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SDoH Legislation and Funding Needle Moves

A number of key events have recently occurred to leverage the necessary legislation, funding, and reimbursement required to implement sustainable social determinants of health (SDoH) programs.

Legislative focus is on the Social Determinants Accelerator Act, HR 2503. This bipartisan sponsored bill is geared to get over $25 million in planning grants and technical assistance directly to state, local, and tribal governments and communities, for the purpose of addressing the SDoH. Associations and organizations are stepping up to endorse the Act with considerable advocacy to advance the legislation; the massive list of entities is viewable on the Aligning for Health website. The bill was a major focus of the recent House Committee on Energy and Commerce hearing. Other social risk legislation received attention as well, including:

  • HR 666: The Anti-Racism in Public Health Act;
  • HR 925: The Data to Save Moms Act;
  • HR 943: The Social Determinants for Moms Act; and
  • HR 3894: The CARING for Social Determinants of Health Act

In addition, a bill to amend title XXVII (27) of the Public Health Service Act was discussed, which include SDoH interventions in medical loss ratio calculations. Links to each bill, and the  Accelerator Act endorsement page, appear throughout this article.

The Gravity Project also continues to achieve success. You might remember that the Project advanced a multi-domain submission to the ICD-10-CM Coordination and Maintenance Virtual Meeting in March. We now have liftoff! The codes have been approved and will be implemented Oct. 1, 2021. This is exciting news for those who have been longing to expand the Z-code and subcategories that encompass education, food insecurity, and housing.

The list of enhancements is exciting to review; it includes, but is not limited to:

  • Z55.5 Less than a high school diploma;
  • Z58.6 Inadequate drinking water supply;
  • Z 59.00 Homelessness, unspecified (new subcategories);
  • Z 59.01 Sheltered homelessness;
  • Z 59.02 Unsheltered homelessness;
  • Z 59.41 Food insecurity;
  • Z 59.81 Housing instability, housed and subcategories of;
  • Z59.811 Housing instability, housed with risk of homelessness;
  • Z59.812 Housing instability, housed, homelessness in past 12 months; and
  • Z59.819 Housing instability, housed unspecified.

More recommendations are on the Gravity Project’s wish list. Additional codes are being refined and submitted for 2022 approval to address veteran status, transportation insecurity, financial insecurity, and material hardship. I’ll continue to provide updates as they become available on this topic and the Project’s important work. The full set of released terms can be viewed at the CDC’s National Center for Health Statistics, ICD-10-CM page, under section heading, “2022 release of ICD-10-CM.”

Our most recent Monitor Mondays Listeners Survey focused on “which potential ICD-10-CM-Z code submission listeners would want to see approved for 2022.” Time will tell what the priorities on the reimbursement horizon will be, although you can view the survey responses here.

Programming Note:

Listen to Ellen Fink-Samnick’s SDoH live reports Mondays on Monitor Mondays, 10 Eastern.

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Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management and Social Determinants of Health: Case Management’s Next Frontier (with foreword by Dr. Ronald Hirsch), are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk Ten Tuesdays, and member of the RACmonitor Editorial Board.

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