Search Results: MCHLine

Annotation: The purpose of this project was to develop and apply a model for providing comprehensive nutrition services for children in Utah who have certain developmental disabilities or disease conditions. The objectives of the project were to (1) provide comprehensive nutrition care and expand resources; (2) demonstrate the costs and benefits of providing nutrition services to those children with selected developmental disabilities using an economic model; and (3) obtain third-party reimbursement for nutrition services provided to children with selected special health needs. [Funded by the Maternal and Child Health Bureau]

Contact: National Technical Information Service, O.S. Department of Commerce, 5301 Shawnee Road, Alexandria, VA 22312, Telephone: (703) 605-6050 Secondary Telephone: (888) 584-8332 E-mail: [email protected] Web Site: http://www.ntis.gov Document Number: NTIS PB93-199172.

Keywords: Cystic Fibrosis, Developmentally Delayed/Disabled, Financing Health Care, Inborn Errors of Metabolism, Neonatal Intensive Care Unit(NICU), Nutrition, Reimbursement

Annotation: The goal of this project was to assist in the formation of a collaborative effort involving the government, providers, private payers, and families in order to reconcile the operational difficulties of achieving health care cost containment while retaining quality, access, and family-centeredness. The project sought to: develop approaches to health care financing that are sensitive to the needs of families with children who have special health care needs; assist families with special health care needs in dealing with financial problems which pose barriers to obtaining appropriate health services; and disseminate information regarding financing of care for children with special health care needs. Family health benefits counselors assisted approximately 1600 over the course of the project by conducting intake interviews, informing families about health care financing options, assisting in completing applications and/or filing appeals or denials of public or private benefits and facilitating negotiations with medical creditors. Consultation with legal backup and referral for legal intervention were distinguishing aspects of the project. Benefits counselors and project attorney worked with state and county administrative and regulatory agencies, private insurers and health care providers and associations to resolve systemic problems. [Funded by the Maternal and Child Health Bureau]

Contact: National Technical Information Service, O.S. Department of Commerce, 5301 Shawnee Road, Alexandria, VA 22312, Telephone: (703) 605-6050 Secondary Telephone: (888) 584-8332 E-mail: [email protected] Web Site: http://www.ntis.gov Document Number: NTIS PB93-199156.

Keywords: Advocacy, Case Management, Chronic illnesses and disabilities, Families, Family health, Financial Counseling, Financing Health Care, Health Insurance, Health Maintenance Organizations (HMOs), Medicaid, Reimbursement

Annotation: This manual provides policies and procedures for Wisconsin Seal-A-Smile (SAS) grantees, with the goal of helping them administer programs and ensure consistency across programs. The purpose of SAS is to improve the oral health of Wisconsin children through school-based dental sealant programs. Topics include administrative and regulatory guidelines; program requirements; forms, reporting, and recording; and budget and funding information.

Contact: Children's Health Alliance of Wisconsin, 6737 West Washington Street, Suite 1111, West Allis, WI 53214, Telephone: (414) 292-4000 Secondary Telephone: (414) 337-4561 Fax: (414) 231-4972 Web Site: https://www.chawisconsin.org/ Available from the website.

• Link

Keywords: Administration, Data collection, Dental sealants, Disease prevention, Forms, Grants management, Oral health, Prevention programs, Reimbursement, School age children, School health programs, School health services, Screening, State programs, Wisconsin

Annotation: This report discusses minimally invasive care (MIC), how state Medicaid agencies' support of MIC can contribute to improving oral health, and opportunities for these agencies to support the availability of MIC through payment strategies that encourage oral health professionals to use this approach to providing care. Topics include what MIC is, avenues toward supporting it, supporting an expanded oral health workforce, promoting opportunities for clinical integration, and identifying oral health Medicaid payment strategies. Spotlights describing programs that use MIC are included.

Contact: Center for Health Care Strategies, 200 American Metro Boulevard, Suite 119, Hamilton, NJ 08619, Telephone: (609) 528-8400 Fax: (609) 586-3679 Web Site: http://www.chcs.org Available from the website.

• PDF

Keywords: Access to health care, Health care delivery, Low income groups, Medicaid, Oral health, Oral health equity, Reimbursement, Service integration

Annotation: This brief provides data on variations across states in the recognition of and reimbursement for select oral health services for children. Content build upon two editions of the American Academy of Pediatric Dentistry's resource, Are Your Kids Covered? The brief also presents information on the importance of selected services. Time trends in state coverage for selected services for children are included, and data and methods are discussed.

