OMHSAS & Permissible Arrangements for Psychologists Providing Behavioral Health Rehabilitation Services
|
|
- Mark Nash
- 5 years ago
- Views:
Transcription
1 OMHSAS & Permissible Arrangements for Psychologists Providing Behavioral Health Rehabilitation Services T R A I N I N G O N M E D I C A L A S S I S T A N C E B U L L E T I N O M H S A S I S S U E D M A R C H 8,
2 OVERVIEW I. Background on Pennsylvania DPW-OMHSAS Medical Assistance Bulletin (MAB) II. Introduce Verification of Responsibilities form III. Examples of appropriate/inappropriate service delivery arrangements
3 MAB OMHSAS March 8, 2011 Over time, OMHSAS found. some psychologists lacked a full understanding of the BHRS requirements they were a provider of or how these requirements intersected with Pennsylvania State Board of Psychology regulations. Key findings include: Exceeding supervision limit of unlicensed professionals (MT s & BSC s) Allowing other psychologist or providers to bill for services under their provider number or billing for services supervised by other psychologist No participation in treatment planning or service delivery No oversight of program development Deviating from approved Service Description
4 Providing BHRS Background 1989 Congress amends the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provisions of the Medicaid statue, requiring states to provide necessary treatment and services 1994 Therapeutic Support Staff (TSS), Mobile Therapy (MT) and Behavioral Specialist Consultant (BSC) added to Medicaid fee schedule (MAB ) MAB revises policies related to BHRS including qualifications, training and supervision requirements for TSS 2003 MAMIS-to-PROMISe transition psychologists previously enrolled as provider type 50 re-enrolled as provider type 19 to align with federal taxonomy codes DPW begins utilizing National Provider Identifier (NPI) and associating with PROMISe ID DPW begins offering MA Bulletins via
5 General Enrollment To do business with the Department of Public Welfare, provider entities must first enroll in the Pennsylvania Medical Assistance Program. Enrollment requires a complete a base provider enrollment form and applicable addenda documents. For psychologists. Must be licensed without restriction and meet established provider type criteria: Approved applicants are issued unique PROMISe number and entered into statewide network
6 Providing BHRS Current regulations allow for a psychologist to offer BHRS as an independently recognized provider (provider type 19) To provide BHRS, a psychologists must.
7 Providing BHRS Submit Service Description (SD) the OMHSAS- Children s Bureau for review and approval (new provider) A completed SD includes information as outlined in MAB and formatted in accordance with Attachment 7 of MAB Supporting documentation includes: signed Verification of Responsibility form, copy of valid license, letters of county support and collaboration with BH-MCO s (technical assistance materials provided by the Children s Bureau available upon request). Approval, denial or request for revisions provided within 45 days of submission
8 Providing BHRS MAB requires providers to submit a revised Service Description if. there are substantial changes in a service that the Department previously approved. According to MAB examples of substantial changes include some of the following: 1. Changes to the actual services provided 2. Change in staff qualifications or staffing ratios 3. Change in service site (e.g. main service location or counties served, addition of a new service location)
9 Providing BHRS MAB OMHSAS initiates requirement for Verification of Responsibility form Acknowledges awareness of regulations governing standard billing practices and limits on supervised employees. This is required for all new submissions effective March 8, 2011 Service Descriptions will not be approved without submission Previously approved providers must sign and submit to OMHSAS-Children s Bureau
10 Verification of Responsibilities I understand that when I provide Behavioral Health Rehabilitation Services (BHRS) I must comply with both the Pennsylvania Board of Psychology s licensing requirements and the requirements that govern participation in the Pennsylvania Medical Assistance Program and provision of BHRS. I also understand that I am fully responsible for any services billed under my Medical Assistance provider number. By signing the attached service description, I accept responsibility for the following services to be billed using my Medical Assistance provider number: Evaluations MT BSC TSS Psychologist Signature Psychologist Printed Name Date Psychologist License Number
11 Providing BHRS Why is the Department of Public Welfare-OMHSAS requiring the psychologists signature? The signed Verification of Responsibilities acknowledges that the psychologist will be using their individual MA provider number and thus financially, legally and ethically responsible for all services outlined on the approved Service Description. Providers lacking direct involvement in the development of their Service Description risk program noncompliance, unethical practice arrangements or unacceptable billing practices resulting in financial penalties or practice sanctions
12 Permissible Service Arrangements The Professional Psychologist Practice Act (1986, P.L. 89, No. 33) empowers the Pennsylvania State Board of Psychology to define and regulate standards for professional practice. Title 49, Chapter 41 State Board of Psychology, defines standards for the employment and supervision of unlicensed persons with graduate training in psychology. Subsections 41.58(b) and 41.58(c)(2) directly apply to the provisions of BHRS for psychologist providers and supervision of BSC s, MT s and TSS.
