New Practice Updates Address Medicare, Homeless Children

NASW has new social work practice updates available.

The first update focuses on ways to avoid a Medicare claim denial due to unreported changes to a group or solo practice.

According to the update, "Medicare-Mandated Reportable Changes for Clinical Social Worker in Solo or Group Practice," clinical social workers are required to report to Medicare the following changes using Form CMS-8551: practice location change, any changes to business name or change in taxpayer identification number with the Internal Revenue Service; any decision to close, retire, or sell or to withdraw from Medicare; any change in the business structure of the practice; suspension or termination of a clinical social worker's clinical license and any felony conviction within the past 10 years.

The update, written by NASW Senior Practice Associate Mirean Coleman, notes that other reportable changes on different forms include:

  • Banking arrangements. For electronic claims, the clinical social worker should report any changes in his or her bank or bank account number. Payment information can be made by completing Form CMS-588, Electronic Fund Transfer Authorization Agreement.
  • Reassignment of benefits. When a clinical social worker adds or voluntarily withdraws a reassignment of Medicare benefits, the changes are submitted on Form CMS-855R.

The above changes also pertain to group practice, according to the update. However, changes regarding group practices are made on Form CMS-855B instead of form CMS-8551. Additional changes include:

  • Medicare must be informed whenever a provider is added or removed from group practice.
  • When the current owner sells more than 5 percent of the practice or a partner is added or deleted, these changes in ownership must be reported.

The update states that questions about reporting changes to Medicare may be directed to the local Medicare Administrative Contractor. A Web link to contractors and CMS is listed in the report. It also lists resources and links related to Medicare.

Similarly, the Clinical Social Work Practice Update "2009 Medicare Bonus Incentive Program for Clinical Social Workers" includes information about the Physician Quality Reporting Initiative (PQRI), which provides a financial incentive for clinical social workers and other Medicare providers who report quality measures on claims and correctly file those claims for reimbursement.

While participation in the program is optional at this time, the practice update notes that the Medicare Improvements for Patients and Providers Act of 2008 made PQRI a permanent program and authorized bonus incentive payments only through 2010.

NASW Senior Policy Associate Mirean Coleman says it is wise for clinical social workers to take advantage of the voluntary bonus incentive program so that they can learn how to document performance measures.

"Medicare intends to switch to a value-based purchasing system, which could require clinical social workers and other providers to report performance measures in order to receive payment," she said.

The practice update lists the 12 quality measures that may be used by clinical social workers, and also includes instructions and tools for using the 2009 measures.

A third practice update is called "From Poverty to Child Welfare Involvement: The Critical Role of Housing in Family Stability."

The update, written by NASW Senior Practice Associate Roxana Torrico, explains how poverty places families with children at risk of experiencing a wide array of life-changing experiences and unhealthy outcomes. These can include homelessness and involvement with the child welfare system. Housing instability often brings families to the attention of child welfare and in many cases serves as a barrier to family reunification.

The update notes that more than 37 million people, including 13.3 million children, live below the poverty level. Families living in or near poverty face tremendous challenges in meeting their children's basic needs including safe and stable housing.

Thousands of homeless children are at risk of entering the child welfare system because of their family's inability to provide adequate housing.

These children are also more likely to experience increased rates of chronic health issues, emotional and behavioral problems, and developmental and educational delays. Too often, families do not receive adequate prevention services in time to remedy potential unhealthy outcomes.

According to the update, inadequate housing is also a key factor contributing to the placement of children in foster care.

Like families at risk of entering the child welfare system, families facing reunification also face housing needs. It was noted that 30 percent of children in foster care could be reunited with their parents if they had access to safe, stable and affordable housing.

The update lists ways social workers can help families with limited economic supports to obtain and maintain safe, stable and affordable housing.

Some of these methods include:

  • Work with families to develop a housing plan as they prepare for reunification.
  • Access resources for financial assistance to keep families together when housing is a major obstacle.
  • Become familiar with local housing resources such as housing subsidies, public housing units, grant programs, and low-income housing units in the community.
  • Tap into community resources for additional support for families. Social workers can reach out to landlords, religious organizations, schools or universities and/or volunteers to help address the housing needs of families.
  • Participate in cross-system training opportunities to avoid duplication of services and ensure well-being of children, youth and families.

The practice update notes that social workers have the skills to find viable solutions to address the link between economic security, homelessness and child welfare involvement.

"No one system can bear sole responsibility for all children, youth and families," the update notes. "However, communities can foster collaborations to improve the delivery of services to address economic security, prevent homelessness and address housing needs of families in an effort to avoid the unnecessary removal of children due to a lack of housing and expedite family reunifications."

To aid social workers, the update contains a list of federal policies and programs that fund services to support the economic security and housing needs of families involved in the child welfare system.