCE). It is similar to the Accountable Care Organizations that have been in use for the past five years, but is run by commercial for-profit agencies. CMS has started to ‘assign’ beneficiaries who are in traditional Medicare to MDCE plans without consent. There is concern that this could lead to the privatizing of Medicare which would have the same difficulties that commercial insurance for-profit plans have, i.e., the focus on profit leads to diminished health care services.
Surgeon General Report on Youth Mental Health
U.S. Surgeon General Vivek Murthy, MD, released an advisory statement on December 7 to highlight the urgent need to address the nation’s youth mental health crisis. “Protecting Youth Mental Health” (PDF, 1.01MB) . This excellent document outlines the COVID-19 pandemic’s harm to the mental health of America’s youth and families, as well as the mental health challenges that had accumulated before the pandemic began. CSWA is delighted to see the Surgeon General paying attention to this increasingly difficult situation.
CSWA wishes you a happy and healthy holiday season!
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