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Tags Posts tagged with "Telehealth"

Telehealth

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The Office of Developmental Programs (ODP) is pleased to offer a webinar regarding the Specialty Telehealth and Assessment Team (STAT) waiver service. STAT is a new waiver service available to individuals in the Person/Family Directed Support (P/FDS), Community Living, and Consolidated Waiver programs. STAT is a telehealth service that is consultative and provides disability-specific advice on when best to seek additional or in-person medical treatment for the participant. It provides 24/7 access to physicians with extensive education and experience within the IDA population 365 days a year, who triage and evaluate medical conditions as needed. This webinar will provide an in-depth look at the STAT waiver service, how it works, and the benefit to participants.

ODP Will be holding two sessions. The information will be the same at both. Pre-registration is required. Select the preferred session date to register.

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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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RCPA is pleased to report several successful collaborative efforts this week, including a meeting with DHS, OMHSAS, and a delegation of House and Senate Representatives. We reviewed proposed language for a new bill that would address the 4 walls standard for ongoing telehealth with practitioners not within the 4 walls of a clinic. The bill will also include language previously introduced on the Psychiatric Outpatient Regulatory requirements for the 50% in-office time for clinics and the use of advanced practice professionals to meet those time requirements.

The language for both target areas was approved by all parties and will now move on to the House Human Services Committee. RCPA has a meeting scheduled for early next week to review the finalized version prior to its introduction. We have also met with Senate counterparts to support the measure.

Lastly, RCPA continues its dialogue with OMHSAS for guidance and clarification, including sharing members’ and stakeholders’ feedback. We have had the opportunity to speak with our BH-MCO members and understand OMHSAS Deputy Secretary Jen Smith will be meeting with that group and the county contractors on the processes moving forward.

We are hopeful for an expedited legislative solution that will aid OMHSAS in making any resulting policy, practice, or program changes that will support the initiative. We are extremely encouraged by the system’s efforts and focus this week and will continue to provide key updates to members and stakeholders.

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

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Photo by Markus Winkler on Unsplash

In response to the recent developments on the delivery of telehealth services and its intersection with Federal Medicaid payment standards outlined in the “4 walls” requirements, RCPA has widened its efforts in addressing the barriers currently in place. It has been determined that the most effective route to address this would be through legislation. The necessary changes cannot be achieved through a revised Tele-Behavioral Health Bulletin.

RCPA has been working with a bipartisan team of legislators on an updated version of Act 76 to address our limited access to psychiatric services through utilization of our advanced practice professionals. We are working with the Office of Mental Health and Substance Abuse Services (OMHSAS), our stakeholders, and the legislative committees to introduce a bill that would address both the psychiatric office time and the “4 walls” service delivery barriers.

Our members’ feedback over the last few days and during the OMHSAS telehealth forum on Monday has provided an invaluable backdrop to our efforts. RCPA is focused on working with our legislators and stakeholders to introduce this bill, and we will look to our members for support with these efforts. Additionally, we continue our daily efforts with our partners at OMHSAS, who are jointly committed to creating this viable and sustainable effort to preserve Medicaid service access to those most vulnerable in our Commonwealth.

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

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RCPA attended the Office of Mental Health and Substance Abuse Services (OMHSAS) telehealth webinar on Monday, January 29, alongside many provider members, regarding the Federal payment conditions related to the delivery of telehealth services and the requirement that the physicians or clinicians must present in the office, or that the client must be in the office during the telehealth session, to meet the guideline. It was explained that despite the standards outlined in the current OMHSAS Telebehavioral Health Bulletin, under the Federal “4 walls” statute, this is a required Federal Medicaid payment condition. These requirements cannot be waived.

The purpose of today’s call was twofold: explaining the “4 walls” requirements, and for providers to give vital feedback to OMHSAS on the impacts, challenges, and barriers to accessing services that this may create for consumers and families. This Medicaid standard remains in effect, and RCPA recommends provider members review their operating practices to ensure compliance.

During this time, RCPA will continue its efforts and work with OMHSAS, the HealthChoices partners, and stakeholders to ensure access to services via telehealth. You can review today’s OMHSAS telehealth webinar slide deck. We are also looking to obtain a recording of the webinar to share with our members.

If you have questions, please contact RCPA Policy Director Jim Sharp. The next RCPA Telehealth Operations Committee meeting is scheduled for Tuesday, February 27; however, we will be reviewing if we need to meet sooner based on current information.

Please share this information with your stakeholder networks.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) is holding a series of virtual conversations on Monday, January 29, to discuss opportunities in modernizing tele-behavioral health services within the Commonwealth. These meetings will be held using Microsoft Teams, and time will be allotted for discussion. To facilitate discussions most efficiently, OMHSAS will hold three meetings based on stakeholder type: BH-MCO/Primary Contractor/County Mental Health Administrators, licensed service providers, and individuals who access services and their families. Please choose the most appropriate webinar for you. The licensed service providers forum will be at 11:00 am. Attendance will be taken so that feedback can be cataloged accordingly.

These conversations will drive OMHSAS closer to finding solutions to the complicated work of increasing access to behavioral health services that are utilizing tele-behavioral health platforms and ensuring service recipients have a choice. This first conversation will focus on psychiatric outpatient clinic services and telehealth.

Join on your computer, mobile app or room device
Visit here to join the meeting
Meeting ID: 290 432 891 13
Passcode: 6nz9cp
Download Teams | Join on the web
Or call in (audio only)
+1 267-332-8737,,985858579#   United States, Philadelphia
Phone Conference ID: 985 858 579#

OMHSAS looks forward to you joining this critical conversation. If you have questions, please contact RCPA Policy Director Jim Sharp.

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