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Tags Posts tagged with "Bulletin"

Bulletin

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Guidance - wooden signpost, roadsign with one arrow

The Pennsylvania Department of Human Services (DHS) has released DHS-26-01 Complex Needs Planning for Children, Youth, and Young Adults Through Age 21. This bulletin updates guidance provided in 14-Bul-110 Complex Case Planning for Children and Youth Under Age 21. The guidance clarifies the referral process, roles, and responsibilities; offers the availability of technical assistance; and describes the benefit of technical assistance to the agencies in the human services systems that support children, youth, young adults through age 21 and their families and/or caregivers.

This bulletin, an online referral form, and suggested resources (tools/templates) are now posted on the DHS website.

If you have questions regarding this bulletin, the online referral form, or the suggested resources, please contact DHS electronically.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has notified counties of the finalization of the Cost Center Bulletin, which states:

The purpose of this bulletin is to accommodate data reporting for the changing and growing array of services provided by county Mental Health Administrations using federal, state, and county funding. This bulletin establishes new cost centers, updates existing cost centers, and combines existing cost centers. It enables appropriate reporting and monitoring of expenditure and service information for a number of community mental health services. The reporting of county mental health program costs must conform to the cost centers identified in this bulletin beginning with the County Human Service Plans and Income and Expenditures Report for State Fiscal Year 2026/2027.

The complete bulletin is available here. If you have any questions, please contact OMHSAS via email or RCPA COO and Mental Health Policy Director Jim Sharp.

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Photo by Markus Winkler on Unsplash

The Office of Mental Health and Substance Abuse (OMHSAS) is issuing a correction to the OMHSAS-26-01 Payment for Psychiatric Rehabilitation Services bulletin that was originally issued on February 6, 2026.

This correction addresses a typo in the service description for Psychiatric Rehab Mobile – Group. The previous bulletin incorrectly listed the group size limit as two (2). The correct maximum group size is no more than five (5) individuals in alignment with the licensing standard in § 5230.54 (a)(2). This update corrects the group size limit to five in the service description for procedure code H0036.

Please refer to the updated version of the Payment for Psychiatric Rehabilitation Services.

If you have any questions, please contact OMHSAS for further clarification. Members may also direct questions to RCPA COO and Mental Health Policy Director Jim Sharp.

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The Office of Developmental Programs (ODP) is anticipating the release of a new bulletin on the Appeal and Fair Hearing process. ODP is scheduling this webinar for individuals, families, and Supports Coordinators (SC). This webinar will explain the information that is included in the bulletin, the process of appealing a decision, and what a Fair Hearing is.

This webinar was developed for individuals and families, but we encourage SCs to attend so they understand the Appeal and Fair Hearing process. Supports Coordinators are responsible for understanding this process so they can assist their individuals and families when they have questions. There will be time throughout the webinar for individuals and families or SCs to ask questions directly to ODP staff about the topic.

Who should attend?
Individuals, Families, and Supports Coordinators

Date and Time:
Friday, May 1, 2026
11:00 am – 12:30 pm

Register Here

ODP encourages professionals to share this webinar broadly with the individuals and families they support.

Please note that this session is intended specifically for individuals and families. We respectfully ask that professionals refrain from attending, as ODP’s goal is to communicate directly with and hear feedback from these audiences.

A recording of the webinar will be made available on MyODP following the event.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced that Psychiatric Rehabilitation Services (PRS) has been added to the Medical Assistance Program Fee Schedule, effective January 1, 2026.

On January 30, 2026, the Centers for Medicare & Medicaid Services approved the addition of PRS as a rehabilitative service to the Medicaid State Plan, leading to the issuance of OMHSAS-26-01, “Payment for Psychiatric Rehabilitation Services.” Prior to the inclusion in the Medicaid State Plan, PRS was available only to MA beneficiaries enrolled in Behavioral Health HealthChoices as an in lieu of service. PRS is now available as a state plan service to MA beneficiaries in the Fee-for-Service and Behavioral Health HealthChoices delivery systems.

The published bulletin OMHSAS-26-01 can be found here. Please contact RCPA COO and Mental Health Director Jim Sharp with any questions.

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Today, the Office of Long-Term Living (OLTL) issued Bulletin 59-26-02, “Participant Review Tool,” which updates the standardized Participant Review Tool (PRT) for Service Coordinators (SC) as well as provides additional clarification on the location of face-to-face visits with participants when completing the PRT.

