Behavioral Health Updates
From PA Behavioral Health Managed Care Organizations (MCO’s)
Community Behavioral Health (CBH) – Provider Bulletin 21-07: Utilization Management: Psychiatric Residential Treatment Facilities (PRTF)
This bulletin changes Community Behavioral Health (CBH) initial PRTF requests from 120 to 30 days — still requiring a packet submission. However, a packet submission is no longer necessary for Continued Authorization Requests. Continued Authorization has also changed from 120 to 30 days. Determination will be made at monthly interagency meetings, during which a psychiatrist must sign off on documentation. Providers must keep this interagency meeting documentation on file. Additionally, Comprehensive Biopsychosocial Evaluations/Re-evaluations (CBE/CBR) will need to be submitted every 6 months.
Community Behavioral Health (CBH) – Transition Plan for COVID-19 Alternative Payment Arrangement (APA)
This Bulletin serves as official notification regarding the transition plan for those service providers who are currently on the COVID-19 APA.
Beacon Health Options – Expectations for Safe Discharge from Residential Care Settings, Provider Alert # 5.21.7
This provider alert from Beacon Health Options states that a discharge from a facility is not the end of treatment but rather the transition to the next level of recovery. It outlines the expectations from a youth’s preliminary discharge planning from the actual discharge planning, transportation and shelter, high risk windows, and after-care information.
Community Care Behavioral Health Organization (CCBH) – Provider Alert # 15
This alert is specific to CCBH North Central contracts.
Magellan Behavioral Health of PA – Provider Performance Standards
In order to support providers regarding best practice and quality improvement, the performance standards for each level of care are now on Magellan’s website. These performance standards do not replace regulations.