The Prevention and Medicaid Financing Task Force welcomes others who may be interested in participating as a collaborative working partner at the next Task Force meeting on July 11, 2014, 9:30-11:30am at IPHI.  The DC Primary Care Association (DCPCA) and IPHI led the formation of the Task Force to help lay groundwork to facilitate future Medicaid financing of preventive health services offered by non-licensed providers.

The federal Centers for Medicare and Medicaid Services (CMS) created a new rule, which took effect January 1, 2014, that allows state Medicaid agencies to finance preventive health services provided by professionals that may fall outside of a state’s clinical licensure system, as long as a licensed practitioner, such as a physician, nurse or social worker, recommends such services.  With this new rule, the DC Department of Health Care Finance (DHCF) has the option to cover more community-based preventive services, including but not limited to, those provided by community health workers (CHWs).  The rule defines preventive services as those which: prevent disease, disability, and other health conditions or their progression; prolong life; and promote physical and mental health and efficiency.

Before DHCF can expand the financing of preventive health services in the District of Columbia, significant work will need to be done to determine eligible providers; ensure definition of scope(s) of practice, qualifications and standards; institute processes for ensuring those qualifications and standards are met; and structure payment mechanisms.  This Task Force will organize community stakeholders so some of that work can be done in preparation for a possible State Plan Amendment.

If you are interested in participating in the Task Force, email CCHW@institutephi.org  and identify in the email the organization you work for and how you would like to contribute to be involved.