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Authors Posts by Jack Phillips

Jack Phillips

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Mr. Phillips is responsible to assist the association with health policy, which primarily includes member communication and advocacy with the Governor’s office, General Assembly, and state regulatory agencies. Mr. Phillips was most recently at the Pennsylvania Department of State as Director of Legislative Affairs.

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FOR IMMEDIATE RELEASE
July 16, 2020

Harrisburg, PA – The Wolf Administration today announced that the Department of Human Services (DHS) will allow for additional Medicaid providers to enroll as an opioid use disorder Center of Excellence (COE). Since 2016, 45 COEs have transformed the way care is provided to people with opioid use disorder and have helped more than 30,000 Pennsylvanians access comprehensive, whole-person treatment that makes recovery possible.

“Connecting people to treatment that addresses both their opioid use disorder as well as physical and behavioral health needs is critical in saving lives and fighting the opioid epidemic,” said Governor Tom Wolf. “Centers of Excellence have proven themselves to be a critical part of our efforts to improve treatment options. By taking the next step in sustaining this program, individuals with opioid use disorder will have more access to treatment in their communities.”

DHS has announced a process for providers to enroll in the commonwealth’s Medicaid program as a COE specialty type provider. Providers who bear this specialty designation will be eligible to bill MCOs for care management services. This will allow DHS to continue to hold COEs to elevated standards by ensuring fidelity to the COE care model while also allowing other qualified providers to attain the distinction of COE.

“DHS is proud to oversee the development of the COE program, and we remain committed to helping the people at the center of this crisis,” said DHS Secretary Teresa Miller. “COEs are on the front lines in the fight against the opioid epidemic, and we want to be sure we are doing everything we can to support them. In continuing the program, DHS is taking the next step to cement the COE model as a standard of care for people with opioid use disorder.”

The COE program was established in 2016 through grants awarded to 45 providers throughout the commonwealth in order to increase access to medication assisted treatment, improve coordination of behavioral and physical healthcare for patients, and use community-based care management teams to keep people engaged in treatment across the continuum of care toward recovery.

COEs are designed to take care of the whole person by incorporating opioid use disorder treatment with physical, mental, and behavioral health treatment, as well as recovery support services. COEs use a blend of licensed and unlicensed, clinical and non-clinical staff to coordinate the care needs of an individual to ensure that their treatment and non-treatment needs are met.

The COEs’ care managers work to keep people with an opioid use disorder engaged in treatment by coordinating follow-up care and community supports that are vital to maintaining recovery. COEs work as a hub-and-spoke network, with the designated center serving as the hub. The spokes can include primary care practices, the criminal justice system, emergency departments, social services providers, other treatment providers, and other referral sources.

A study by the University of Pittsburgh found that COEs save lives by increasing access to medication assisted treatment and keeping people engaged in that treatment. Before receiving services from a COE, 46 percent of patients received medication assisted treatment, but after receiving COE services, nearly 73 percent of those patients were receiving treatment. The study also found that people who receive services from a COE are less likely to be admitted to the emergency room or the hospital due to an overdose. There is also a significant difference in how long a patient stays engaged in treatment; those who receive services from a COE stay in treatment longer than those who do not.

Applications for Medicaid providers to be enrolled as a COE may be submitted any time. Beginning January 1, 2021, only providers with the COE specialty type will receive payment for COE-type care management services. More information and the application for Medicaid providers to become a COE can be found here.

MEDIA CONTACT: Erin James, [email protected]

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The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services (HHS or Department), announces the adoption of the revised Confidentiality of Substance Use Disorder Patient Records regulation, 42 CFR Part 2. The adoption of this revised rule represents a historic step in expanding care coordination and quality through the Deputy Secretary’s Regulatory Sprint to Coordinated Care.

“This reform will help make it easier for Americans to discuss substance use disorders with their doctors, seek treatment, and find the road to recovery,” said HHS Secretary Alex Azar. “President Trump has made the availability of treatment for Americans with substance use disorders, including opioid use disorder, a priority. Thanks to the valuable input of stakeholders, our final rule will make it easier for Americans to seek and receive treatment while lifting burdens on providers and maintaining important privacy protections.”

