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From NASW-VA
CLINICAL SOCIAL WORK PRACTICE UPDATE: MEDICARE-MANDATED REPORTABLE CHANGES FOR CLINICAL SOCIAL WORKERS IN SOLO OR GROUP PRACTICE
Mirean Coleman, MSW, LICSW, CT
Senior Practice Associate
mcoleman@naswdc.org
Clinical social workers who are Medicare providers frequently encounter claim denials due to unreported changes in their solo or group practice. Clinical social workers are responsible for reporting changes to their Medicare Administrative Contractor (MAC) as soon as possible or within 30 days of the change. Reporting changes immediately ensures timely and proper processing of claims and prevents rejections.
Solo Practice Changes
Clinical social workers are required to report to Medicare the following changes using Form CMS-8551:
- Practice location: Any change in practice location or any portion of an existing address
- Business name or tax identification number: Any legal change in business name or change in taxpayer identification number with the Internal Revenue Service
- Practice status: Any decision to close, retire, or sell a practice or to withdraw from Medicare
- Business structure: Any change in the business structure of the practice (for example, incorporation)
- Adverse legal action: Suspension or termination of a clinical social worker’s clinical license and any felony conviction within the past 10 years
Other reportable changes on different forms include the following:
- Banking arrangements: For electronic claims, the clinical social worker should report any changes in his or her bank or bank account number. Payment information changes 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 change is submitted on Form CMS-855R.
Group Practice Changes
The above changes also pertain to a group practice. However, group practice changes are made on Form CMS-855B instead of Form CMS-8551. Additional group practice reporting changes include the following:
- Authorized or delegated officials: Medicare must be informed whenever a provider is added to or removed from the group practice.
- Ownership or managing interest control: When the current owner sells more than five percent of the practice or a partner is added or deleted, these changes in ownership must be reported.
Additional Information
Solo and group practices enrolled in the Medicare program that have not completed Form CMS-8551 or CMS-855B since 2003 must submit one of these forms as an initial application when reporting a change for the first time.
In the event of the death of a clinical social worker who is a Medicare provider in a solo or group practice, the date of death should be reported immediately to the MAC.
Questions about reporting changes to Medicare may be directed to the local MAC. A list of MACs is available online at www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/contact_list.pdf. CMS forms are available online at www.cms.hhs.gov/CMSForms/CMSForms/list.asp.
Resources
Centers for Medicare and Medicaid Services, U.S.
Department of Health and Human Services.
(2009). Fee-for-service provider enrollment reporting responsibilities for individual nonphysician practitioners enrolled in the Medicare program. Available at www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/nonPhysicianReportingResponsibilities.pdf.
Centers for Medicare and Medicaid Services, U.S.
Department of Health and Human Services.
(2009). Fee-for-service provider enrollment reporting responsibilities for physician group practices enrolled in the Medicare program. Available at www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/GroupPracticeReportingResponsibilities.pdf.
NASW-VA LETTER TO JOINT COMMISSION ON HEALTH CARE
September 28, 2009
Senator R. Edward Houck, Chairman
Joint Commission on Health Care
P.O. Box 1322
Richmond, Virginia 23218
RE: Staff Report: Virginia’s Healthcare Workforce Present & Future Need
Recommendation to add Clinical Social Workers
Dear Senator Houck:
Thank you for this opportunity to submit feedback regarding the staff report Virginia’s Healthcare Workforce Present & Future Need. Recently, it was brought to our attention that clinical social workers were omitted from the above noted report. While the study provides necessary focus to the critical lack of mental health services in Virginia, the primary emphasis appears to be on psychiatrists and psychologists only. Today, social workers are prominent and in demand in the healthcare workforce. The social work profession is also facing an increasing shortage that requires attention. At this time, we respectfully request that the Commission add clinical social workers to the report and subsequent considerations.
Demand for Social Work:
Mental Health - Clinical social workers are the single largest group of psychotherapists in the country. The Department of Health and Human Services notes that 60% of mental health providers in the United States are clinical social workers. There are more clinically trained social workers than clinically trained members of psychology, psychiatry and psychiatric nursing combined. Also, social workers are often the only providers of mental health services in rural areas. According to the Virginia Department of Health Professions as of 6/30/09, there were 5566 licensed social workers in Virginia.
