Behavioral Health Updates
Managed Care Organizations Updates as of 3/30/2022
PerformCare – Revised Intensive Behavioral Health Services (IBHS) Referral Management Process
PerformCare issued notice IBHS 22 100: Revised IBHS Referral Management Process (PDF) to inform individual and applied behavioral analysis (ABA) Intensive Behavioral Health Services (IBHS) providers of changes made to the referral management process and the existing biweekly IBHS monitoring process.
Get more information in this notice and access additional ones on PerformCare’s website.
PerformCare – Group Services Guidelines and Code Authorization Bundling
As a result of the transition from behavioral health rehabilitation services (BHRS) to intensive behavioral health services (IBHS), PerformCare is revising the guidelines for group services. This applies to all IBHS group services, including Short-Term Group Services provided under IBHS, which replaces the Summer Therapeutic Activities Program (STAP) previously provided under BHRS. Learn more in notice IBHS 22 101: IBHS Group Services Guidelines (PDF).
Additionally, PerformCare has simplified some IBHS code authorization requirements. The notice IBHS 22 102: Code Authorization Bundling (PDF) clarifies previously issued guidance.
Access these and other notices on PerformCare’s website.
PerformCare – Updated Intensive Behavioral Health Services (IBHS) Provider Choice Forms for Cumberland, Perry, and Dauphin Counties
Updated IBHS forms are available for Cumberland, Perry, and Dauphin counties:
You can find these IBHS forms as well as others on PerformCare’s website.
PerformCare – Family Based Mental Health Services (FBMHS) Extensions in the Value Based Purchasing Program
PerformCare, CABHC, and TMCA have successfully implemented the Family Based Mental Health Services Value Based Purchasing (VBP) Initiative using a tiered case rate approach based on the length of stay. However, some recent issues concerning extension requests require us to make a change in the model.
Notice MH 22 101: FBMHS Extensions in the Value Based Purchasing Program (PDF) provides information on tier four case rates and a second 32-week authorization. Effective April 1, 2022, PerformCare will allow a second 32-week authorization for circumstances when treatment beyond the typical two- to three-month extension built into the VBP model is medically necessary. However, PerformCare, CABHC, and TMCA will not include those cases in the VBP initiative.
Access this and other notices on PerformCare’s website.
PerformCare – Substance Use Intensive Outpatient Registration Change
PerformCare issued notice SU 22 100: SU Intensive Outpatient Registration Change (PDF), which shares that effective April 1, 2022, the length of an authorization for Substance Use Intensive Outpatient (IOP) is changing to six months with 494 units of service. The change is a result of our review of internal processes, as well as a review of our authorization volume and patterns and length of stay in IOP.
A revised Substance Use Disorder IOP Program Prior Authorization Request and Discharge Form (PDF) was also included in the notice.
Access this and other notices on PerformCare’s website.
PerformCare – Expectations and Best Practices on the Use of Restrictive Procedures
PerformCare promotes best practice initiatives, particularly the effective management of problematic behaviors in an environment free of restrictive procedures, including restraints. Providers of all levels of care are encouraged to implement trauma-informed care initiatives and continuously work to eliminate the use of restrictive procedures with PerformCare members.
We provide an online resource with definitions related to PerformCare’s expectations and best practices on the use of restrictive procedures.
For more information on effective management of problematic behaviors, visit PerformCare’s website.
PerformCare – Information for Providers on Managing Clients with Suicidal Thinking
PerformCare released its fourth memo on Information for Providers on Managing Clients With Suicidal Thinking (PDF). For the latest memo, we provide an overview of core clinical competencies related to the clinical best practice standards on assessment, treatment, and management of clients with suicidal thinking.
Read the accompanying Core Competencies Suicide (PDF) resource and access this and previous suicide prevention memos on PerformCare’s website.
Community Behavioral Health (CBH) – Diversity, Equity, and Inclusion Training Services Request For Proposal (RFP) (Reissued)
CBH has reissued the Diversity, Equity, and Inclusion Training Services RFP to contract with a qualified, independent vendor who specializes in Diversity, Equity, and Inclusion (DEI) Business Strategy, Consultation and Training Services.
Please click here to view the RFP.
Community Behavioral Health (CBH) – COVID-19 Waivers and Suspensions Expiring
On Thursday, March 31, remaining COVID-19 waivers and suspensions set by the Department of State on March 26, 2020 are set to expire.
Please click here to learn more.
Community Behavioral Health (CBH) – Request for Information (RFI): Targeted Case Management, Substance Use Case Management
CBH has issued an RFI to give interested, qualified organizations the opportunity to inform CBH of their capacity and ability to meet Members’ current case management needs.
