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Bulletin

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has released the OMHSAS-24-05 Peer Support Services (PSS) Bulletin and PSS Provider Handbook, updating the requirements for Peer Support Services. OMHSAS significantly reorganized the existing language in the Handbook to better clarify which requirements apply to OMHSAS licensure and which apply to Medical Assistance payment. Along with these formatting changes, OMHSAS-24-05 includes the following updates:

  • Staff Qualifications and Requirements for Certified Peer Specialists (CPS)
    • The requirement for a CPS to have a high school diploma or GED has been removed.
    • The requirement for a Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED) has been replaced with a requirement to have a mental health diagnosis. Please note, to be eligible to receive PSS services, there is still a requirement for “the presence or history of an SMI or SED.”
    • The clause requiring CPSs “to attain certification through the PCB within six months of hire” has been removed, as the certification examination is now available on-demand, eliminating the need for a grace period for testing to be completed.
  • Staff Qualifications and Requirements for CPS Supervisors
    • Adding a new qualification category for individuals with an associate degree.
    • Supervisory meetings held in an audio-only format shall not be considered supervision.
    • Supervisory meetings shall be provided at a minimum of one hour each week.
  • Telehealth
    • The prior requirement that only 25% of total services provided per beneficiary per calendar year can be delivered by telephone has been removed.
    • PSS may be provided via telehealth technology, including audio-only service delivery, when it is clinically appropriate to do so.
    • PSS providers must ensure that the preference of individuals receiving services (or their legal guardian) is given a high priority when determining the appropriate service delivery modality.

Please review all other revisions to OMHSAS-24-05 here.

Comments and questions regarding this bulletin should be directed to:
Office of Mental Health and Substance Abuse Services, Bureau of Policy, Planning and Program Development,
P.O. Box 2675,
Harrisburg, PA 17105
General Office Number: 717-772-7900
Email

If you have any questions, please contact RCPA COO and Mental Health Policy Director Jim Sharp.

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The Centers for Medicare and Medicaid Services (CMS) has released an informational bulletin, as well as a slide presentation, that are related to continuity of coverage for individuals receiving home and community-based services (HCBS). The purpose of the bulletin is to highlight the federal renewal requirements and available flexibilities to promote continuity of coverage.

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The Pennsylvania Department of Human Services released Medical Assistance Bulletin 99-24-03 on May 28, 2024, detailing updates to the Medical Assistance (MA) Program Fee Schedule based on the 2024 Healthcare Common Procedure Coding System (HCPCS) changes. These updates include new codes such as 90867, 90868, and 90869 for transcranial magnetic stimulation (TMS) treatment billing, along with additional modifications to other procedure codes, setting of limitations, fee adjustments, and new prior authorization requirements effective from the same date. This bulletin applies to all providers serving MA beneficiaries under the Fee-for-Service system and those in the MA Managed Care system should contact their respective organizations for specific billing guidance.

For more detailed information, read the full bulletin here.

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

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The Office of Developmental Programs (ODP) has shared ODPANN 24-051. The purpose of this communication is to announce the release of the ISP Manual that includes information from the Consolidated, Community Living, and Person/Family Directed Support waiver amendments that were effective on November 1, 2023. View the announcement and documents below for instructions and details:

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A new bulletin addressing revisions to the Older Adults Protective Services Act (OAPSA) has been released by the Commonwealth Court. This bulletin specifically focuses on clarifying the legal standing of certain provisions, notably the “lifetime employment ban” for individuals with criminal convictions. Enacted in 1987, OAPSA aimed to protect Pennsylvania’s older population from exploitation, neglect, and abuse, establishing a program for their safeguarding, including those in mental health inpatient and residential facilities. However, subsequent amendments in 1996 introduced a permanent employment ban for individuals convicted of certain crimes. Despite this, a 2015 ruling by the Commonwealth Court found this provision unconstitutional, citing violations of due process guarantees under the PA constitution.

The full bulletin, titled “Bulletin OMHSAS-24-03 Employment Bans in OAPSA,” can be accessed here. Further inquiries regarding OMHSAS-24-03 can be directed to OMHSAS via email. You can also contact RCPA Policy Director and COO, Jim Sharp, with any additional questions.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has released the OMHSAS-24-01 Restraint Seclusion and Exclusion Bulletin, updating policies on restraint, seclusion, and exclusion in state mental hospitals to reduce these practices. This bulletin supersedes OMHSAS-09-06, necessitating adjustments in local hospital policies. Changes include shifting from “manual hold” to “physical restraint” terminology and clarifications in definitions. It strictly prohibits mechanical and chemical restraints, allowing physical restraint only as a last-resort emergency measure with detailed guidelines on application, documentation, and debriefing protocols. The emphasis is on individualized care, de-escalation techniques, and personnel training to ensure the humane and judicious use of physical restraint.

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

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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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The Office of Developmental Programs (ODP) has shared the bulletin Home and Community-Based Waiver Services Provided to Individuals in an Acute Care Hospital along with its accompanying attachment. The purpose of this bulletin is to provide guidance on the delivery of home and community-based waiver services to individuals who are hospitalized in an acute care hospital. Please review the bulletin and attachment for information and details relevant to this topic.

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Image by Tom und Nicki Löschner from Pixabay

The Department of Drug and Alcohol Programs (DDAP) issued Policy Bulletin 23-02, which describes modifications to the DDAP Gambling Treatment Manual. Changes outlined in the bulletin include updated qualifications for providers, extended certification timelines, revised billing rates, and streamlined processes for client sessions, record-keeping, and grievance handling. The revised manual can also be accessed on the DDAP website.

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