The new rule advances the integration of healthcare for individuals with substance use disorders while maintaining critical privacy and confidentiality protections. Under Part 2, a federally assisted substance use disorder program may only disclose patient identifying information with the individual’s written consent, as part of a court order, or under a few limited exceptions. Health care providers, with patients’ consent, will be able to more easily conduct such activities as quality improvement, claims management, patient safety, training, and program integrity efforts.

“Coordinated care is a vital piece of President Trump’s vision for a patient-centric healthcare system, and regulatory reform is a key step toward promoting more coordinated care,” said HHS Deputy Secretary Eric Hargan. “As part of our Regulatory Sprint to Coordinated Care, these changes are just the beginning of a comprehensive agenda for reforming regulations that govern the delivery and financing of American healthcare, with the ultimate goal of better care, and better health, at a lower cost.”

“The adoption of this rule means Americans will be better able to receive integrated and coordinated care in the treatment of their substance use disorders,” said HHS Assistant Secretary for Mental Health and Substance Use Elinore F. McCance-Katz, MD, PhD, the head of SAMHSA. “We are grateful to the individuals and organizations that contributed their input to the rule-making process. This is great news for our nation’s families and communities.”

“Modernizing 42 CFR Part 2 will strengthen the nation’s efforts to reduce opioid misuse and abuse and to support patients and their families confronting substance use disorders,” the Assistant Secretary said. “The rule will make it easier for primary care clinicians to treat individuals with substance use disorders.”

“We need an all-hands-on-deck approach to treating substance use disorders,” said McCance-Katz. “We must do all we can to ensure the greatest access and availability to care for individuals living with substance use disorders. Although well-intentioned, the non-disclosure of critical, lifesaving information the previous rule permitted is itself stigmatizing.”

The ease of sharing information, with patient consent, among providers will enable better, higher-quality care for those with substance use disorders. This serves as an important milestone in further aligning 42 CFR Part 2 and the Health Insurance Portability and Accountability Act of 1996 (or HIPAA) regulations.

To view a list of the changes in the final rule, please click here.

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Recently, DDAP hosted live webinars on the alignment of services within the 3.0 levels of care (3.1, 3.5 & 3.7) with The ASAM Criteria, 2013. The recorded version of this presentation, along with the PowerPoint slides are now available on the ASAM Transition page on the DDAP website.

Questions regarding alignment of 3.0 services to the ASAM Criteria may be submitted by email for inclusion in WebEx Q&A sessions to be held on July 27 and July 28 (see Rollout Schedule on DDAP website) and an FAQ that will be made available around the same time.

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FOR IMMEDIATE RELEASE
July 14, 2020  

Harrisburg, PA – The Department of Human Services (DHS) today announced applicants selected to participate in the Regional Response Health Collaboration Program (RRHCP). The RRHCP will directly support COVID-19 continued readiness and response planning in long-term residential care facilities, improve quality of care related to infection prevention, expand COVID-19 testing to include asymptomatic staff and residents in facilities, and facilitate continuity of care and services provided by long-term care facilities in an attempt to mitigate the risk of spread of COVID-19 to staff or residents. This effort is a collaboration between DHS, the Pennsylvania Department of Health, Centers for Disease Control and Prevention, and the Pennsylvania Emergency Management Agency.

“Long-term care providers provide a home and care for some of the most vulnerable Pennsylvanians, and COVID-19 remains a serious threat. The Wolf Administration will continue to do all we can to support our long-term care providers during this pandemic and beyond,” said DHS Secretary Teresa Miller. “The Regional Response Health Collaboration Program will build on accomplishments thus far and be a resource to long-term care facilities as COVID-19 evolves. Through these collaboratives, long-term care facilities will have a network to learn, respond, and prepare for what is ahead in the fight against COVID-19.”

