Behavioral Health Updates
Managed Care Organizations Updates 1/5/2022
Beacon Health Options – Monthly Provider Newsletter
Click on the link below to view the December issue of ValueAdded, Beacon Health Options of Pennsylvania’s monthly provider newsletter.
Issue Highlights …
- Advance Directives: FAQs for Providers
- Beacon Reimburses for Tobacco Cessation Services
- Depression Around the Holidays
And much more!
Community Behavioral Health (CBH) – Rescinding Provider Bulletin 21-18: Place of Service 02 and Modifier 95 for Telehealth Service Delivery
CBH is rescinding Provider Bulletin 21-18 and suspending implementation of the modifier. CBH will issue an updated bulletin and further information during the week of January 3, 2022.
Community Behavioral Health (CBH) – Provider Notice: Intensive Behavioral Health Services (IBHS) ABA Group Service
CBH has posted the Provider Notice: Intensive Behavioral Health Services (IBHS) ABA Group Service. This Notice is to inform providers about the services provided through and requirements necessary for IBHS ABA Group Service.
Click here to view the full Notice.
Community Behavioral Health (CBH) – Updates to Medical Necessary Criteria Webpage
CBH has updated its Medical Necessary Criteria (MNC) webpage for providers. These updates include links to new MNC for Community Treatment Teams and Private Room Exception.
Click here to visit the MNC webpage for more information.
Community Behavioral Health (CBH) – *UPDATED* Provider Notice: Request for detailed Pay-for-Performance (P4P) Data
CBH has updated the Provider Notice: Request for Detailed Pay-for-Performance (P4P) Data, originally issued on November 18, 2021, to include a Pay-for-Performance Operational Definitions Master Document for Reporting Year 2021.
This Operational Definitions Master Document can serve as a guide for providers to understand the performance measures, scoring methodology, and award eligibility criteria for the 2021 Pay-for-Performance program. Providers who would like to request their member-level data should complete the form that is attached to this notice as well.
Click here to view the updated Notice.
Community Behavioral Health (CBH) – Recorded Webinar: 2021 Compliance Forum Sessions
CBH hosted its Compliance Forum virtually this year with three one-hour sessions presented on November 9, 10, and 12, 2021. Forum sessions, described below, were recorded and can be accessed via the Provider Trainings page. The PowerPoint slides and Q&A are also available on the Audit Tools page.
- COVID & Beyond: COVID-related topics including Schemes (Labs, Phishing/Cyber-attacks, Fake Medications), Telehealth, Return to Auditing, Staffing Challenges, Waivers, Alternative Payment Arrangements (APA), and Tips and Tricks for Self-Audits
- ASAM & Compliance: ASAM-related topics including Outpatient DA Transition and Monitoring (including VBP), Per Diem Updated Guidelines and Follow Up Audit Tour, and IOP Preparations
- Fighting Fraud in Value-Based Payment (VBP) Models: VBP-related topics including Anti-Kickback Statute (AKS), Stark Law, Eliminating Kickbacks in Recovery Act (EKRA), Safe Harbors, APA, and Monitoring
Please email CBH.ComplianceContact@phila.gov with any questions.
Community Behavioral Health (CBH) – Methadone Maintenance Treatment Request for Proposals and Bidder’s Conference
CBH is seeking a provider to acquire two existing Methadone Maintenance Treatment (MMT) programs within the city of Philadelphia. Applications for this RFP are due by
2 p.m. on Tuesday, January 18, 2022.
The RFP procurement schedule will also include a Bidder’s Conference at 11:00 a.m. on Tuesday, January 4, 2022.
Click here to view the RFP and register for the Bidder’s Conference.
Community Behavioral Health (CBH) – Provider Bulletin 22-01: Delay of American Society of Addiction Medicine (ASAM) Value Based Payment (VBP) (Case Rate) Arrangement
CBH has released the Provider Bulletin 22-01: Delay of American Society of Addiction Medicine (ASAM) Value Based Payment (VBP) (Case Rate) Arrangement. This Bulletin is to alert providers of the delay in implementation of the ASAM VBP arrangement (case rate). Given the provision of the Bridge Payments that will begin January 1, 2022, the ASAM VBP implementation date has been modified from January 1, 2022 to the new target implementation date of April 1, 2022.
Click here to view the full Bulletin.
Community Behavioral Health (CBH) – Provider Bulletin 22-02: Psychological Services Rate Increases
CBH has released the Provider Bulletin 22-02: Psychological Services Rate Increases. This Bulletin is to alert providers that, effective January 1, 2022, CBH implemented a rate increase for specific psychological services. CBH will issue an updated schedule to reflect the rate increase for eligible providers.
Click here to view the full Bulletin.
Community Care Behavioral Health (CCBH) – Provider Alert #27: Mental Health Crisis Intervention Services and Mental Health Crisis Residential Services Performance Standards
Please see Provider Alert regarding updated standards by clicking on the link: CCBH Provider Alert #27
Community Care Behavioral Health (CCBH) – Provider Newsletter: December 2021
Please see the Provider Newsletter dated December 2021 by clicking on the link: CCBH Provider Newsletter: Dec. 2021