Contact: American Academy of Pediatric Dentistry, 211 East Chicago Avenue, Suite 1600, Chicago, IL 60611-2637, Telephone: (312) 337-2169 Fax: (312) 337-6329 Web Site: http://www.aapd.org Available from the website.

• PDF

Keywords: Oral health, Reimbursement, Statistical data, Trends

Annotation: This report provides information about policies and practices related to paying for community health workers for their services, including oral health services, through Medicaid. The report discusses each state's approach to covering these services through Medicaid. It also includes a spreadsheet that can be filtered and sorted to identify states with various approaches. A summary of findings is included.

Contact: Connecticut Health Foundation, 100 Pearl Street, Hartford, CT 06103, Telephone: (860) 724-1580 Fax: (860) 724-1589 E-mail: [email protected] Web Site: http://www.cthealth.org Available from the website.

• Link

Keywords: Administrative policy, Community health, Low income groups, Medicaid, Oral health, Personnel, Reimbursement, State information

Annotation: This report discusses systemic barriers to oral health care and overall health care coordination and how these barriers can be mitigated. It provides an analysis of 715 pieces of literature and categorizes them into five primary segments: education exploratory, education implemented, health professional exploratory, health professional implemented, and informative. The report highlights ways that the literature reflects four main themes: awareness, workforce development and operations, information exchange, and payment. Recommendations for developing frameworks to address oral health care and overall health care coordination are included.

Contact: National Association of Chronic Disease Directors, 2200 Century Parkway, Suite 250, Atlanta, GA 30345, Telephone: (770) 458-7400 Web Site: https://chronicdisease.org Available from the website.

• Link

Keywords: Care coordination, Oral health, Reimbursement, Research, Service integration

Annotation: This profile provides information on state Medicaid dental programs. For each state, the following topics are discussed: category of care provided (e.g., diagnostic, exam, screen, preventive, restorative); diagnostic code; description of category; whether adults over age 21, adults with intellectual and developmental disabilities, and pregnant women are covered; adult fees; whether the category is part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program; and EPSDT rates for pregnant women.

Contact: Medicaid | Medicare | CHIP Services Dental Association, 4411 Connecticut Avenue, N.W., #104, Washington, DC 20008, Telephone: (202) 855-3993 Fax: (202) 248-2315 E-mail: [email protected] Web Site: http://www.medicaiddental.org Available from the website.

• PDF

Keywords: Adults, Costs, Developmental disabilities, Intellectual development, Medicaid, Oral health, Pregnant women, Prevention, Reimbursement, State information, State programs

Annotation: This toolkit focuses on how teledentistry can be used to maintain oral health and improve access to oral health care. It is intended for for dental boards, policymakers, health professionals, and advocates. The toolkit provides background information and discusses technology and practice and payment as they relate to teledentistry. A note for policymakers is included.

Contact: CareQuest Institute for Oral Health, 465 Medford Street, Boston, MA 02129-1454, Telephone: (617) 886-1700 Web Site: https://www.carequest.org Available from the website.

• PDF

Keywords: Access to health care, Health care delivery, Oral health, Public policy, Reimbursement, Teledentistry

Annotation: This report focuses on aspects of Medicaid's mission to ensure access to high-quality health services and the program's future as a major health care payer driving health system change toward value. The report focuses on topics of interest to Congress, including Medicaid’s responsiveness during economic downturns; concerns about high rates of maternal morbidity and mortality; improving hospital payment policy for the nation's safetynet hospitals, and the integration of care for people who are dually eligible for Medicaid and Medicare.

Contact: Medicaid and CHIP Payment and Access Commission, 1800 M Street, N.W., Suite 360 South, Washington, DC 20036, Telephone: (202) 350-2000 Fax: (202) 273-2452 E-mail: [email protected] Web Site: http://www.macpac.gov Available from the website.

• 2022
• 2021

Keywords: Access to health care, Adolescents, Children, Children', Costs, Financing, Health care reform, Health services delivery, Medicaid, Medications, Mental health, Oral health, Organizational change, Pregnant women, Reimbursement, Systems development, s Health Insurance Program

Annotation: This tip sheet for professionals providing transition services in pediatric and adult primary and specialty care settings summarizes innovative transition payment models. Contents include alternative payment methodologies and transition-related CPT codes and corresponding Medicare fees. Enhanced fee-for-service payments, pay-for-performance, capitation, bundled payments, shared savings, and administrative or infrastructure payments are among the topics covered.