More than 45,000 Pennsylvanians live in more than 1,200 personal care homes and assisted living residences, and more than 80,000 residents live in 693 skilled nursing facilities throughout the commonwealth. These residents are often some of the most vulnerable and susceptible to COVID-19 due to age, presence of existing health conditions that may lead to complications, and the congregate nature of these facilities.

The RRHCP will provide clinical, operational, and administrative support to protect residents in long-term care facilities from COVID-19. It will help those facilities implement best practices in infection control, implement contact tracing programs in facilities, support clinical care through on-site and telemedicine services, and provide remote monitoring and consultation with physicians. The RRHCP will assist in identifying alternate care arrangements for patients no longer requiring acute care but needing assistance in returning to their long-term care facilities.

Selected grantees will be awarded $175 million collectively through funding approved by the General Assembly. Funding for the RRHCP is divided regionally by the long-term care facility census in each region. Applicants selected and the regions they will serve include:

  1. Southeast Region ($65.8 million):
    1. Thomas Jefferson University
    2. University of Pennsylvania
  1. Northeast Region ($24 million):
    1. Geisinger Clinic
    2. Lehigh Valley Hospital, Inc
  1. Southcentral Region ($22.9 million):
    1. The Pennsylvania State University
  1. Northcentral Region ($9.8 million):
    1. Geisinger Clinic
  1. Southwest Region ($38.9 million):
    1. UPMC Community Provider Services
  1. Northwest Region ($13.6 million):
    1. LECOM Health
    2. UPMC Community Provider Services

The program will also support facilities as they enhance testing capability for both individuals in care and staff under the expanded statewide testing order released last month. The RRHCP partners will be a critical resource in implementing this testing order for facilities that do not have dedicated clinical staff.

The RRHCP is based on the Educational Support and Clinical Coaching Program (ESCCP), a learning network that provided technical assistance and educational support to long-term care facilities in light of the current pandemic. Unlike the ESCCP, which operated on a voluntary basis, the RRHCP will operate under grant agreements through December 1, 2020.

Visit the Pennsylvania Department of Health’s dedicated Coronavirus webpage for the most up-to-date information regarding COVID-19.

Guidance to DHS providers related to COVID-19 is available here.

MEDIA CONTACT: Erin James, [email protected]

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FOR IMMEDIATE RELEASE
July 8, 2020  

Harrisburg, PA – The Department of Human Services today announced applicants selected through a Request for Applications (RFA) for Pennsylvania’s HealthChoices program, the Medicaid physical health managed care program that provides healthcare coverage to more than 2.6 million people.  DHS is unable to move forward with the selections, however, due to the pendency of protests.

“Pennsylvania’s HealthChoices program is a lifeline for more than 2.6 million Pennsylvanians covered under the Medical Assistance program. This program not only helps with essential health services like doctors’ visits, routine and preventive care, and access to prescriptions necessary to live a healthy life – it also is an opportunity to greatly impact participants’ social and economic trajectory,” said Human Services Secretary Teresa Miller. “As one of our farthest-reaching and highest-cost programs, we are committed to constant quality improvement that focuses on participants’ health and well-being, and innovative, outcomes-driven efficiencies.”

Applicants were selected through a competitive procurement that evaluated applicants’ soundness of approach, personnel qualifications and staffing and prior experience and performance. More information about evaluation criteria can be found in the RFA. Applicants selected were the top scoring applicants for their zone. Selected applicants for each service zone are as follows:

  • Southeast: Geisinger Health Plan, Health Partners Plans, UnitedHealthCare, UPMC for You, and Vista Health Plan (Keystone First);
  • Lehigh/Capital: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas);
  • Northeast: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas);
  • Northwest: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas); and,
  • Southwest: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas).

At the time of this release, two non-selected applicants filed protests of their non-selection.  Due to the filing of these protests, DHS may not take any further action on the procurement until the protests are resolved.

For more information on the HealthChoices procurement and requirements of the RFA, view the RFA here.

MEDIA CONTACT: Erin James, [email protected]

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