95.000000 Child Partial Hospitalization Program. Signature requirements, including signatures for service plans and written consent, have also been suspended. Centers for Medicare & Medicaid Services, Department of Health and Human Services, Supplementary Medical Insurance (SMI) Benefits, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-410/subpart-B/section-410.43. (5) Services furnished to SNF residents as defined in 411.15(p) of this chapter. Beacon manages behavioral health services for Medical Assistance (MA) recipients in 11 Western Pennsylvania counties: Armstrong, Beaver, Butler, Crawford, Fayette, Indiana, Lawrence, Mercer, Venango, Washington, and Westmoreland. Payment for peer support services is subject to the provisions of these requirements, 55 Pa. Code Chapter 1101 (relating to general provisions) and the limitations established in 55 Pa. Code Chapter 1150 (relating to the MA program payment policies) and the MA program fee schedule. People participate in activities during the day and return home at night. [59 FR 6577, Feb. 11, 1994, as amended at 65 FR 18536, Apr. 138 -Cardiac Catheterization ServicesChap. CMYK 50.000000 14.999998 Regulations, and Minimum Standards Authority: T.C.A. 95.000000 White Requirements for obtaining verbal consent and documentation of the verbal consent remain and must be included in the medical record for every occurrence of a new and updated treatment plan. In the Disaster Proclamation, the Governor authorized suspension of regulations and regulatory statutes that would prevent, hinder or delay necessary action to cope with the COVID-19 emergency. Partial Hospitalization Programs (PHP) were treatment programs originally developed to help people struggling with mental illness. This program is available after school and offers many workshops, including ceramics, music, dance, photography, creative writing, and more. guide. <> This would also include all applicable state bulletins or policy clarifications. PROCESS What Is PHP (Partial Hospitalization Program)? - Solutions Recovery CMYK PROCESS Providers are strongly encouraged to obtain signatures electronically when possible. 0000002452 00000 n Drugs and medications. If you need to connect with resources in your community, but don't know where to look, PA 211 is a great place to start. 0.000000 The regulatory provisions that have been suspended address the following requirements for certain services: Outlined below are the descriptions of the regulatory provisions that have been suspended, the scope of those suspensions and any binding conditions for the suspensions: The regulatory suspensions discussed above are effective March 6, 2020, and will remain in place while the Disaster Proclamation remains in effect or such other time as DHS directs. 25.000000 Partial Hospitalization These programs are defined as structured and medically supervised day, evening and/or night treatment programs. A certified registered nurse practitioner or a physician assistant may substitute for the physician to perform this function, provided it is within their scope of practice. CMYK PDF Provider Bulletin #15-03 - DBHIDS image/epsf OMHSAS-23-03 Bulletin - Aligning Co-Occurring Services with the ASAM Criteria *New. Apply online instantly. 100.000000 The Code of Federal Regulations . Title 42 was last amended 4/12/2023. 0.000000 50.000000 146 -Infection ControlChap. endstream endobj startxref PROCESS The in-page Table of Contents is available only when multiple sections are being viewed. PDF Medicare & Your Mental Health Benefits. A partial hospitalization program (PHP) is a structured mental health program and type of addiction treatment. 50.000000 In addition, providers have seven days from the enrollment date to complete the residential service plan instead of completing it on the day of enrollment. 410.43 Partial hospitalization services: Conditions and exclusions. 0.000000 Merakey - Merakey 121 -Social Work ServicesChap. 101 - General InformationChap. Please call Member Services to determine if a service is available in your county. 0.000000 0914 - Individual Therapy. DHS has also suspended the requirement that substitute staff have equivalent qualifications to absent staff, with the condition that substitute staff receive adequate training to perform the duties. 133 -Special Care UnitsChap. Individual, group and family therapy. PROCESS CMYK Signature requirements have been suspended; however, verbal consent must be documented in the medical record at the time of service and providers are strongly encouraged to obtain signatures electronically when possible. 