13 Permissible Service Arrangements Standards for the employment and supervision of unlicensed persons with graduate training in psychology Paragraph (b) requires that the employing psychologist must: Ensure proper educational requirement of any employee Bear full professional responsibility for services provided by employee Provide appropriate supervision arrangements, including proper delegation of supervisory responsibilities to other psychologists and/or qualified professionals
14 Permissible Service Arrangements Standards for the employment and supervision of unlicensed persons with graduate training in psychology continued.. Paragraph (c)(9) Prohibits the employing psychologist from supervising more than three full-time (FTE) or their equivalent in part-time employees. FTE based on established personnel policy and in accordance with applicable labor laws and regulations
15 Permissible Service Arrangements Psychologist FTE (MT or BSC) FTE FTE
16 Permissible Service Arrangements Then how are TSS employed?
17 Permissible Service Arrangements PA State Board of Psychology: the work of a TSS as it is currently defined and being provided is not the practice of psychology However, regulations by the Board and by virtue of billing under their MA provider number, the psychologist remains responsible for all aspects of BHRS. MAB (June 2001) revised minimum staff qualifications and established minimum training and supervision requirements for TSS workers
18 Permissible Service Arrangements Additionally, MAB establishes minimum qualifications for professionals supervising TSS These criteria allow BSC s and MT s who meet the educational requirement to provide supervision up to 9 full-time equivalent TSS workers For TSS employed 20hrs per week or more, ongoing supervision includes: At least 1hr individual or group supervision per week On-site assessment and assistance prior to working alone with children or adolescents (varies depending on experience) Periodic on-site supervision (determined by supervisor)
19 Permissible Service Arrangements The purpose of the guidance document from the bulletin is: To provide examples of arrangements a psychologist enrolled in the MA Program to provide BHRS. The examples address both permissible and impermissible arrangements. To identify specified regulations and policies that apply to psychologists enrolled in the MA program to provide BHRS.
20 Permissible Service Arrangements Licensed Psychologist Entity TSS TSS TSS MT/BSC TSS TSS TSS
21 Service Arrangements Program Licensed Psychologist Entity Pre-Doc Intern TSS TSS MT/BSC Unlicensed Professional TSS TSS TSS TSS
22 Service Arrangements Psychologist (Type 19) Psychologist (Type 19) Psychologist (Type 19) BHRS (3 FTE & TSS) BHRS (3 FTE & TSS) BHRS (3 FTE & TSS) Entity
23 Penalties Providers billing for services without proper approval or for unnecessary services face civil and criminal penalties in accordance with state and federal laws. Penalties may include: Nonpayment of questionable claims Civil monetary penalties Exclusion from the Medicaid Program Imprisonment and criminal fines
24 Penalties (cont.) Additionally, the Pennsylvania State Board of Psychology may impose penalties and sanctions including: Civil monetary penalties License suspension/revocation Additional training and corrective actions deemed appropriate by the Board.