This bulletin also provides guidance to SCs on when increased face-to-face visits with program participants should be scheduled to protect their health, safety, and welfare. This bulletin rescinds OLTL Bulletin 59-16-12 and any other OLTL policy documents or parts of policy documents that are inconsistent with this bulletin’s contents. This bulletin applies to enrolled Service Coordination Entities (SCEs) performing services in OLTL Medical Assistance Home and Community-Based Services (HCBS) for the OBRA waiver and the Act 150 Program.

Members are encouraged to review the bulletin, as well as the following documents that were included with the bulletin:

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Message from the Office of Mental Health and Substance Abuse Services (OMHSAS):

The Pennsylvania Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) is issuing the bulletin OMHSAS-25-05 “Behavioral Health Clinic Services Provided Outside of the Clinic,” effective November 12, 2025, following changes to Federal Regulation 42 CFR 440.90(d).

OMHSAS 25-05 announces an amendment to Pennsylvania’s Medicaid State Plan which allows all behavioral health clinics that are enrolled in the Medical Assistance (MA) Program, who deliver services through the fee-for-service and managed care systems, to provide clinically appropriate services outside of the clinic. Behavioral health clinics include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and methadone maintenance clinics.

Furthermore, OMHSAS-25-05 also announces the abrogation of 55 Pa Code §§ 1153.14(6) (relating to noncovered services) and 55 Pa. Code 1223.14(11) (relating to noncovered services) by Act 46 of 2025.

The guidance in OMHSAS-25-05 is separate from any “telehealth only” licensure and guidance that may be in place. The changes discussed in this bulletin also do not apply to the existing Mobile Mental Health Telehealth (MMHT) services.

Questions and comments can be directed to OMHSAS via email. RCPA members can also contact RCPA COO and MH Policy Director Jim Sharp with any questions.

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Communication Bulletin 00-25-05 was published and shared last week. The purpose of the bulletin was to establish the Office of Developmental Programs’ (ODP’s) policy on communication and assure all individuals have an effective way to communicate.

To further provide access to the bulletin, ODP has shared another version of the bulletin in easier-to-understand terms and with pictures. This version will be available on MyODP as an attachment to the original bulletin communication released on December 1, 2025.

The following bulletins below are no longer in use:

  • Office of Developmental Programs 00-14-04, Accessibility of Intellectual Disability Services for Individuals Who Are Deaf
  • Office of Developmental Programs 00-08-18, Communication Supports and Services

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The Pennsylvania Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Medical Assistance Programs (OMAP) have jointly issued the Medical Assistance Bulletin Targeted Case Management Services for Eligible Juveniles Enrolled in Medical Assistance Prior to Release From a Carceral Setting, implementing Section 5121 of the Consolidated Appropriations Act, 2023. Eligible juveniles are individuals under 21 years of age who are determined eligible for MA or an individual 18–25 years of age who was determined eligible for the mandatory eligibility group for former foster care children.

This bulletin advises providers of billing procedures for the physical health (PH) and behavioral health (BH) Targeted Case Management (TCM) services provided to eligible juveniles enrolled in the Medical Assistance (MA) Program within 30 days of release from a carceral setting and for at least 30 days following release. This bulletin also advises providers of a new provider specialty (Spec) for TCM services.

Questions and comments can be sent electronically. You can also contact RCPA Policy Associate Emma Sharp with any questions.

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The PA Office of Medical Assistance Programs (OMAP) issued a new Bulletin that applies to personal assistance and community habilitation services under the Office of Long-Term Living (OLTL) and the Office of Developmental Programs (ODP). The key changes from earlier guidance include:

  • Providers 85% Compliance Requirement Effective January 1, 2025: Providers must ensure at least 85% of EVV records are verified without manual edits.
  • Starting January 2026, DHS will issue alerts to fee-for-service providers whose manual edits exceed 15% in the prior quarter. Managed care organizations (MCO) will also receive lists of noncompliant providers for follow-up.
  • Providers failing to meet the 85% thresholds for two consecutive quarters will be required to submit corrective action plans. Continued noncompliance may lead to sanctions, potentially including loss of license.
  • FMS and Participant-Directed Models are also responsible for EVV compliance. Persistent noncompliance can result in termination from participant-directed service models.
  • Additional Resources: DHS EVV Guidance and Handbook now available.
  • Compliance Reports are available on the Sandata platform. The reports allow providers to identify the non-compliant visit dates, participants, and caregivers to initiate internal corrective action.

If you have any questions, contact Fady Sahhar.

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