Contact: Got Transition™/Center for Health Care Transition Improvement, National Alliance to Advance Adolescent Health, 1615 M Street, N.W., Suite 290, Washington, DC 20036, Telephone: (202) 223-1500 Fax: (202) 429-3957 E-mail: [email protected] Web Site: http://gottransition.org Available from the website.

• 2022

Keywords: Adolescents, Financing, Model programs, Pediatric care, Primary care, Reimbursement, Transition planning, Young adults

Annotation: This manual is designed to help non-oral-health professionals implement fluoride-varnish application for infants, children, and adolescents ages 6 months to 21 years who are enrolled in Massachusetts’ Medicaid program. The manual includes instructions on how to complete the online Smiles for Life training, which is required for health professionals to apply fluoride varnish for this population. It also discusses how to begin using fluoride varnish in a practice as well as how to keep fluoride varnish notes and how to bill for fluoride varnish application. Basic information about fluoride varnish application and information to share with parents and other caregivers is included.

Contact: Massachusetts Department of Public Health, Office of Oral Health, 250 Washington Street, 5th Floor, Boston, MA 02108, Telephone: (617) 624-6060 Secondary Telephone: (617) 624-5992 Fax: (617) 624-6062 Web Site: https://www.mass.gov/orgs/office-of-oral-health Available from the website.

• Link
• Program Website

Keywords: Adolescents, Children, Clinical coding, Consumer education materials, Dental care, Dental caries, Disease prevention, Fluorides, Infants, Manuals, Massachusetts, Medicaid, Oral health, Preventive health services, Reimbursement, Resources for professionals, Risk assessment, State programs, Training, Young adults

Annotation: This transition payment tip sheet is produced by Got Transition and the American Academy of Pediatrics in order to support the delivery of recommended transition services in pediatric and adult care settings. The tip sheet begins with a listing of transition-related CPT codes and corresponding Medicare fees and relative value units (RVUs), effective as of 2022. The resource also includes a set of clinical vignettes with recommended CPT and ICD coding, as well as detailed coding descriptions for each transition-related code.

Contact: Got Transition™/Center for Health Care Transition Improvement, National Alliance to Advance Adolescent Health, 1615 M Street, N.W., Suite 290, Washington, DC 20036, Telephone: (202) 223-1500 Fax: (202) 429-3957 E-mail: [email protected] Web Site: http://gottransition.org Available from the website.

• Link

Keywords: Adolescents, Financing, Model programs, Pediatric care, Primary care, Reimbursement, Special health care needs, Transition planning, Young adults

Annotation: This brief presents a range of strategies for improving access to oral health care. It provides recommendations for how to focus efforts to address the problem of poor access to care, the limits of reimbursement rates on improving access to care, and strategies for improving access. Strategies offered include expanding coverage; broadening the oral health workforce; and adopting solutions that deliver care in communities while removing long-standing structural hurdles.

Contact: Community Catalyst, Dental Access Project, 30 Winter Street, 10th Floor, Boston, MA 02108, Telephone: (617) 338-6035 Fax: (617) 451-5838 E-mail: [email protected] Web Site: https://communitycatalyst.org/work/projects/dental-access-project/ Available from the website.

• PDF

Keywords: Access to health care, Community health services, Health care delivery, Oral health, Reimbursement

Annotation: This set of chartbooks contains data about factors that could impact the integration of oral health care into primary care for pregnant women, infants, and children at high risk for oral disease in 11 states and Washington, DC, as part of the Networks for Oral Health Integration (NOHI) Within the MCH Safety Net, an initiative funded by the Maternal and Child Health Bureau. The chartbooks present data related to scope of practice for medical and dental providers, Medicaid billing and reimbursement,dental hygienists, dental therapists, community health workers, and teledentistry. They also presents information about the NOHI projects and the environmental scan data-collection tool. The set includes one chartbook for the 11 states and Washington, DC, and chartbooks for the three NOHI projects: Midwest Network for Oral Health Intregration (MNOHI): Environmental Scan 2021–2022 Chartbook, Rocky Mountain Network for Oral Health Intregration (ROMONOH): Environmental Scan 2021–2022 Chartbook, and Transforming Oral Health for Famlies (TOHF): Environmental Scan 2021–2022 Chartbook, [Funded by the Maternal and Child Health Bureau]

