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Authors Posts by Richard Edley

Richard Edley

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Dr. Richard Edley is the lead executive for RCPA and is responsible for all aspects of operations and direction for the association. His professional career began in 1988 and most recently he was president and CEO of PerformCare/Community Behavioral HealthCare Network of Pennsylvania, Inc., a national, full-service, behavioral health managed care organization.

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The Provider Revalidation Webinar, with Jamie Buchenauer from DHS, was held on Wednesday, January 6. RCPA members and invited guests received answers to many of their questions regarding the revalidation process. Also on hand to offer input and answer questions were Ron Melusky and Chuck Frick from ODP, Lisa Page from OMHSAS, and Rosemary Cosgrove from OMAP. A recorded version of this webinar is available. The PowerPoint presentation is also available to download or print.

Other information supplied by DHS:

ODP email – [email protected]
OMHSAS email – [email protected]
OMAP email – [email protected]

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R371PI.pdf – Page 24 outlines the screening levels.

Link to the OMHSAS 14-03 bulletin regarding revalidation – http://www.dpw.state.pa.us/cs/groups/webcontent/documents/bulletin_admin/c_093853.pdf

ODP Provider Enrollment
General ODP enrollment programs
1-888-565-9435
Fax: 717-783-5141
Hours of operations: Monday – Friday, 8 AM – 5 PM
Office of Long Term Living (OLTL) Provider Call Center
Assists with nursing facilities, ICF/MRs, LIFE program billing questions, OLTL waivers billing and general enrollment questions
1-800-932-0939
Hours of operation: Monday – Thursday, 9 AM – 12 PM & 1 PM – 4 PM
Provider Enrollment – OMAP
Provides assistance regarding MA enrollment processes and MA enrollment file maintenance;
General MA enrollment questions
1-800-537-8862
Hours of operation: Monday – Friday, 8 AM-4:30 PM
 
Behavioral Health Provider Hotline – OMHSAS
Assistance with technical issues (billing/recipient eligibility) from BH provider, BH MCOs, counties etc.
1-800-433-4459
Hours of operation: Monday – Friday, 8:00 AM-3:45 PM

DHS Desk Reference –   http://www.dhs.pa.gov/cs/groups/webcontent/documents/webcopy/c_214048.pdf

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Time is running out; the deadline for revalidating is Thursday, March 24, 2016. Numerous RCPA members have already gone through this process, but it appears that large numbers of providers have not yet done so. A special provider revalidation webinar will be held by RCPA on Wednesday, January 6 at 10:00 am. Jamie Buchenauer, from the Department of Human Services, will be presenting the webcast.

Continue

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As you have heard, registration is open for the 2015 RCPA Conference at Seven Springs, October 6 – 9. We hope you have plans to join us; the schedule is filled with excellent speakers.  We also know that you are being asked to register and pay for the conference at a time when many are feeling the tremendous negative impact of the delayed state budget.

For this reason, RCPA is offering full provider members the opportunity to register for the conference now and defer payment until after the state budget is passed, or an interim stopgap measure is in place (an emergency solution for which we continue to push). All attendees from full provider members are eligible for this offer.

To take advantage of this conference payment deferral offer, please complete a print version of the conference registration form. Do not register electronically through the online system, which requires payment to be collected. Rather, print and complete the form, noting your request for this deferral, and send it to Tieanna Lloyd in the RCPA office via fax to 717-364-3287 or email. RCPA will then invoice members 90 days after the budget is approved or a stopgap measure is in place to allow time for cash flow to stabilize.

We look forward to seeing you in October!

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Recently Senate Bill 1604, Transition to Independence, was introduced in Washington by Senator Grassley (R-IA), and co-sponsored by Senator Casey (D-PA). While it immediately raised red flags for vocational providers, after a careful read and review with ACCSES (one of our national partner associations), we do believe this legislation can be helpful – provided some modifications are made. The RCPA summary and response to the bill, which we were able to present recently to Senator Casey’s lead staff in DC, is available online. Review the actual bill here.

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Below is the RFI to which RCPA submitted comments, which can be seen here.

From: DHS STAKEHOLDERS On Behalf Of HS, Secretary’s Office
Sent: Friday, May 29, 2015 2:38 PM
Subject: [DHS-STAKEHOLDERS] HealthChoices RFI Issued

Dear Stakeholders:

Today the Department of Human Services (DHS) is releasing a Request for Information (RFI) and we want your input. We are soliciting information that will assist with the development of a Request for Proposal (RFP) for a HealthChoices Physical Health services procurement. The overall goal of which is to explore new innovative approaches to the delivery and payment of health care services that reward quality and increase access within the Medicaid program.

HealthChoices is the name of Pennsylvania’s managed care programs for Medical Assistance (MA) recipients. Through Managed Care Organizations (MCO), recipients receive quality medical care and timely access to all appropriate physical health services, whether the services are delivered on an inpatient or outpatient basis. DHS has three simple goals for HealthChoices:  improve access to health care services for MA recipients, improve the quality of health care available to MA recipients, and stabilize our MA spending.

As DHS looks to make improvements to Pennsylvania’s HealthChoices program, we are interested in ideas and approaches we should consider to accomplish the following:

  • Promote the achievement of the Triple AIM (better health, better care, lower cost)
  • Improve care coordination between physical and behavioral health services
  • Promote the expansion of value based purchasing of health care services
  • Promote the expansion of team based approaches to care delivery (for example- patient centered care medical homes)
  • Promote community based public health initiatives
  • Increase consumer access to needed services, especially in rural and underserved areas of the Commonwealth
  • Improve the efficiency of the HealthChoices program
  • Improve the provider experience with the HealthChoices program

I encourage you to provide feedback by close of business on June 26, 2015. Please submit your responses electronically to [email protected], and thank you, in advance, for taking the time to provide your valuable input.

With your unique perspectives and input, we look forward to improving a system that provides quality services for our most vulnerable Pennsylvanians.

The RFI is available at www.emarketplace.state.pa.us/Solicitations.aspx?SID=DHS%20HC%20RFI%202015.

 

Sincerely,

Ted Dallas
Acting Secretary
Department of Human Services

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