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Authors Posts by Jason Snyder

Jason Snyder

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Photo by Markus Winkler from Pexels

On May 1, Beacon Health Options of Pennsylvania, Inc., the behavioral health Medicaid managed care organization serving members in Western Pennsylvania, is becoming Carelon Health of Pennsylvania, Inc.

In June 2022, Beacon’s parent company Elevance Health announced the launch of Carelon, a new healthcare services brand. The name Carelon is derived from the word “care” and suffix “-lon,” which means full and complete. Beacon is joining with other businesses across the nation under the Carelon brand to provide ongoing healthcare services to support whole-person health.

Provider contracts, reimbursement, policies, and points of contact will all remain the same. All existing phone numbers, emails, websites, and portals will redirect to the Carelon-branded locations with no action required from providers.

Providers with questions can call 877-615-8503.

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Today, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) issued Licensing Alert 01-2023 to detail continued expansion of the availability of take-home methadone through the ongoing suspension of 28 Pa. Code § 715.16(e).

On Feb. 9, 2023, the US Department of Health and Human Services announced the final renewal of the federal public health emergency (PHE) declaration. The PHE will not be renewed when it expires on May 11, 2023. Both the federal and Pennsylvania Department of Drug and Alcohol Programs’ (DDAP) expansions of the availability of take-home methadone will remain in place until May 11, 2024. DDAP will keep the field aware of developments at the federal level that could extend flexibilities beyond May 2024. Read the full alert and background information on the regulatory suspension.

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With the passage of the 2023 federal omnibus bill, which included the Mainstreaming Addiction Treatment Act, Congress eliminated the “DATA-Waiver Program.” The DATA-waiver is commonly referred to as the X-waiver.

Now, the requirement to have an X-waiver from the Drug Enforcement Agency (DEA) and Substance Abuse and Mental Health Services Administration (SAMSHA) to prescribe buprenorphine, a Schedule III narcotic, for opioid use disorder (OUD) has been removed. Any prescriber with a general DEA license can prescribe the medication.

DDAP is reminding DEA registrants of the following:

  • A DATA-Waiver registration is no longer required to treat patients with buprenorphine for OUD.
  • Going forward, all prescriptions for buprenorphine only require a standard DEA registration number. The previously used DATA-Waiver registration numbers are no longer needed for any prescription.
  • There are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine.
  • In Pennsylvania, no current state laws or regulations prohibit practitioners from adopting this change.

Separately, the Act also introduced new training requirements for all prescribers. These requirements will go into effect on June 21, 2023. The DEA and SAMHSA are actively working to provide further guidance and DEA will follow up with additional information on these requirements. Please contact the DEA’s Diversion Control Division Policy Section for additional guidance.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) is seeking provider input for a brief workforce survey. DDAP is interested in hearing providers’ perspective on which jobs and positions are in short supply or understaffed, the challenges providers face, attempts to address them, and solutions that DDAP should consider. Responses will help inform DDAP’s regulatory reform efforts.

The survey can be taken here.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) today announced almost $9 million in grant funding awarded to four Single County Authorities (SCAs) to establish or expand crisis stabilization services for individuals with co-occurring mental health and substance use disorders (SUD). The funding is part of the more than $17 million allocated last year to DDAP by the General Assembly from Pennsylvania’s share of a total opioid settlement of $1.2 billion reached with three distributors and manufacturer Johnson & Johnson.

Crisis stabilization services include assessment and stabilization of acute physical and psychiatric symptoms, which may include medical management and behavioral interventions, induction on medications for opioid use disorder, level of care assessments, short-term stays, and connections to supportive services.

Grants up to $3 million each will be awarded to the following four SCAs, serving residents throughout seven counties:

  • Dauphin County Drug and Alcohol Services;
  • Bucks County Drug and Alcohol Commission;
  • Delaware County Department of Human Services; and
  • Blair County Drug and Alcohol Program.

The funding can be applied toward a range of activities, including construction and building infrastructure, staffing, and programming. DDAP’s goal in offering this funding opportunity is to provide an additional mechanism for counties to invest in infrastructure, staffing, programming, and other necessary components to establish or expand crisis stabilization services.

Eligible grantees were chosen based on information presented in their applications demonstrating their capacity to recognize and manage individuals presenting with a wide range of SUD-related symptoms, mental health disorders, and developmental disabilities.

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Effective January 1, Act 111 of 2022 amended the Controlled Substance, Drug, Device, and Cosmetic Act of 1972 to no longer define fentanyl test strips (FTS) as drug paraphernalia in Pennsylvania, making them a legal, low-cost method to prevent drug overdoses.

The Pennsylvania Departments of Drug and Alcohol Programs, Health, and Human Services, and the Pennsylvania Commission on Crime and Delinquency have created a survey to gauge interest in and demand for FTS as the administration works to make them available at no cost across the commonwealth. The survey contains questions on currently available trainings/materials, preferred brands, and current distribution methods and takes about five minutes to complete.

