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<td><span style="font-family:Helvetica, sans-serif; font-size:20px;font-weight:bold;">Clinical Social Work Association Announcements Daily Digiest (Unofficial)</span></td>
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<td><a href="https://www.clinicalsocialworkassociation.org/Announcements/13279824" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Medicare Advantage - FOLLOW-UP - 11-15-23</a>
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<h1 align="center">Medicare Advantage – FOLLOW-UP</h1>
<p align="center">November 15, 2023</p>
<p>The recent communication about Medicare Advantage led to several questions. Please see answers below:</p>
<p><em><strong>Will Medicare Advantage reimburse traditional Medicare paneled LCSWs?</strong></em> Since Medicare Advantage is a separate program from traditional Medicare, it does not reimburse claims for traditional Medicare.</p>
<p><em><strong>Why does Medicare Advantage often pay less than traditional Medicare?</strong></em> Because Medicare Advantage plans are run by commercial insurers, some reimburse at less than traditional Medicare and some at a higher rate. Remember that traditional Medicare rates vary from region to region as well.</p>
<p><em><strong>Should LCSWs accept Medicare Advantage, even if rates are lower, because it is all that some people can afford? </strong></em> Some people think of Medicare Advantage as a midway point between Medicare and Medicaid and want to accept these plans to offer services to lower income patients.</p>
<p><em><strong>How can we make Medicare Advantage have reimbursement parity with traditional Medicare?</strong></em> Medicare Advantage is a completely different system from traditional Medicare with different reimbursement. Medicare Advantage reimbursement has reimbursement governed by commercial insurers; traditional Medicare has reimbursement governed by CMS. While CSWA has advocated for reimbursement parity in traditional Medicare (with medical/surgical reimbursement) and in commercial plans (with medical/surgical), there is no way to create parity between Medicare Advantage and traditional Medicare.</p>
<p><em><strong>How can we improve access to mental health treatment in general?</strong></em> There is no one way to accomplish this but the new mental health parity rules and integration of primary care and mental health should help.</p>
<p><em><strong>Do LCSWs have to be credentialed with Medicare to be eligible for Medicare Advantage?</strong></em> No. The reverse is true as well, i.e., LCSWs can be credentialed with Medicare without accepting Medicare Advantage patients.</p>
<p><em><strong>Do LCSWs have to be credentialed with the commercial insurer sponsoring the Medicare Advantage plan? </strong></em> This varies, but in general it is not necessary to be credentialed with a commercial insurer to be reimbursed for a Medicare Advantage plan. Check with each plan.</p>
<p><strong><em>How much will Medicare Advantage plans affect Medicare beneficiaries going forward? </em> </strong>Many analysts have said that the Medicare Advantage plans will continue to grow to cover 50-60% of Medicare beneficiaries by 2030.<br></p>
<p>Please continue to send questions on Medicare Advantage as they occur.</p>
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<span>Laura Groshong, LICSW, Director, Policy and Practice </span><br><a href="mailto:lwgroshong@clinicalsocialworkassociation.org" data-auth="NotApplicable" data-safelink="true" data-linkindex="7" target="_blank">lwgroshong@clinicalsocialworkassociation.org</a>
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<p><strong>Forwarded by:<br />
Michael Reeder LCPC<br />
Baltimore, MD</strong></p>
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