CMS begins paying for health care for people who are homeless outside medical settings

As of Oct. 1, the federal Centers for Medicare & Medicaid Services began allowing public and private insurers to pay “street medicine” providers for medical services they deliver anyplace people who are homeless might be staying (Source: “Health Care ‘Game-Changer’? Feds Boost Care for Homeless Americans,” Kaiser Health News, Oct. 19).
 
Previously, these providers weren’t getting paid by most Medicaid programs, which serve people with low incomes, because the services weren’t delivered in traditional medical facilities, such as hospitals and clinics.
 
The change comes in response to the swelling number of people experiencing homelessness across the country, and the skyrocketing number of people who need intensive addiction and mental health treatment — in addition to medical care for wounds, pregnancy, and chronic diseases like diabetes.
 
“It’s a game-changer. Before, this was really all done on a volunteer basis,” said Valerie Arkoosh, secretary of Pennsylvania’s Department of Human Services, which spearheaded a similar state-based billing change in July.
 
California led the nation when its state Medicaid director in late 2021 approved a new statewide billing mechanism for treating people who are homeless in the field, whether outdoors or indoors in a shelter or hotel. Hawaii and Pennsylvania followed. And while street medicine teams already operate in cities like Boston and Fort Worth, Texas, the new government reimbursement rule will allow more health care providers and states to provide the services.