About Continuum of Care
Post-acute care — often provided at inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities, and at patients’ homes — is vital to the health care delivery system. These providers deliver essential medical and rehabilitative services following hospital care. Hospital case managers help support, and connect patients, families, and caregivers through communication and coordination with post-acute care providers and home and community-based services. This includes the development of a discharge or transition plan that addresses the patient’s goals, needs and treatment preferences, and prepares patients and caregivers for post-discharge care.
Medicare Patient Reclassification Notices Now in Effect
What’s happening: Effective Feb. 14, providers are required to issue a Medicare Change of Status Notice (MCSN) to eligible patients who were admitted as hospital inpatients, but the hospital subsequently reclassified them as outpatients who are receiving observation services.
What else to know: This requirement only applies to patients with traditional Medicare as the primary payer. The form and its instructions are available to download.
New Resource Available on Assisted Living Waiver, CalAIM Community Supports
What’s happening: The California Health Care Foundation has issued an Explainer document that describes and compares two key Medi-Cal programs: the Assisted Living Waiver (ALW) and Community Supports (a component of California’s Medi-Cal reform initiative, California Advancing and Innovating Medi-Cal (CalAIM)).
CMS Provides Additional Guidance on Beneficiary Observation Status Appeals
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued additional information, including billing instructions, for the Medicare Change of Status Notifications (MCSN).
What else to know: Beginning Feb. 14, CMS will require giving MCSNs to patients who are reclassified from inpatient to observation (outpatient) status.
Federal Funding Will Bolster Medi-Cal Reimbursement for Inpatient Psychiatric Care
What’s happening: On Dec. 16, California was approved for the large BH-CONNECT behavioral health demonstration project, which is estimated to bring $5 billion of new federal Medicaid dollars for California over the next five years.
What else to know: During this time, BH-CONNECT will use the funds to test new approaches to behavioral health treatment, housing, and workforce development.