25 Information Service Bulletins and policies related to the provision of BHRS can be found: Pennsylvania Recovery and Resiliency- Provides access to behavioral health resources both at the state and community level www. services.dpw.state.pa.us/olddpw/bulletinsearch.aspx DWP link to bulletin search (A list of BHRS-related bulletins referenced in OMHSAS-05-11) Pennsylvania Community Providers Association (PCPA) serves as a forum for the exchange of information and experience, archived information related to BHRS and updates on trainings for providers Provides access to regulatory language governing DPW and the provision of BHRS
26 Information Provider Enrollment Provides assistance regarding MA enrollment processes, file maintenance and general MA enrollment questions: Hours of operation: Monday Friday, 8 AM-4:30 PM OMHSAS Toll-Free Inquiry Line Technical assistance for behavioral health counties, plans and providers to assist with enrollment, billing, eligibility discrepancy, etc Hours of operation: Mon-Fri 8 AM-4 PM, Voic available after 4 PM
27 Information Contact: Garrett Rosas, PsyD Consulting Psychologist OMHSAS- Bureau of Children's Behavioral Health Services P.O. Box 2675 Harrisburg, PA Voice: Fax: Courtney Coover, Chief Planning, Policy & Development Division OMHSAS- Bureau of Children's Behavioral Health Services P.O. Box 2675 Harrisburg, PA Voice: Fax:
OMHSAS & MTFC. Accessing Medical Assistance Funding Presented by the OMHSAS Children s Bureau. Updated
OMHSAS & MTFC Accessing Medical Assistance Funding Presented by the OMHSAS Children s Bureau Updated 4-2-2010 OVERVIEW Who are we? The treatment components of MTFC are a Program Exception for MA purposes:
More informationBEHAVIORAL HEALTH REHABILITATION SERVICES
BEHAVIORAL HEALTH REHABILITATION SERVICES TODAY S AGENDA New Developments Update on PA of TSS Highlights of Draft Regulations CORRECTIVE ACTION WORKGROUP In response to: Ever Increasing Utilization Complaints
More informationOFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN
OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN ISSUE DATE: EFFECTIVE DATE: NUMBER: September 22, 2009 October 1, 2009 OMHSAS-09-05 SUBJECT: Peer Support Services - Revised BY: Joan L. Erney,
More informationMEDICAL ASSISTANCE BULLETIN
MEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE ISSUE DATE EFFECTIVE DATE NUMBER September 8, 1995 September 8, 1995 1153-95-01 SUBJECT Accessing Outpatient Wraparound
More informationAD Ordering, Referring, and Prescribing Providers
Provider Notice To: From: All PerformCare Network Providers Scott Daubert, PhD, VP Operations Date: Revised December 1, 2017 (originally September 30, 2017) Subject: AD 17 104 Ordering, Referring, and
More informationOFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN
OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN ISSUE DATE EFFECTIVE DATE: NUMBER: SUBJECT: Clarification of Policies Regarding the Authorization and Delivery of Behavioral Health Rehabilitation
More informationTreatment Planning. General Considerations
Treatment Planning CBH Compliance has been tasked with ensuring that our providers adhere to documentation standards presented in state regulations, bulletins, CBH contractual documents, etc. Complying
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 06-09/17 REPLACED: 03/14/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.1: PROVIDER REQUIREMENTS PAGE(S) 15
PROVIDER REQUIREMENTS A provider must be enrolled in the Medicaid Program and meet the provider qualifications at the time service is rendered to be eligible to receive reimbursement through the Louisiana
More informationSummary of PA DHS policies & procedures regarding EPSDT & BHR Service delivery
Summary of PA DHS policies & procedures regarding EPSDT & BHR Service delivery Since 1992, any child in Pennsylvania has been entitled under the law to "Early and Periodic Screening, Diagnosis and Treatment"
More informationProvider Relations currently is the public relations arm, for providers, of the Provider Operations
Provider OPERations 6.1 Provider Relations Provider Relations currently is the public relations arm, for providers, of the Provider Operations Department. Provider Relations consists of a group of Provider
More informationMEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE
MEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE SUBJECT BY NUMBER: ISSUE DATE: September 8, 1995 EFFECTIVE DATE: September 8, 1995 Mental Health Services Provided
More informationCommunity Behavioral Health. Manual for Review of Provider Personnel Files
Community Behavioral Health Manual for Review of Provider Personnel Files 2/21/2014 Version 1.2, rev. 4/24/2015 Introduction 2 Documentation Requirements 3 Mental Health Services Medical Director 5 Psychiatrist
More informationMEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE
MEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE SUBJECT BY Summer Therapeutic Activities Program NUMBER: 50-96-03 Darlene C. Collins, M.Ed.,M.P.H. Deputy Secretary
More informationInfant Toddler Early Intervention Services - Infant/Toddler/Family (ITF) Waiver
II-G Waiver Services Infant Toddler Early Intervention Services - Infant/Toddler/Family (ITF) Waiver The Infant, Toddler and Family (ITF) Waiver applies to children from birth to their third birthday.