100.000000 For MA payment for Outpatient Drug and Alcohol services provided in accordance with 55 Pa. Code Chapter 1223, DHS will allow up to 60 days of intake to complete the Initial Treatment Plans instead of 15 days. On March 6, 2020, Governor Tom Wolf issued a Proclamation of Disaster Emergency (the Disaster Proclamation), which was renewed for 90 days on June 3, 2020, to enable agencies to respond promptly to the pandemic. Patients, family members and friends. Choosing an item from (4) Qualified psychologist services, as defined in section 1861(ii) of the Act. HS has suspended the requirement related to the frequency of the fire safety inspection; however, the CRR must take due diligence to obtain the fire safety inspection within the required time frame. Skip to article content, Intensive Behavioral Health Services (IBHS), Recovery, Resilience, Wellness & Peer Support, Ambulatory Withdrawal Management (WM) (Detox) Drug and Alcohol, Case Management Services (Includes Intensive Case Management, Resource Coordination, Blended Case Management, and Recovery Coaching), Clinically Managed Residential WM (Detox) Drug and Alcohol, Clinically Managed High Intensity Residential Drug and Alcohol, Clinically Managed Low Intensity Residential Drug and Alcohol, Clozapine (Clozaril) Monitoring and Support, Community Residential Rehabilitative (CRR) Host Home, Family Based Mental Health Services for Child/Adolescent, Intensive Behavioral Health Services (IBHS) Child/Adolescent, Intensive Outpatient Program (IOP) Services Drug and Alcohol, Laboratory (when related to a behavioral health diagnosis and prescribed by a behavioral health practitioner under the practitioners scope of practice), Medically Managed Intensive Inpatient Drug and Alcohol, Medically Managed Residential WM (Detox) Drug and Alcohol, Medically Monitored Inpatient WM (Detox) Drug and Alcohol, Medically Monitored Intensive Inpatient Drug and Alcohol, Mental Health Crisis Intervention Services, Outpatient Services Mental Health, Substance Use or Co-Occurring Services, Partial Hospital Programs for Substance Use Disorder, Partial Hospital Services for Mental Health, Substance Use or Co-Occurring Services, Psychiatric Rehabilitation Services (PRS), Residential Treatment Facilities (Child/ Adolescent), Early and Periodic Screening, Diagnostic and Treatment (EPSDT)*, Extended Acute Care (EAC) Hospital Based*, Extended Acute Care (EAC) Non-Hospital Based*, Mental Health Intensive Outpatient Services*, Residential Treatment Facilities (Adult)*. 10.000002 Payment will also be made until October 15, 2020, to an agency that was approved to provide Applied Behavioral Analysis (ABA) services as of October 19, 2019, and otherwise complies with Chapters 1155 and 5240. 51 -General ProvisionsChap. Waiver of standards. Pennsylvania Code (Rules and Regulations) . PROCESS CMYK CMYK PROCESS 85.000000 Print 0.000000 817 0 obj <>stream This service also helps individuals transition back into the community from a psychiatric hospital. 1302, 1395m, 1395hh, 1395rr, and 1395ddd. Additionally, on May 6, 2020, Governor Wolf issued an order (Order Of The Governor of the Commonwealth of Pennsylvania to Enhance Protections for Health Care Professionals) to enhance protections for health care professionals, in which he also suspended multiple statutes and regulations, including several related to the provision of mental health services in the MA program. CMYK gcPrJR^66f4Wl\F 3&YT.'3}-}^P Z,W2hyBpp2]z3^Pp@i+RSz^.um;_l2YrH0%)o6]_%barQQ 0.000000 Care managers are available to providers 24 hours a day, 7 days a week, 365 days a year. 0.000000 125 -Laboratory ServicesChap. 153 - Initial Construction and Continuing Operating Standards. 158 -Vital Organ Transplantation Services. 0.000000 CMYK 0000010052 00000 n 50.000000 will bring you to those results. 0.000000 Due to HIPAA regulations, our staff is unable to . <> CMS regulations (42 CFR 410.43(c)(1)) state that partial hospitalization programs (PHPs) are intended for members who require a minimum of 20 hours per week of therapeutic services as . PDF Magellan Care Guidelines 2022-2023 Choosing an item from Map & Directions. About Us. 0.000000 0.000000 These services may be provided via telehealth/telephone if clinically appropriate to do so. 89.999405 4.998803 2Utt`h$l 72! :?]qtK;}@^N\Alfy Q` B CMYK 2 Requirements for staff-to-patient ratios. C=75 M=100 Y=0 K=0 B%R! PROCESS 0.000000 C=0 M=0 Y=0 K=60 5210.58. . 39.999996 PDF Partial hospitalization services - Amerigroup Listed beloware the services provided by Magellans network of credentialed providers through your Pennsylvania HealthChoices plan. CMYK The requirements for a written quarterly review of the drug regimen of each resident, by a licensed pharmacist, and that the findings be submitted to the program director and prescribing physicians, have also been suspended. 70.3 - Partial Hospitalization Services (Rev. xmp.iid:F77F1174072068118A6DF0C37545496F 80.000000 105 -Admission and DischargeChap. 39.999996 The CRR may keep prescribed medications for the week in a weekly pill container for the client instead of keeping them in their original prescription containers. 710 -Drug and Alcohol ServicesChap. 0.000000 For Inpatient Psychiatric Services under 55 Pa. Code Chapter 1151, DHS has suspended the requirement that a physician establish an individual written plan of care before authorization for payment for care provided to a recipient 21 years of age or older. C=0 M=75 Y=100 K=0 Carelon manages behavioral health services for Medical Assistance (MA) recipients in 11 Western Pennsylvania counties: Armstrong, Beaver, Butler, Crawford, Fayette, Indiana, Lawrence, Mercer, Venango, Washington, and Westmoreland. 0.000000 <>>> 29.998802 CMYK Providers may utilize telehealth to develop the initial service plan and for the subsequent reviews of the plan. 137 -Obstetrical ServicesChap.