CMSA revises Case Management Model Act to promote care standards

The Case Management Society of America (CMSA) recently released an updated version of its Case Management Model Act, which is aimed at standardizing best practices in case management to improve clinical and financial outcomes, according to CMSA Today.

The updated 2017 version of the Model Act replaces the 2009 version and includes the following changes:

• The 2009 definition of client caused confusion over whether it referred to patients or businesses, and was dropped from the 2017 version of the Model Act. The term consumer now describes individuals receiving care while the term sponsor refers to the entity providing services.
• The term case management extender was added to describe support staff who assist case managers but cannot practice case management or nursing.
• Additional details were provided about the appeals process from the case management perspective.
• Additional information was added about paying for case management programs and the new, associated payment codes.
• A provision on consumer disclosure requirements was added to explain the nature of case management services sponsored by third parties.

The Model Act offers insight into the key elements of case management programs that should be implemented at state and federal levels. It is intended to provide policymakers with guidelines as they work to develop and improve regulations impacting reduced healthcare costs, improved care coordination and transitions, and promoting improved clinical outcomes.

See CMSA Today for additional information on the Model Act.