More informationSonoma County Department of Health Services Behavioral Health Division Mental Health Services
Sonoma County Department of Health Services Behavioral Health Division Mental Health Services Medi-Cal Mental Health Provider Credentialing Procedure 2-8-18 The following procedure describes the necessary
More informationDEVELOPMENTAL PROGRAMS BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
DEVELOPMENTAL PROGRAMS BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE I NUMBER DATE OF ISSUE December 27,2007 J EFFECTIVE DATE January 1,2008 00-08-01 ------- SUBJECT' BY: Process for
More informationREVISED 05/12 STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P.O. BOX 2649 HARRISBURG, PA
Email st-socialwork@pa.gov STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P.O. BOX 2649 HARRISBURG, PA 17105-2649 APPLICATION FOR A LICENSE BY EXAMINATION TO
More informationRULES AND REGULATIONS Title 55 PUBLIC WELFARE
2572 RULES AND REGULATIONS Title 55 PUBLIC WELFARE DEPARTMENT OF PUBLIC WELFARE [ 55 PA. CODE CH. 5230 ] Psychiatric Rehabilitation Services The Department of Public Welfare (Department), under the authority
More informationNotification Regarding BHRS Brief Treatment Services for Providers of Child and Adolescent Behavioral Health Services
Alert #3 2008 2-03 HCNC Notification Regarding BHRS Brief Treatment Services for Providers of Child and Adolescent Behavioral Health Services Community Care will begin to allow NC BHRS providers to implement
More informationIntegrated Children s Services Initiative Frequently Asked Questions July 20, 2005
Integrated Children s Services Initiative Frequently Asked Questions July 20, 2005 1. What is the rationale for this change? Last year the Department began the Integrated Children s Services Initiative
More informationJoining Passport Health Plan. Welcome IMPACT Plus Providers
Joining Passport Health Plan Welcome IMPACT Plus Providers Agenda Passport Behavioral Health Services Overview Steps to Joining Passport Health Plan s Network Getting a Medicaid Number Enrolling in the
More information1 of 138 DOCUMENTS. NEW JERSEY REGISTER Copyright 2006 by the New Jersey Office of Administrative Law. 38 N.J.R. 4801(a)
Page 1 1 of 138 DOCUMENTS NEW JERSEY REGISTER Copyright 2006 by the New Jersey Office of Administrative Law VOLUME 38, ISSUE 22 ISSUE DATE: NOVEMBER 20, 2006 RULE PROPOSALS LAW AND PUBLIC SAFETY DIVISION
More information...,...,.., ,,...,...::.,-----'
SANTA BARBARA COUNTY ~ DEPARTMENT OF Behavioral Wellness ~ ~ A System of Care and Recovery Pa g e 1 of 10 Departmental Policy and Procedure Section Sub-section Policy Quality Care Management General Policy#
More informationBEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual
BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual Issued March 14, 2017 State of Louisiana Bureau of Health Services Financing SECTION: TABLE OF CONTENTS PAGE(S) 1
More informationMEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE
MEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE SUBJECT BY Health Insurance Portability & Accountability Act (HIPAA) NUMBER: 99-02-07 Peg J. Dierkers, Ph.D. Deputy
More informationRequirements for Provider Type 21 Case Manager
Requirements for Provider Type 21 Case Manager Specialty Code 076 Peer Support Services 211 Medical Assistance Case Management for HIV&AIDS 212 Medical Assistance Case Management for Under 21 213 Early
More informationpennsylvania D E P A R T M E N T O F P U B L I C W E L F A R E D E P A R T M E N T O F A G I N G
ISSUE DATE 7/6/10 pennsylvania D E P A R T M E N T O F P U B L I C W E L F A R E D E P A R T M E N T O F A G I N G www.dpw.state.pa.us/about/oltl/ EFFECTIVE DATE 7/1/10 OFFICE OF LONG-TERM LIVING BULLETIN
More informationCMHC Conditions of Participation
CMHC Conditions of Participation Mary Rossi-Coajou Center for Clinical Standards and Quality/Clinical Standards Group The Centers for Medicare and Medicare Services March 4,2014 Key Themes The CMHC NPRM
More informationRULES OF THE BOARD OF EXAMINERS IN PSYCHOLOGY CHAPTER RULES GOVERNING PSYCHOLOGISTS TABLE OF CONTENTS
RULES OF THE BOARD OF EXAMINERS IN PSYCHOLOGY CHAPTER 1180-02 RULES GOVERNING PSYCHOLOGISTS TABLE OF CONTENTS 1180-02-.01 Scope of Practice 1180-02-.07 Free Health Clinic and Volunteer Practice 1180-02-.02
