Behavioral Health Updates
Managed Care Organizations Updates as of 5/11/2022
Beacon Health Options of Pennsylvania – Staff Announcement
Beacon Health Options of Pennsylvania is pleased to announce that Dr. Deb Luther has accepted the position of CEO for Beacon Health Options of Pennsylvania. As you may know, Deb has been a respected member of the Pennsylvania team for the past five years. In her tenure with Beacon she has led many significant programmatic initiatives including: spearheading the conversion of over 30% of medical claims to value based and alternative payment arrangements; reduced costs through the creation of special needs program; developed a complex case management program driving improved clinical outcomes and medical spend efficiency; and led her team in achieving “Best in Class” status for low hospital readmission rates year over year.
Deb is a well-established servant leader who is respected in our market, across our colleagues, clients and stakeholders. Prior to her tenure at Beacon, Deb has held executive level positions with increasing responsibility within community-based, non-profit organizations. Deb’s local experience will ensure a deeply experienced and passionate leader with whom our clients and all of you can partner. Deb is a recognized expert in Trauma Informed Care, and her clinical expertise will ensure a continued member centric focus throughout all that we do. Deb is a licensed psychologist within the Commonwealth of PA, receiving her graduate degree from Bryn Mawr College in Developmental Psychology and a bachelor’s degree in Psychology from Rutgers University.
Please outreach to offer your congratulations to Deb on this well-deserved promotion.
Beacon Health Options of Pennsylvania – Updated Covered Services Grid
Beacon Health Options of Pennsylvania’s Covered Services Grid has been updated effective April 22, 2022. This grid lists all the service classes, modifiers, and service codes for authorizations and billing purposes. Changes/updates are highlighted in orange.
Please view the most recent version by visiting this page https://pa.beaconhealthoptions.com/providers/provider-manual/3-provider-covered-services-grid-hipaa-compliant/ and clicking on the text, “The most recent version”.
Please note that since this grid is updated regularly, it is advisable to save the above mentioned page and then click on the hyperlinked text to ensure you can get to the most recent version.
Beacon Health Options of Pennsylvania – Substance Use Disorder: Partial Hospitalization Services Request for Proposal (RFP) Serving HealthChoices Members of Mercer County
Deadline for submissions is Noon, Friday, June 10, 2022. Please view the RFP in its entirety here:
Substance Use Disorder: Partial Hospitalization Services
Submissions: Email a completed copy of the signed RFP to: RFP-RFI4BeaconPA@beaconhealthoptions.com. Please type the title of the RFP and your organization’s name in the subject line.
Community Behavioral Health (CBH) – Security and Network Operation Center (SOC/NOC) Solution Request For Proposal (RFP): Notification of the Right to Negotiate
CBH has released the Notification of the Right to Negotiate for the Security and Network Operation Center (SOC/NOC) Solution RFP.
Please click here to view the Notification.
Community Behavioral Health (CBH) – Provider Bulletin 22-09: Termination of GT Modifier
This Bulletin is to inform Providers that the GT modifier used to denote interactive audio and video telecommunication systems will be terminated from Provider contracts effective June 1, 2022.
Please click here to view the full Bulletin.
Community Behavioral Health (CBH) – Provider Notice: Revalidation and Enrollment
This Notice is to remind Providers that they must revalidate their Medicaid enrollment every five years.
Please click here to view the full Notice.
Community Behavioral Health (CBH) – Provider Notice: 2022 Pay-for-Performance Measures and Thresholds Webinar Schedule
This Notice is to inform Providers about upcoming webinars to review performance measures and thresholds that will be used to evaluate CBH Providers through Pay-for-Performance in 2022 for 2021 services.
Please click here to view the full Notice.
Community Behavioral Health (CBH) – CBH Tobacco Recovery Initiative Messaging
The CBH Tobacco Recovery Initiative seeks to address tobacco-related health disparities by ensuring that Philadelphians with behavioral health challenges have equitable access to evidence-based tobacco interventions. As part of the initiative, CBH encourages Providers to share the following snippet from a study about mental health and smoking cessation published by The BMJ when appropriate:
“A meta-analysis of 26 tobacco intervention studies found that smoking abstinence was significantly associated with decreased anxiety, depression, and stress, and improvements in overall mood and quality of life.”
For more information about the CBH Tobacco Recovery Initiative, please email Carol Larach, Director of Integrated Care Programs.
Magellan of PA – Provider Notice: Telehealth Updates
Please see this Provider Notice outlining Magellan’s Telehealth Updates for providers regarding claims submission.
Magellan of PA – Extended Acute Care (EAC) Request for Proposal (RFP)
Please see the Procurement Notice regarding the RFP for EAC.
Magellan of PA – Provider Notice: Telehealth Updates
Please see the Provider Notice regarding Telehealth Updates.
PerformCare – Intensive Behavioral Health Services (IBHS) Updates: IBHS and Applied Behavioral Analysis (ABA) Group and Referral Process
PerformCare has issued the following Intensive Behavioral Health Services (IBHS) notices:
- IBHS 22 103: IBHS Group and ABA Group (formerly Summer Therapeutic Activities Program ― STAP) (PDF) ― this provider notice serves to inform Individual and ABA IBHS providers and IBHS prescribers of changes made to the program formerly known as the Summer Therapeutic Activities Program (STAP).
- IBHS 22 104: IBHS Monitoring and Referral Process for Members with Primary Insurance (PDF) ― members identified as having active primary commercial insurance at the time a written order is received will not be following the IBHS monitoring and referral process. Instead, providers should retain these members (and their written orders) until staffing is available, or work with them and their commercial insurance company to identify another provider who accepts the member’s commercial insurance.
Access these and other notices on PerformCare’s website.
PerformCare – Inpatient Withdrawal Management Notification of Admission Program
The notice SU 22 101: Inpatient Withdrawal Management Notification of Admission Program (PDF) is to inform providers that PerformCare has decided to discontinue the current Withdrawal Management Notification of Admission Program for all in-network withdrawal management providers.
A detailed and comprehensive internal review of the process has been completed. As a result, there is no longer a need to provide an additional notification for members accessing the withdrawal management level of care.
Access these and other notices on PerformCare’s website.
Community Care Behavioral Health (CCBH) – Provider Newsletter
Please click to read CCBH Provider Newsletter – The Provider Line: Volume 10, Issue 1 – May 2022