By Federal definition, HPSA mental health shortage areas include clinical social workers as recognized providers of mental health services. The Health Resources and Services Administration (HRSA) State Health Workforce Profiles of 2000 note that while Virginia ranked 14th among states in psychiatrists per capita, and 29th among states in psychologists per capita, Virginia also ranked 29th among states in social worker per capita, highlighting a significant shortage there as well.
Healthcare - Approximately 1700 social workers work in medical settings in Virginia, including 708 in hospital employment, 335 in nursing and residential care facilities, 306 in home health care agencies, 235 in local government health care related positions and 107 in outpatient care centers.
Aging - The National Institute on Aging projects that 60,000 to 70,000 social workers will be needed by 2010 as more people reach the age of 65. Today approximately 30,000 licensed clinical social workers specialize in gerontology nationwide. Social workers in gerontology settings work with older adults, including those with dementia, to support their physiological, psychological and social needs through mental health therapy, caregiver and family counseling, health education, program coordination and case management. Social workers are also in frequent contact with Adult Protective Services and report elder and vulnerable adult abuse and neglect. Nationally, the issue of elder mistreatment is garnering the attention of the law enforcement, medical, and research communities as more people are living longer than ever before. This trend is expected to increase, as the U.S. Census Bureau projects that more than 62 million Americans will be age 65 or older in 2025, an increase of 78 percent from 2001. This aging population will require more care and protection than is currently available or possible.
Shortage - Not unlike physicians, nurses and psychologists, social workers are also facing a shortage nationwide. The Bureau of Labor Statistics notes that employment for social workers is expected to increase an estimated 22% between 2006 and 2016, which is faster than average for all occupations. There is already a shortage in the areas of aging and child welfare, and 12% of surveyed social workers plan to leave the workforce in the next two years. Further, 53% of social workers surveyed reported that vacancies in their agencies were either difficult or somewhat difficult to fill (NASW Center for Workforce Studies).
Avenues to Address Shortages / Policy Options:
Loan Forgiveness – We support restoring funding for the State Loan Repayment Program (SLRP) and the Virginia Loan Repayment Program (VLRP), which includes licensed clinical social workers as recipients. NASW is promoting loan forgiveness for social workers as part of its on-going work to improve working conditions, salaries, and other benefits for members of the profession and to ensure that consumers have access to qualified professionals. 68% of persons surveyed with a Master’s of Social Work Degree (MSW) graduated with an average debt of $26,777 (Council on Social Work Education). Staggering educational debt affects many life decisions, and can influence or delay home purchasing, retirement planning, and personal savings. Educational debt has also been blamed for deterring students from public service careers, like social work, thus increasing pressures on a workforce already facing shortages.
Title Protection - Although the Association of Social Work Boards (ASWB) published the Model Social Work Practice Act supporting certain definitions of a social worker, in reality each state determines what areas of social work practice are protected by law. It is those discrepancies that allow anyone to identify himself as a social worker despite their qualifications. As an example, fewer than 40% of child welfare workers are professional social workers. This threat to the professionalism of social has encouraged advocacy within the field for greater protection of the public through a combination of practice and title protection laws with limited exceptions or exemptions to legal requirements. Social Work practice protection refers to licensure laws that require all those who act as social workers to be licensed thus protecting the specific actions performed by social workers by ensuring that only qualified individuals carry out social work functions. A Title protection statute protects a specific social work title, such as Licensed Master Social Worker, from being used by anyone that does not meet the legal definition of a social worker for that level of licensure.
Telemedicine Services - We support expanding the use of telemedicine services. Clinical social workers are essential members of hospice teams and are also involved in telemedicine endeavors, including the University of Virginia’s Remote Area Medicine Wise Clinic, the nation’s largest mobile free health clinic.
Additional Policy Option - We would also respectfully request a letter from the JCHC Chairman that the Department of Health Professions improve the information collected and compiled about clinical social workers for the Healthcare Workforce Data Center.
Thank you in advance for your consideration. If you need additional information, please contact Debra Riggs, Executive Director, National Association of Social Work Virginia Chapter, at 804-938-6028 or debrariggs@naswva.com.