More informationParkview Hospital Medical Staff Bylaws Supplement Allied Health Practitioner Manual
Parkview Hospital Medical Staff Bylaws Supplement Allied Health Practitioner Manual PVH AHP Manual December 9, 2014 Table of Contents A. Comparison of Advanced and Dependent AHP 3 B. Authorizations of
More informationAmerican Recovery and Reinvestment Act. Centers for Medicare and Medicaid Services. Medical Assistance Provider Incentive Repository
Terminology ARRA CMS EHR HIE HIT MAPIR OMAP ONC SMHP American Recovery and Reinvestment Act Centers for Medicare and Medicaid Services Electronic Health Record Health Information Exchange Health Information
More informationApplication Checklist for Facilities
Application Checklist for Facilities Please use the following checklist to complete the credentialing process. Current copies of all items listed below are required for the facility to participate with
More informationThe nurse delegating the activity is directly responsible for the nursing care given to the patient, and the final decision as to what nursing
5.1 Detail how the state Nurse Practice Act, other regulatory stipulations (e.g., Staffing ratios mandated in California), and professional standards influence the care delivery model(s). At Massachusetts
More informationEXHIBIT A SPECIAL PROVISIONS
EXHIBIT A SPECIAL PROVISIONS The following provisions supplement or modify the provisions of Items 1 through 9 of the Integrated Standard Contract, as provided herein: A-1. ENGAGEMENT, TERM AND CONTRACT
More informationThe Medicaid-Education Connection
The Medicaid-Education Connection Medicaid EPSDT BHRS Wraparound IDEA IDEIA School-Based Mental Health Services This presentation provides an in-depth understanding of the Early and Periodic, Screening,
More informationDEVELOPMENTAL PROGRAMS BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
DEVELOPMENTAL PROGRAMS BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE DATE OF ISSUE May 26, 2010 EFFECTIVE DATE May 26, 2010 NUMBER 00-10- 06 SUBJECT: Supports Coordination Services
More informationAs of June. Psychiatric Rehabilitation. referred to. ARIZONAA officially FLORIDA. Certification GEORGIA. for each service: and advocacy. community.
State Recognitionn of the CPRPP Credential As of June 2013, the Certified Psychiatric Rehabilitation Practitioner (CPRP) credential is recognized by the statess listed below. Please note: The Psychiatric
More informationLICENSING INSPECTION INSTRUMENT FOR VOCATIONAL FACILITIES CHAPTER 2390
LICENSING INSPECTION INSTRUMENT FOR VOCATIONAL FACILITIES CHAPTER 2390 OFFICE OF MENTAL RETARDATION DEPARTMENT OF PUBLIC WELFARE COMMONWEALTH OF PENNSYLVANIA (Revised June 29, 2011) This licensing Inspection
More informationSession of 2008 No AN ACT
SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS ACT - QUALIFICATIONS FOR LICENSE, ENDORSEMENT OF OUT-OF-STATE LICENSES AND PROSCRIBING UNLAWFUL PRACTICE Act of Jul. 9, 2008,
More informationMEDICAID MANAGEMENT INFORMATION SYSTEMS 2020 PLATFORM PROJECT INFORMATION TECHNOLOGY CONSULTING AND QUALITY ASSURANCE SERVICES
MEDICAID MANAGEMENT INFORMATION SYSTEMS 2020 PLATFORM PROJECT INFORMATION TECHNOLOGY CONSULTING AND QUALITY ASSURANCE SERVICES Request for Proposals (RFP) #13-17 Pre-proposal Conference May 31, 2018 1
More informationHB 254 AN ACT. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:
PUBLIC WELFARE CODE - DEPARTMENT OF PUBLIC WELFARE POWERS, DETERMINING WHETHER APPLICANTS ARE VETERANS, MEDICAL ASSISTANCE PAYMENTS FOR INSTITUTIONAL CARE AND STATEWIDE QUALITY CARE ASSESSMENT Act of Jul.
More informationMental Health and Substance Abuse Services Bulletin COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE. Effective Date:
Mental Health and Substance Abuse Services Bulletin COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE Date of Issue: July 30, 1993 Effective Date: April 1, 1993 Number: OMH-93-09 Subject By Resource
More informationNC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Comprehensive Case Management for AMH/ASU.
NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Comprehensive Case Management for AMH/ASU Table of Contents 1.0 Description of the Procedure, Product, or Service...