Proposals for this RFI are due by 2:00 p.m. on Friday, April 8, 2022.
Please click here to view the RFI.
Community Behavioral Health (CBH) – Provider Training for Pay-for-Performance (P4P) Behavioral Health Screening Events
Again in 2022, CBH will give a special pay-for-performance (P4P) award to all outpatient Providers that complete a certain number of required behavioral health screening events. One of the requirements to receive P4P credit for the award is to attend a training.
The next training, Screening Partners Learning Collaborative, will be held on Thursday, March 31st at two different times:
9:30 a.m. – 11:00 a.m.
Please click here to register for the morning session.
1:30 p.m. – 3:00 p.m.
Please click here to register for the afternoon session.
Community Behavioral Health (CBH) – Provider Notice: Pending End of PA DHS Regulatory Suspensions and Reminder of Telehealth Waiver Process for Outpatient Services
This notice is to remind the CBH Provider Network about the end of suspension of various regulatory provisions under the state disaster emergency declaration on Thursday, March 31, 2022.
Please click here to view the full Notice.
Community Care Behavioral Health (CCBH) – Provider Alert #1: Universal Discharge Form – Update
This Provider Alert applies to providers in all Community Care provider networks. Community Care is reissuing this Provider Alert to include the following partial hospital levels of care that are now part of the Universal Discharge process.
Community Care Behavioral Health (CCBH) – Provider Alert #2: Warm Handoff Authorization Process Change
This Provider Alert applies to all HealthChoices contracted Drug & Alcohol Case Manager (CM) and Certified Recovery Specialist (CRS) providers of warm handoff activities. The purpose is to alert these providers of warm handoff to the change in authorization process for these services.
Community Care Behavioral Health (CCBH) – Provider Alert #3: New Enrollments for ASAM 3.5 (Clinically Managed High-Intensity Residential Services) and 3.7 (Medically Monitored Intensive Inpatient Services)
This Provider Alert applies to all HealthChoices providers of ASAM 3.5 (Clinically Managed High-Intensity Residential Services) and 3.7 (Medically Monitored Intensive Inpatient Services). The purpose is to inform ASAM 3.5 and 3.7 providers of new PROMISe enrollment requirements.
Community Care Behavioral Health (CCBH) – Provider Alert #4: Access to the HealthChoices Claims (Provider OnLine) System is Changing
This Provider Alert applies to all HealthChoices and ALDA contracted providers. The purpose of this Provider Alert is to inform providers about a change to the login process for Provider Online.
Community Care Behavioral Health (CCBH) – Provider Alert #5: PA Department of Human Services (DHS) Reinstatement of Suspended Regulations, Bulletins and Other Guidance, Effective 04/01/2022
This Provider Alert applies to all HealthChoices contracted providers including agencies, independent practitioners and group practices. Community Care’s FWA Special Investigations Unit (SIU) is issuing this alert to remind providers that previously suspended regulatory, documentation, and compliance
requirements are to be reinstated effective April 1, 2022.
Community Care Behavioral Health (CCBH) – Provider Alert #6: Guidelines for the Delivery of Behavioral Health Services Through
Telehealth, April 1, 2022
This Provider Alert applies to all HealthChoices contracted providers including practitioners and facilities/agencies. Community Care’s FWA Special Investigations Unit (SIU) is issuing this alert to remind
providers of regulatory, documentation and compliance requirements related to the delivery of telehealth services following the reinstatement of regulations previously suspended under the state disaster emergency declaration. For further detail, please review Community Care Provider Alert PA Department of Human Services (DHS) Reinstatement of Suspended Regulations, Bulletins and Other Guidance, Effective April 1, 2022.
Community Care Behavioral Health (CCBH) – Provider Alert #7: Suspended Regulations Lift and Updates to Reinstated Authorization/Notification & Discharge Protocol
This Provider Alert applies to all HealthChoices contracted providers. The purpose is to alert all Community Care providers of the website Suspended Regulations Lift (pa.gov) informing Behavioral Health HealthChoices Primary Contractors, BH-MCOs, and behavioral health providers enrolled in MA per Act 21 of 2021, the suspension of various regulatory provisions under the state disaster emergency declaration will expire on March 31, 2022. A list of the regulations that were suspended in whole or in part and their current status is available within the link above. In addition to these regulations, some regulations have been reinstated. Those regulations are also designated in the list on the DHS website.
Magellan Behavioral Health of PA – Provider Notice: Provider Reminders – Please Review
Please share with colleagues as appropriate. Listed in this link are two provider alerts and a best practice document to review within your team. If you have any questions or concerns, please send an email to MBHofPA@magellanhealth.com.
