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Mental Health

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Photo by Markus Winkler on Unsplash

The Medical Assistance Bulletin 08-24-04, issued by the Department of Human Services (DHS) Office of Medical Assistance Programs (OMAP), provides updates to the PROMISe (Provider Reimbursement and Operations Management Information System) Provider Handbook 837, Professional/CMS-1500 Claim Form, specifically focusing on Appendix E – FQHC/RHC (Federally Qualified Health Center/Rural Health Center) Handbook. Released on March 1, 2024, the bulletin outlines revisions to Federal and State requirements for FQHCs and RHCs in Pennsylvania participating in the Medical Assistance (MA) Program.

Notable changes include the addition of pharmacists and licensed dietician-nutritionists as eligible practitioners for billable encounters starting March 1, 2024. The revision addresses group therapy encounters and introduces guidelines for telehealth, telemedicine, and teledentistry in FQHC and RHC services. A new section on alternative payment methodologies is included, along with updates to the MA Cost Reporting and Wraparound Reporting sections. The Centers for Medicare & Medicaid Services’ clarification designates “hospital” as an allowable place of service for FQHC and RHC services. Providers are encouraged to review the revised handbook for detailed information on these changes.

If you have any questions, please contact RCPA Policy Director Jim Sharp.

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Message from The Centers for Medicare & Medicaid Services (CMS):

The Centers for Medicare & Medicaid Services (CMS) is continuing to monitor and assess the impact that the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare has had on all provider and supplier types. Today, CMS is announcing that, in addition to considering applications for accelerated payments for Medicare Part A providers, we will also be considering applications for advance payments for Part B suppliers.

Over the last few days, we have continued to meet with health plans, providers and suppliers to hear about their most pressing concerns. As announced previously, we have directed our Medicare Administrative Contractors (MAC) to expedite actions needed for providers and suppliers to change the clearinghouse they use and to accept paper claims if providers need to use that method. We will continue to respond to provider and supplier inquiries regarding MAC processes.

CMS also recognizes that many Medicaid providers are deeply affected by the impact of the cyberattack. We are continuing to work closely with States and are urging Medicaid managed care plans to make prospective payments to impacted providers, as well.

All MACs will provide public information on how to submit a request for a Medicare accelerated or advance payment on their websites as early as today, Saturday, March 9.

CMS looks forward to continuing to support the provider community during this difficult situation. All affected providers should reach out to health plans and other payers for assistance with the disruption. CMS has encouraged Medicare Advantage (MA) organizations to offer advance funding to providers affected by this cyberattack. The rules governing CMS’s payments to MA organizations and Part D sponsors remain unchanged. Please note that nothing in this statement speaks to the arrangements between MA organizations or Part D sponsors and their contracted providers or facilities.

If you have any questions, please contact Fady Sahhar.

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As noted in a previous alert from the Department of Human Services (DHS), the Department of Health and Human Services (HHS) has also been providing updates regarding the recent cybersecurity incident that impacted Change Healthcare (a unit of UnitedHealth Group). HHS has noted that their first priority is to help coordinate efforts to avoid disruptions to care throughout the health care system.

On March 5, 2024, HHS announced immediate steps that the Centers for Medicare and Medicaid Services (CMS) is taking to assist providers to continue to serve patients. CMS will continue to communicate with the health care community and assist, as appropriate. Providers should continue to work with all their payers for the latest updates on how to receive timely payments.

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Advocate for yourselves and others by meeting with legislators directly! Take the opportunity to join RCPA as we hold our annual Capitol Day this year on Tuesday, March 19. We will hold a press conference in the Main Rotunda between 10:30 am – 11:30 am, which will tentatively include speakers such as:

  • Representative Dan Miller;
  • Representative Stephen Kinsey;
  • Representative Doyle Heffley;
  • Senator Art Haywood; and
  • Senator Frank Farry.

You can register for our Capitol Day press conference by contacting Allison Brognia or Christine Tartaglione with the number of anticipated attendees. RCPA requests that members schedule appointments with their Senate and House legislators directly to discuss the state budget, legislation, and regulations after our press conference.

