U.S. citizens who experience chronic homelessness, die, on average, three decades earlier than those with housing. This is often the result of poor access to consistent and timely medical care and results in overuse of more costly emergency department services.
The Department of Human Services (DHS) issued a Bulletin, effective July 5, 2023, detailing the services that can be offered to Medicaid beneficiaries in their “lived environment” (i.e. on the street) and providers who can be reimbursed for those services.
DHS will pay for certain physical and behavioral health services including but not limited to primary care, vaccine administration, wound care, preventive services, counseling, and diagnostic services, when delivered to MA beneficiaries experiencing unsheltered homelessness when delivered in their lived environment.
Medicaid reimbursable providers include physicians, certified nurse midwives (CNMs), certified registered nurse practitioners (CRNPs), physician assistants (PAs), psychologists, mobile mental health treatment (MMHT) providers, and mental health outpatient practitioners who render services in the MA Fee-for-Service or MA Managed Care delivery systems.
In an interview with Pittsburgh’s NPR station WESA, DHS Secretary Dr. Val Arkoosh said: “[H]opefully, this will result in people being connected to services that can then help them take those next steps to some better type of stability in a hopefully housed situation, getting treatment[.]"
The MA Bulletin explains how eligible physical and behavioral health providers can bill for allowable services delivered on the street to Medicaid beneficiaries.
The only other state Medicaid programs that currently reimburse for street medicine are California and Hawaii. PHLP applauds DHS for joining California and Hawaii in delivering these critical services to Medicaid beneficiaries.