Organizations are urged to complete the survey here and to distribute the link to others.

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Hole torn in a dollar bill with medicaid text

Because of the continuous coverage requirement, states were able to use additional money from the federal government during the federal public health emergency (PHE) for health care programs like Medicaid if they kept people covered. Therefore, Pennsylvanians did not lose their Medicaid/Medical Assistance (MA) or CHIP coverage if their income changed or they did not complete a renewal during the PHE.

However, starting April 1, 2023, Pennsylvania and other states will have to start disenrolling people if households are ineligible for MA at the time of their renewal or do not complete their renewal. The Pennsylvania Department of Human Services (DHS) will have to return to normal renewal processing procedures for Pennsylvanians enrolled in MA and the CHIP. Renewals will be completed over 12 months. Everyone with MA or CHIP coverage will need to submit a renewal to see if they are still eligible.

In Pennsylvania, approximately 3.5 million people rely on Medicaid. Last year, it was estimated that about 500,000 of those would lose coverage when the continuous coverage requirement ended, creating access issues for individuals and exacerbating financial challenges for providers.

The Pennsylvania Department of Human Services has created an online resource, including a stakeholder toolkit as well as a guide on how to become a helper, that provides resources for groups like providers to communicate ways for Pennsylvanians who receive MA or CHIP coverage to continue their coverage.

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On January 30, the Biden Administration announced that the COVID-19 national emergency and public health emergency (PHE) will both expire on Thursday, May 11, 2023. Under Act 30 of 2022, the Department of Drug and Alcohol Programs’ (DDAP) regulatory suspensions that are “related to federal exemptions granted under the federal public health emergency declaration” were extended until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.” In other words, Act 30 aligned the timing for DDAP’s regulatory suspensions with the deadline for flexibilities granted by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) — not with the deadline of the PHE itself.

Below is a description of each currently suspended regulation and what DDAP knows about efforts to make these changes permanent at the federal level.

Methadone Take-Home Supply

Current regulatory suspension: Under the federal PHE, SAMHSA is currently allowing up to 28 days of take-home medications for patients on stable dosages, as deemed appropriate by their physician. DDAP’s regulation 28 Pa. Code § 715.16(e) (prohibiting narcotic treatment programs [NTPs] from permitting a patient to receive more than a two-week take-home supply) is currently suspended under Act 30.

Expiration of the PHE: In November 2021, SAMHSA announced that the methadone take-home flexibilities will be extended for one year after the end of the PHE (now May 11, 2024). DDAP submitted its written concurrence with this exemption in February 2022. Furthermore, SAMHSA issued a notice of proposed rulemaking in December 2022 that proposes modifying regulations related to methadone take-home supply up to 28 days, among other changes.

Buprenorphine Telehealth

Current regulatory suspension: Under the federal PHE, SAMHSA and the DEA are currently allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth. DDAP has two related regulations that are currently suspended under Act 30:

  • 28 Pa. Code § 715.9(a)(4): Requires NTPs to make a face-to-face determination before admission to treatment for those clients who will receive medication to treat opioid use disorder (OUD).
  • 28 Pa. Code § 715.6(d): Requires NTPs to have narcotic treatment physician services onsite.

Expiration of the PHE: In March 2022, the DEA announced that it is currently working to make its teleprescribing regulations permanent. In June 2022, SAMHSA announced to State Opioid Treatment Authorities that flexibilities around telehealth evaluations before buprenorphine treatment at NTPs, specifically, will be extended for one year after the end of the PHE (now May 11, 2024).

SAMHSA and DEA have made clear that support for these flexibilities has been overwhelmingly positive, decreased stigma associated with OUD, and enhanced care for patients. Given the information above, DDAP does not anticipate any lapses in these flexibilities at either the federal or state level but will continue to provide updates and guidance as available.

Resources

If you have any further questions, please contact the Bureau of Program Licensure at (717) 783-8675 or via email.

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Photo by Markus Winkler from Pexels

Former Department of Drug and Alcohol Programs (DDAP) Secretary Jennifer Smith has been named Deputy Secretary for the Office of Mental Health and Substance Abuse Services (OMHSAS). As DDAP Secretary, Smith led DDAP’s efforts to fulfill its mission of engaging and coordinating the commonwealth’s efforts to prevent and reduce substance use disorder and problem gambling and to promote recovery. Smith was integral in the formation and implementation of Pennsylvania’s first licensure program for recovery houses as well as leading Pennsylvania’s treatment system transition away from the Pennsylvania Client Placement Criteria to ASAM Criteria.

Dr. Dale Adair, who has served as Acting Deputy Secretary for OMHSAS, will continue to serve as the Chief Psychiatric Officer for OMHSAS.

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