We ask that you please use RCPA’s legislative priorities one-pager during your legislative visits. As an additional resource, members can visit the Pennsylvania Capitol website to locate parking and view maps of the building. If you have questions regarding our 2024 Capitol Day, please contact Jack Phillips.

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The Department of Human Services (DHS) has shared several available resources to address providers’ concerns regarding the Change Healthcare outage. The system remains unavailable due to a current cyber-attack. You can read the full press release, which details resources and short-term solutions.

If you have any questions, please contact Fady Sahhar.

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AID In PA is accepting applicants for its April 2024 TRAIN program. This free training program was developed for therapists, counselors, and clinical social workers who already have experience working with clients who have an ID/A diagnosis and are looking to gain knowledge and skills related to trauma therapy.

Individuals with intellectual disabilities or autism are at an increased risk of experiencing trauma; however, few therapists are skilled in both trauma and ID/A support. To bridge this gap, psychologists with the ASERT team created the TRAIN program – 12 weeks of self-guided learnings and live webinars to equip therapists across Pennsylvania currently working with the ID/A populations with the skills to support clients through trauma experiences.

Participants have direct supervision from psychologists with backgrounds in both trauma and ID/A and interactive discussions with fellow participants, as well as receive Continuing Education (CE) credits provided through the National Board for Certified Counselors (NBCC) upon completion of the program. You must currently be licensed and provide 1:1 talk therapy sessions to adult clients at the moment to qualify for this course and participate in the case consultation presentations.

The TRAIN program focuses on:

  • Trauma-focused mental healthcare
  • Types and prevalence of trauma
  • Disclosures of abuse
  • Ethical principles of reporting abuse
  • Expression of trauma
  • Assessing trauma and trauma-focused interviews
  • Psychoeducation
  • Trauma response management strategies
  • Trauma processing
  • Resiliency and self-care

Course Structure:
12 weeks in total, comprised of 3 modules that are each 4 weeks long. The first three weeks are self-paced learning courses that are assigned through AID in PA’s online Learning Management System. The fourth week of each module is an hour and a half interactive discussion with the other group members and instructors. These live sessions are required and are held from 9:00 am – 10:30 am on the following dates:

  • 4/9: Pre-training live session
  • 5/14: Module 1 live session
  • 6/11: Module 2 live session
  • 7/9: Module 3 live session
  • 8/13 – 10/29: Weekly Case Consultation Calls (8:00 am – 9:00 am, Tuesdays)

Case Consultations

After the initial 12 weeks, there is a short break, followed by a second 12-week session that consists of weekly one-hour case consultations. Each participant is expected to present a case from a current patient and receive feedback/information from other participants and the instructors. Participants need to join at least 6 of the 12 weekly case consultation calls, although it’s encouraged to attend all. If you are not currently seeing patients or are not in a capacity to present any cases, this may not be the right program for you.

Cost and CE Credits:
It is free to participate, and if you complete the entire program, you will receive 13.5 CE credits through the NBCC.

If you believe this program is appropriate for you and can commit to the requirements, please complete the survey by March 25, 2024. This is on a first come, first serve basis, so don’t delay! If you cannot attend the Spring session, the program will also be available in Fall 2024.

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Image by photosforyou from Pixabay

RCPA member Achieva and the Pennsylvania Health Law Project are hosting a webinar titled “Understanding Medicaid Home and Community-Based Waivers for People With Disabilities” from 10 am – 12 pm on Tuesday, April 2, 2024. Led by Janice Meinert from the Pennsylvania Health Law Project, the webinar will explore Pennsylvania’s Medicaid Home & Community-Based Waiver programs. Topics include eligibility criteria, the application process, available services, and annual waiver clinical eligibility redeterminations. For more details and registration, visit Achieva’s website. This project receives funding from the Pennsylvania Developmental Disabilities Council. For accessibility accommodations, please contact Patty Yerina. If you have additional questions, you may contact Jim Sharp, RCPA Mental Health Policy Director.

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