Sincerely,
Andrea Therrien, MSW, LCSW Mary Sasser, MSW, LCSW, MPA
President Legislative Committee
Board of Directors Board of Directors
National Association of Social Work National Association of Social Work
Virginia Chapter Virginia Chapter
Debra A Riggs
Executive Director
National Association of Social Workers, Virginia Chapter
NASW-VA REACTS TO TRAGEDY, ADVOCATES PROFESSIONAL AND CONSUMER PROTECTIONS
In response to the recent stories detailing the tragic death of Alexis “Lexie” Agyepong–Glover in Prince William County, Virginia, NASW-VA has released the following Letters to the Editor:
Dear Editor:
In an article published on June 18, 2009, the tragic death of Alexis “Lexie” Agyepong –Glover in Prince William County and the subsequent firing of the social worker who handled her case was reported by your newspaper. As the Executive Director of the National Association of Social Workers (NASW) Virginia Chapter, I express my sincerest condolences for the loss of Alexis, as she is truly an innocent victim of our imperfect system.
Alexis’ case represents a concern that NASW has been working for three years to address in the state of Virginia— title protection for social workers. NASW considers a professional social worker to be someone with a bachelor’s, master’s or doctorate in social work. Only with the proper education do we believe that social workers will have the knowledge, training and expertise necessary to prevent tragedies such as in the case of Alexis. Currently, the Virginia Department of Social Services is not required to hire degreed social workers for case worker positions, which can be harmful to vulnerable children and families.
While we do not know whether or not the social workers who handled Alexis’ case had a social work degree, we strongly believe that if title protection and licensure requirements were in place, there would be more accountability on behalf of the social workers to ensure that proper protocol is followed in sensitive cases such as this.
A recent report by the Virginia Board of Social Work found that there is potential harm for citizens, especially those most vulnerable, such as children, who receive services from those who present themselves as social workers but are not licensed and accountable to a regulatory board. NASW has tried repeatedly to share this concern with state legislators to no avail.
The social work profession has and always will continue to work on behalf of children who have been abused and neglected. We hope that this tragedy will bring to light the importance of proper training and education for social workers in Virginia, for the sake of the people who have the most to lose without it.
Debra Riggs
Executive Director
National Association of Social Workers, Virginia Chapter
To access the report released by the Board of Social Work, click here.
Word document courtesy of the Virginia Board of Social Work.
To view the Public News Service story, "Mother Pleads Guilty to Adopted Daughter's Death," about NASW-VA's reaction to the tragic death of Alexis “Lexie” Agyepong–Glover, featuring NASW-VA Executive Director Debra Riggs, click here. This story and interview were broadcasted on radio stations across the Commonwealth.
Member Feedback:
"I would like to congratulate Executive Director Debra Riggs on her excellent letter of concern re: the tragic death in Prince William County of Alexis "Lexie" Agyepong-Glover. Only professionally trained and degreed Social workers should fill case worker positions to insure that the vulnerable children of Virginia receive the highest standards of accountability and protection. Our professional social work training informs our advocacy on behalf of abused and neglected children.
"Let us continue to work together to press the issue of the need for trained social workers to fill case work positions in public agencies."
- Rita Reilly Siebenaler, LCSW, Northern Virginia District
Social Work at Christopher Newport University Saved!
On Tuesday, May 5, 2009, Christopher Newport University Provost Mark Padilla announced that the Social Work major will continue to be offered as part of the University's Sociology Program. In addition, on July 1, 2009, the Department of Community Engagement and Social Work will become part of the new Department of Sociology, Anthropology, and Social Work in the College of Social Sciences.
NASW would like to congratulate all of our members who made their voices heard during CNU's decision making process.
To view the Public News Service story, "Social Work Program Shuttered - Professional Organization Protests," about NASW-VA's efforts to save CNU's Social Work Program, featuring NASW-VA Executive Director Debra Riggs, click here. This story and interview was broadcasted on radio stations across the Commonwealth!
Letter to Christopher Newport University from NASW-VA Executive Director
March 24, 2009
President Paul Trible, Jr.
Christopher Newport University
1 University Place
Newport News, VA 23606-2998
Dear President Trible;
Recently, it has come to the attention of the National Association of Social Workers, Virginia Chapter, that Christopher Newport University has begun consideration and the process for cutting its Social Work Program, by 2012. As the Executive Director of the Chapter, I would be remiss in not adding comment of support for the merit and practicality of the continuation of the social work degree program at your university.
Meritoriously speaking, the social work degree program has an established history of both academic and professional success. I’m sure you are well aware of the high rate at which your social work graduates are accepted into prestigious graduate programs-many of whom are given advanced standing status upon admission. The high rate of employment at graduation is also a testament to the exceptional quality of the graduates your university’s program produces. It is also a reflection; however, of the dire need our Commonwealth has for high-caliber, trained, educated professional social workers, which is projected to only increase in the coming years and decades.