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 08/24/17 REPLACED: 07/06/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES APPENDIX B GLOSSARY/ACRONYMS PAGE(S) 5 GLOSSARY
GLOSSARY The following is a list of abbreviations, acronyms and definitions used in the Behavioral Health Services manual chapter. Ambulatory Withdrawal Management with Extended On-Site Monitoring (ASAM
More informationterm does not include services provided by a religious organization for the purpose of providing services exclusively to clergymen or consumers in a
HEALTH CARE FACILITIES ACT - LICENSURE OF HOME CARE AGENCIES AND HOME CARE REGISTRIES, CONSUMER PROTECTIONS, INSPECTIONS AND PLANS OF CORRECTION AND APPLICABILITY OF ACT Act of Jul. 7, 2006, P.L. 334,
More informationNP or PA as Billing Provider
NP or PA as Billing Provider Claire Agnew, CPA MBA CHC Vice President of Financial Operations Phoenix Children s Medical Group Phoenix Children s Hospital Arizona s only children s hospital recognized
More informationState Recognition of the CPRP Credential
State Recognition of the CPRP Credential ARIZONA AHCCCS (the state Medicaid authority) and the Arizona Department of Health Services officially recognized the CPRP in a letter directed to T/RBHA agencies
More information77th OREGON LEGISLATIVE ASSEMBLY Regular Session. Enrolled. House Bill 2768 CHAPTER... AN ACT
77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session Sponsored by COMMITTEE ON HEALTH CARE Enrolled House Bill 2768 CHAPTER... AN ACT Relating to professions regulated by the Oregon Board of Licensed
More informationMEDICAID ENROLLMENT PACKET
MEDICAID ENROLLMENT PACKET Follow the steps below. This will prevent errors which will delay enrollment. Physicians Only: 1. Answer the one page questionnaire 2. SIGN EACH FORM where it indicates Signature
More informationPreventing Fraud and Abuse in Health Care
Preventing Fraud and Abuse in Health Care Corporate Compliance what is it? Corporate Compliance is about the effort to fight healthcare fraud and abuse by making it a state and federal criminal offense
More informationPlease mail your completed application, documentation and required fee(s) to: 2601 Blair Stone Road Tallahassee, Florida
State of Florida Department of Business and Professional Regulation Board of Architecture and Interior Design Application for Certificate of Authorization Architectural Business Form # DBPR AR 5 1 of 8
More informationSUPPLEMENTAL NOTE ON SENATE BILL NO. 449
SESSION OF 2016 SUPPLEMENTAL NOTE ON SENATE BILL NO. 449 As Amended by Senate Committee on Public Health and Welfare Brief* SB 449, as amended, would standardize regulatory statutes administered by the
More informationCore Services Provided in Federally Clinical Coverage Policy No: 1D-4 Qualified Health Centers and Amended Date: October 1, 2015 Rural Health Clinics
Qualified Health Centers and Amended Date: October 1, 2015 Rural Health Clinics Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Federally Qualified Health Centers... 1
More informationAccess to Adult BH HCBS for Non-Health Home Enrollees: The State Designated Entity. February 22, 2018
Access to Adult BH HCBS for Non-Health Home Enrollees: The State Designated Entity February 22, 2018 February 22, 2018 Agenda Overview of HARP and Adult BH HCBS What is a State Designated Entity? Becoming
More informationVirginia. Phone. Web Site Licensure Term. Assisted Living Facilities.
Virginia Phone Agency Department of Social Services, Division of Licensing Programs (804) 726-7157 Contact Judy McGreal (804) 726-7157 E-mail judith.mcgreal@dss.virginia.gov Web Site http://www.dss.virginia.gov/facility/alf.cgi
More informationI am Jill Morrow, the Medical Director for the PA Office of Developmental Programs. I will be your presenter for this webcast.
1 Welcome to Lesson 1 in ODP s Nursing Services Overview. I am Jill Morrow, the Medical Director for the PA Office of Developmental Programs. I will be your presenter for this webcast. 2 This series of
More informationHighlights of Program Integrity Provisions Managed Care Delivery System Subcommittee June 9, 2011
Patient Protection and Affordable Care Act: Highlights of Program Integrity Provisions Managed Care Delivery System Subcommittee June 9, 2011 1 Provider Screening and Other Enrollment Requirements Provider
More informationOkla. Admin. Code 340: : Purpose. Okla. Admin. Code 340: : Definitions [REVOKED] Okla. Admin.
