Biden-Harris Administration Greenlights Coverage of LGBTQ+ Care as an Essential Health Benefit in Colorado

New health plan benchmarks expand access to care for transgender patients

For the first time, the Centers for Medicare & Medicaid Services (CMS) approved a request to provide gender-affirming care in the individual and small group health insurance markets as part of Colorado's Essential Health Benefit (EHB) benchmark. Today's landmark step is aligned with the Biden-Harris Administration's efforts to address health care disparities by removing longstanding barriers and expanding access to care for transgender persons.

Colorado's new EHB-benchmark plan will enhance access to coverage for gender-affirming care that meets individual needs and discourages the use of a "one-size-fits-all" framework for transgender persons seeking medical care. Changes to the EHB-benchmark plan will allow access to a wider range of services for transgender individuals in addition to benefits already covered. Such treatments will include eye and lid modifications, face tightening, facial bone remodeling for facial feminization, breast/chest construction and reductions, and laser hair removal. The state is also adding EHBs in the benchmark plan to include mental wellness exams and expanded coverage for 14 prescription drug classes. These changes will take effect beginning on January 1, 2023.

"Health care should be in reach for everyone; by guaranteeing transgender individuals can access recommended care, we're one step closer to making this a reality," said HHS Secretary Xavier Becerra. "I am proud to stand with Colorado to remove barriers that have historically made it difficult for transgender people to access health coverage and medical care."

"Health care should be accessible, affordable and delivered equitably to all, regardless of your sexual orientation. To truly break down barriers to care, we must expand access to the full scope of health care, including gender-affirming surgery and other treatments, for people who rely on coverage through Medicare, Medicaid & CHIP and the Marketplaces," said CMS Administrator Chiquita Brooks-LaSure. "Colorado's expansion of their essential health benefits to include gender-affirming surgery and other treatments is a model for other states to follow and we invite other states to follow suit."

Gender-affirming care is considered a standard level of care by the American Medical Association, the American Academy of Family Physicians, and the American Psychiatric Association. Transgender patients often face discriminatory hurdles in accessing medically necessary health care services that affirm gender identity.

The Affordable Care Act (ACA) requires non-grandfathered health plans in the individual and small group markets to provide coverage in 10 categories of EHBs, including preventive and wellness services, chronic disease management, maternity and newborn care, hospitalization, prescription drugs, mental health and substance use disorder services, behavioral health treatment, and lab services. CMS regulations allow states the flexibility to develop state-specific "benchmark" plans that detail the specific services covered among these broad categories based on a typical employer plan offered in the state.

CMS recognizes that expanded, gender-affirming coverage vastly improves health care outcomes for the LGBTQ+ community, reduces high rates of depression, anxiety, and suicide attempts as well as decreases substance use, improves HIV medication adherence, and reduces rates of harmful self-prescribed hormone use.

 

Seasonal Affective Disorder (SAD)

National Center for Complimentary and Integrative Health (NIH)

As the days grow shorter in the fall, some people develop symptoms of seasonal affective disorder (SAD), a type of depression with a recurring seasonal pattern. 

Several types of treatment can be helpful for SAD symptoms. They include antidepressant medications, cognitive behavioral therapy, and light therapy—which involves daily exposure to bright artificial light every morning, from early fall until spring.

The evidence on dietary supplements for SAD is limited. Although low levels of vitamin D have been found in people with SAD, it’s unclear whether vitamin D supplementation can help relieve SAD symptoms. Very little research has been done on supplements other than vitamin D, so no conclusions can be reached about their effects.

Read Full Article

 

 

New Bill Seeks To Increase Physical Therapy's Role at Community Health Centers

The bipartisan legislation would ease billing and other restrictions to boost patient access to care, especially in rural areas. Patients who receive care through community health centers could find it easier to access physical therapy, if a new bill introduced into the U.S. House of Representatives makes its way into law.

Click here to read more.

 

Beginning Oct. 1: Stop Using This ICD-10 Code for LBP

In a continuing press for codes that are more specific, a single, general LBP code has been replaced with several.

One of the most commonly billed codes in the rehab industry is about to disappear: Beginning Oct. 1, the International Classification of Diseases code for low back pain — M54.5 — will no longer exist in the ICD-10 listings. The more general code is being replaced by a series of codes related to LBP aimed at providing greater specificity around diagnosis.

The changes come as part of annual updates to the ICD-10 that are implemented every October.

Click here to read more.

 

We Went to D.C. to Advocate for Our Profession. Here's What It Was Like

APTA wrapped up its centennial celebration with an in-person advocacy day in Washington, D.C., on Sept. 14. More than 450 PTs, PTAs, students, and supporters turned out for the event, which was preceded by a training session on Sept. 13.

So what happens during an APTA advocacy event? We asked Theresa Marko, PT, DPT, the New York Physical Therapy Association's; federal affairs liaison, to chronicle her experience. She was joined in the project by Sabrina Basile, SPT, a student at Daeman College and advocacy chair of the NYPTA student special interest group; and Zaryna Sanchez, SPT, from Mercy College.

Click here to read more.

 
<< first < Prev 81 82 83 84 85 86 87 88 89 90 Next > last >>

Page 83 of 172