Several factors have begun to emerge that have increased the need for professional social workers across the nation, but more importantly, in our own Virginia. The most immediate is the current economic crisis that has left many Americans and Virginians struggling financially, physically and emotionally. Social Workers are trained and armed with specific skills to step in and provide support in all of these areas whether through financial counseling, mental health services, physical health services, support in local school, and more.
On a similar note, in reaction to the increase of Virginians living without health insurance, the Virginia Health Care Foundation, a key element of the Commonwealth of Virginia’s strategy to buttress local primary care delivery systems and strengthen the health safety net, specifically requested that we, the Association of Social Workers, join their Mental Health Roundtables. These roundtables will explore ways in which clinics can recruit, access, and employ much needed professional social workers. Their eagerness to collaborate with NASW-VA is a fine example of how influential foundations contributing to human services, recognize the importance and influence that the profession of social work has now and will continue to have in the coming years.
In addition to the current economic climate, the Center for Health Workforce Studies has projected a 54 percent growth in the number of older adults between 2000 and 2020 due to the aging of the Baby Boomer Population. This increase will be a fundamental driver in the increased demand for social work services and practice in the coming decades. It would be unfortunate if one of Virginia’s Senior Citizens needs the services of a social worker only to be unable to find help because there are not enough trained professionals to offer support. That alone is a monumental reason why it would be imprudent to disband an academic program in a time when the need for social work services will absolutely increase.
In the case that building capacity for new social workers wasn’t great enough, it is also compounded by the fact that 12 percent of our current professionals plan on retiring in the next 2 years. All of these factors have combined to create an environment in which Social Work jobs are expected to increase between 18 and 26 percent by the year 2014 according to the Bureau of Labor Statistics. If the current and impending need for trained, educated social workers weren’t serious enough, in its current state, the profession is already facing a crippling shortage of individuals to step up to Virginias’ current and impending challenges. Knowing this, it begs the question of how the community of which the university is a part be without the addition of new professionals?
I am sure you will agree, with all of the above mentioned factors, it is not only advisable, it is imperative that all social work degree programs continue to thrive and produce highly educated professionals, such as those molded at Christopher Newport University. It will be these individuals who will be called upon to carry the burden of Virginia and who will support your own community with the skills and services with which you armed them.
In a time as unsure as our own, and with the rapid aging of a large percentage of population, cutting the social work degree program at CNU would be detrimental to the state of human services for the Commonwealth of Virginia, and especially for the residents of the Hampton Roads area.
I hope that you will re-consider your decision, and look forward to the possibility of speaking with you, and collaborating to produce more social work professionals from the University.
Sincerely,
Debra A Riggs
Executive Director, NASWVA
Cc: Provost Mark Padilla
Dr. Carolyn Ericson, CNU School of Social Work
Ms.Cheryl Matthews, CNU School of Social Work
2009 Legislative Update- NASW-VA
The session began under the dark cloud of having to close a 3.2 billion dollar shortfall and the gloomy feeling has not lifted. Tuesday, February 10th was Crossover, the midway point in the 2009 legislative session. It’s been a tough year, with failing economy looming around every corner. A lot of bills we were following have already been killed- a bill banning bullying, one calling for fair housing protections for gays and lesbians and the bills to raise the tax on cigarettes to pay for the increase in Medicaid costs.
Senator Howell’s bill allowing heath insurance benefits to be offered to anyone in the household passed, no longer banning someone based on their sexual orientation. A compromise was also struck between the Governor and Speaker Howell on a bill banning smoking in restaurants- the final bill that passed the House has some unacceptable amendments that will be struck out on the Senate side. A similar bill without those amendments has already passed the Senate. A bill extending the Commission on Alzheimer’s until 2014 passed their respective houses, as did the bills designating lead agencies for the “No Wrong Door” system for the aging.
Two bills mandating health insurance companies to cover autism spectrum disorders were filed this year, originally without licensed clinical social workers listed as one of the licensed providers. We were able to remedy that omission and now, in both bills, LCSW’s are listed as able to diagnose and provide applicable services to children with autism. Unfortunately, the House version failed to pass on Thursday and the Senate version, with numerous amendments, is expected to have a tough fight on the Senate floor today.