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

• PDF

Keywords: Community health, Dental hygienists, Medicaid, Oral health, Reimbursement, Service integration, Teledentistry

Annotation: The chartbook contains data about factors that could impact the integration of oral health care into primary care for pregnant women, infants, and children at high risk for oral disease in 11 states and Washington, DC, as part of the Networks for Oral Health Integration (NOHI) Within the MCH Safety Net, an initiative funded by the Maternal and Child Health Bureau. The chartbook presents data for one of the three NOHI projects, the Midwest Network for Oral Health Integration, related to scope of practice for medical and dental providers, Medicaid billing and reimbursement,dental hygienists, dental therapists, community health workers, and teledentistry. It also presents information about the NOHI projects and the environmental scan data collection tool. [Funded by the Maternal and Child Health Bureau]

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

• PDF

Keywords: Community health, Dental hygienists, Medicaid, Oral health, Reimbursement, Service integration, Teledentistry

Annotation: The chartbook contains data about factors that could impact the integration of oral health care into primary care for pregnant women, infants, and children at high risk for oral disease in 11 states and Washington, DC, as part of the Networks for Oral Health Integration (NOHI) Within the MCH Safety Net, an initiative funded by the Maternal and Child Health Bureau. The chartbook presents data for one of the three NOHI projects, the Rocky Mountain Network of Oral Health, related to scope of practice for medical and dental providers, Medicaid billing and reimbursement,dental hygienists, dental therapists, community health workers, and teledentistry. It also presents information about the NOHI projects and the environmental scan data collection tool. [Funded by the Maternal and Child Health Bureau]

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

• PDF

Keywords: Community health, Dental hygienists, Medicaid, Oral health, Reimbursement, Service integration, Teledentistry

Annotation: The chartbook contains data about factors that could impact the integration of oral health care into primary care for pregnant women, infants, and children at high risk for oral disease in 11 states and Washington, DC, as part of the Networks for Oral Health Integration (NOHI) Within the MCH Safety Net, an initiative funded by the Maternal and Child Health Bureau related to scope of practice for medical and dental providers, Medicaid billing and reimbursement, dental hygienists, dental therapists, community health workers, and teledentistry. It also presents information about the NOHI projects and the environmental scan data collection tool. [Funded by the Maternal and Child Health Bureau]

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

• PDF

Keywords: Community health, Dental hygienists, Medicaid, Oral health, Reimbursement, Service integration, Teledentistry

Annotation: This report addresses questions on whether the Centers for Medicare & Medicaid Services should require state Medicaid agencies to implement Medicaid reimbursement and payment policies that promote access to oral health care for adults with intellectual and developmental disabilities (I/DD) and on whether doing so could be cost-effective. The report discusses barriers to accessing oral health care for adults with I/DD, Medicaid’s role in making oral health care accessible for them, an analysis of state Medicaid oral health dental coverage, Medicaid reimbursement rates, receipt of oral health care among this population, opportunities for change, and areas for future research.

Contact: National Council on Disability, 1331 F Street, N.W., Suite 850, Washington, DC 20004-1107, Telephone: (202) 272-2004 Secondary Telephone: (202) 272-2074 Fax: (202) 272-2022 E-mail: [email protected] Web Site: http://www.ncd.gov/ Available from the website.

• PDF
• Link

Keywords: Access to health care, Adults, Costs, Developmental disabilities, Intellectual development, Medicaid, Oral health, Reimbursement, Research, Special health care needs

Annotation: This report provides information about Ohio’s 2021–2022 state oral health plan goal to ensure equitable health care systems and access to oral health care in the state. It discusses three policy opportunities: preserving the adult benefit under the Medicaid program; preserving Medicaid expansion, and increasing the number of oral health professionals in the state who accept patients enrolled in Medicaid by advocating for higher reimbursement rates.

Contact: Center for Reproductive Rights , 120 Wall Street , New York, NY 10005, Telephone: (917) 637-3600 Fax: (917) 637-3666 E-mail: [email protected] Web Site: http://www.reproductiverights.org Available from the website.

• PDF

Keywords: Access to health care, Costs, Medicaid, Ohio, Oral health, Reimbursement, Statewide planning