Another professional issue we were following closely in the budget was the issue of school social workers and the support staff cuts in K-12 that the Governor had recommended. In the introduced budget, school social workers were subject to such cuts, along with all other administrative staff. We filed two budget amendments to exempt them from those support staff cuts. However, the House and Senate versions of the budget eliminated the Governor’s language and instead of keeping a ratio of cuts, which would have had permanent ramifications, the legislative versions gave the local school boards the discretion to cut the positions they felt were appropriate. This means that no positions are exempt and the decision of who to cut will not be made at the state level as we had hoped with our budget amendments, but rather at the local level. We were able to raise awareness with the legislators about the important role school social workers play in the K-12 arena.
Finally, both versions of the budget reinstated the funding for the CommonwealthCenter for Children and Adolescents- a public safety net for children with severe mental illness. The House version reinstated all of the money and asked for a comprehensive study looking into how to close the center and move toward community based services. The Senate version reinstated 50 percent of the beds and did not have language requiring an in depth study.
We will continue advocating for our priorities after Crossover- be sure to keep checking our website where we post action alerts and have a hotlinked categorized bill list:
http://capwiz.com/socialworkers/va/home/
What IS a Social Worker Anyway?
By Debra Riggs, Executive Director of NASW-Virginia
From the Fall 2007 issue of Virginia Capitol Connections
Generally speaking, the public’s conception of who social workers are and what they do is unclear, and often inaccurate. Professional social workers are found in every facet of community life—in schools, hospitals, mental health clinics, senior centers, elected office, private practice, prisons, military, corporations, and in numerous public and private agencies.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), professional social workers are the nation’s largest group of mental health services providers. There are more clinically trained social workers than psychiatrists, psychologists, and psychiatric nurses combined. Federal law and the National Institutes of Health recognize social work as one of five core mental health professions. More than 40% of all disaster mental health volunteers trained by the American Red Cross are professional social workers.
In a profession dedicated to orchestrating positive change, it should come as no surprise that there are over 170 social workers in national, state and local elected office, including two U.S. Senators and four U.S. Representatives. Today, 48 special interest social work organizations contribute to the vitality and credibility of the social work profession.
Professional social workers assist individuals, groups, or communities to restore or enhance their capacity for social functioning, while creating societal conditions favorable to their goals. Social workers help people overcome some of life’s most difficult challenges: poverty, discrimination, abuse, addiction, physical illness, divorce, loss, unemployment, educational problems, disability, and mental illness. They help prevent crises and counsel individuals, families, and communities to cope more effectively with the stresses of everyday life.
The practice of social work requires knowledge of human development and behavior, of social, economic and cultural institutions, and of the interaction of all these factors. Social workers are uniquely trained to help people overcome the obstacles that impact their personal circumstances and quality of life.
A professional social worker holds a, BSW, MSW or DSW degree from an accredited school of social work, has received extensive training in standards and ethics, and must demonstrate competency and complete (minimally) 400 hours of supervised field experience. What consumers need to understand is that not all caseworkers are social workers.
Currently, anyone in Virginia can use the title “social worker”, and claim to be engaged in social work practice, even if they do not have nationally recognized standards of education and experience. Would we allow someone to call him or her self a physician if they had not graduated from medical school or a pilot if they had not taken flying lessons and logged many hours at the controls of a plane? Licensing and regulation instills a level of public safety that is essential.
At present, Virginia does not require licensure for social workers other than those in private practice. Due to exemptions in the law, there is no protection afforded to consumers of other services that may be provided by a social worker such as home health care, case management, nursing home services, group home care, hospital services, etc.
The National Association of Social Workers Virginia Chapter (NASWVA), supports licensure for ALL social workers to assure accountability, and thereby the utmost protection for social work clients. NASWVA has worked diligently, along with other stakeholders in the field of Social Work, to promote legislation which would ultimately result in greater protection for the public at large.
Don’t we owe it to our most vulnerable citizens to ensure that the service providers with whom they work are competent, ethical professionals?
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (The Wellstone-Domenici Parity Act), enacted into law on October 3, 2008, will end health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees. The law becomes effective on January 1st, 2010. Under this new law, 113 million people across the country will have the right to non-discriminatory mental health coverage, including 82 million individuals enrolled in self-funded plans (regulated under ERISA), who cannot be assisted by State parity laws.
Summary of the Wellstone-Domenici Mental Health Parity and Addiction Equity Act of 2008
Q&A on the Wellstone-Domenici Mental Health Parity and Addiction Equity Act of 2008
(PDFs courtesy of the American Psychological Association)
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