Okla. Admin. Code 340:110-1-1 340:110-1-1. Purpose The purpose of this Chapter is to describe the responsibilities and functions of Licensing Services in regard to the licensure of child care facilities.
More informationOFFICE OF DEVELOPMENTAL PROGRAMS BULLETIN
ISSUE DATE XX-XX-XXXX SUBJECT EFFECTIVE DATE XX-XX-XXXX OFFICE OF DEVELOPMENTAL PROGRAMS BULLETIN NUMBER 00-XX-17 BY Office of Developmental Programs Claim and Service Documentation Requirements for Providers
More informationCOMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE ISSUE DAT E: DRAFT
MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE NUMBER: DRAFT ISSUE DAT E: DRAFT EFFECTIVE DATE: DRAFT SUBJECT: Behavioral Health Services:
More informationLCB File No. R PROPOSED REGULATION OF THE BOARD OF OCCUPATIONAL THERAPY
LCB File No. R179-01 PROPOSED REGULATION OF THE BOARD OF OCCUPATIONAL THERAPY Chapter 640A of NAC is hereby amended by adding thereto a new section to read as follows: NAC640A.XXX Application for a temporary
More informationEXHIBIT AAA (3) Northeast Zone PROVIDER NETWORK COMPOSITION/SERVICE ACCESS
EXHIBIT AAA (3) Northeast Zone PROVIDER NETWORK COMPOSITION/SERVICE ACCESS 1. Network Composition The PH-MCO must consider the following in establishing and maintaining its Provider Network: The anticipated
More informationPolicy Issuer (Unit/Program) Policy Number. QM QM Effective Date Revision Date Functional Area: Beneficiary Protection
Title: Staff Registration County of Sacramento Policy and Procedure Policy Issuer (Unit/Program) Policy Number QM QM-03-07 Effective 06-07-2005 Revision 02-15-2018 Functional Area: Beneficiary Protection
More informationDISCLOSURE AND POLICY STATEMENT
ERIN A. BEASLEY, Ph.D. Licensed Child & Adolescent Psychologist (206) 661-3199 DISCLOSURE AND POLICY STATEMENT PLEASE READ AND SIGN Welcome to my practice. I am pleased to have the opportunity to work
More informationManual for All Patient Refined Diagnosis Related Group Review of Inpatient Hospital Services
Manual for All Patient Refined Diagnosis Related Group Review of Inpatient Hospital Services Effective for Inpatient Stays with Discharges On or After July 1, 2010 OFFICE OF MEDICAL ASSISTANCE PROGRAMS
More informationCOMMCARE and Independence Waiver Renewals Aging, Attendant Care and OBRA Waiver Amendments Side-by-Side Comparison of Current and Revised Language
Appendix and Waiver Section Current Language Revised Language Waiver Affected Commenter Name, Date Submitted and Comment Appendix A: Waiver Administration and Operation Appendix A-2-a. Medicaid Director
More informationAdult Behavioral Health Home and Community Based Services Quality and Infrastructure Program: Improving Lives
Adult Behavioral Health Home and Community Based Services Quality and Infrastructure Program: Improving Lives April 30, 2018 2 Agenda for the Day Vision and Overview: HARP and BH HCBS Recovery Coordination
More informationEnhanced Mental Health Clinical Coverage Policy No: 8-A and Substance Abuse Services Amended Date: October 1, 2016.
Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Definitions... 1 2.0 Eligibility Requirements... 1 2.1 Provisions... 1 2.1.1 General... 1 2.1.2 Specific... 2 2.2 Special
More informationCh COUNTY NURSING FACILITY SERVICES CHAPTER COUNTY NURSING FACILITY SERVICES
Ch. 1189 COUNTY NURSING FACILITY SERVICES 55 1189.1 CHAPTER 1189. COUNTY NURSING FACILITY SERVICES Subchap. Sec. A. GENERAL PROVISIONS... 1189.1 B. ALLOWABLE PROGRAM COSTS AND POLICIES... 1189.51 C. COST
More informationEducation, Training and Licensure
Meredith M. Sargent, Ph.D. Licensed Clinical Psychologist 2950 Northup Way, Suite 204 Bellevue, Washington 98004 425.739.4772 (phone) 425.739.4778 (fax) msargentphd@gmail.com Welcome to my practice! I
More informationApplication for a 1915(c) Home and Community-Based Services Waiver
Application for 1915(c) HCBS Waiver: PA.0147.R04.03 - Jul 01, 2009 (as of Jul 01, 2009)Page 1 of 271 https://www.hcbswaivers.net/cms/faces/protected/35/print/printselector.jsp 5/4/2011 Application for
More informationOFFICE OF DEVELOPMENTAL PROGRAMS BULLETIN
ISSUE DATE July 25, 2018 SUBJECT EFFECTIVE DATE July 25, 2018 OFFICE OF DEVELOPMENTAL PROGRAMS BULLETIN NUMBER 00-18-04 BY Interim Technical Guidance for Claim and Service Documentation Nancy Thaler, Deputy
More informationxwzelchzz April 20, 2009
Z xwzelchzz April 20, 2009 Assertive Community Treatment and Community Treatment Teams in Pennsylvania Commonwealth of Pennsylvania Office of Mental Health and Substance Contents 1. Introduction...1 2.
More informationManaging employees include: Organizational structures include: Note:
Nursing Home Transparency Provisions in the Patient Protection and Affordable Care Act Compiled by NCCNHR: The National Consumer Voice for Quality Long-Term Care, April 2010 Part I Improving Transparency
More informationIRRC. Comments of the Independent Regulatory Review Commission. Department of Human Services Regulation # (IRRC #3176)
- g-jixcri Comments of the Independent Regulatory Review Commission -: - - IRRC Re,ww Corns ssa Department of Human Services Regulation #14-538 (IRRC #3176) Outpatient Psychiatric Services and Psychiatric
More informationJeffrey N. Gregg, Bureau Chief Anne Menard, Home Care Unit Manager Bureau of Health Facility Regulation Agency for Health Care Administration July 30
HOME HEALTH AGENCY STATE LAW CHANGES Jeffrey N. Gregg, Bureau Chief Anne Menard, Home Care Unit Manager Bureau of Health Facility Regulation Agency for Health Care Administration July 30 & 31, 2008 Copies
More informationALABAMA BOARD OF MEDICAL EXAMINERS ADMINISTRATIVE CODE CHAPTER 540-X-8 ADVANCED PRACTICE NURSES: COLLABORATIVE PRACTICE TABLE OF CONTENTS
Medical Examiners Chapter 540-X-8 ALABAMA BOARD OF MEDICAL EXAMINERS ADMINISTRATIVE CODE CHAPTER 540-X-8 ADVANCED PRACTICE NURSES: COLLABORATIVE PRACTICE TABLE OF CONTENTS 540-X-8-.01 540-X-8-.02 540-X-8-.03
More informationCompliance Program Updated August 2017
Compliance Program Updated August 2017 Table of Contents Section I. Purpose of the Compliance Program... 3 Section II. Elements of an Effective Compliance Program... 4 A. Written Policies and Procedures...
More informationSTAR+PLUS through UnitedHealthcare Community Plan
STAR+PLUS through UnitedHealthcare Community Plan Optum 06012014 Who We Are United Behavioral Health (UBH) was created February 2, 1997, through a merger of U.S. Behavioral Health, Inc. (USBH) and United
More informationALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-5 ADVANCED PRACTICE NURSING COLLABORATIVE PRACTICE TABLE OF CONTENTS
Nursing Chapter 610-X-5 ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-5 ADVANCED PRACTICE NURSING COLLABORATIVE PRACTICE TABLE OF CONTENTS 610-X-5-.01 610-X-5-.02 610-X-5-.03 610-X-5-.04 610-X-5-.05
More informationThe House of Virtue director shall develop a transitional staffing plan for any new services, added locations, or changes in capacity.
Policy: The House of Virtue shall design and implement a staffing plan that includes the type and role of employees and contractors and reflects the: 1. Needs of the population served; 2. Types of services
More informationProvider Handbooks. Telecommunication Services Handbook
Provider Handbooks December 2016 Telecommunication Services Handbook The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health
More informationKANSAS MEDICAL ASSISTANCE PROGRAM. Fee-for-Service Provider Manual. Local Education Agency
Fee-for-Service Provider Manual Local Education Agency Updated 07.2018 Introduction PART II Section Page 7000 Local Education Agency Billing Instructions............ 7-1 7010 Local Education Agency Billing
More informationBEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual
BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual Issued March 14, 2017 State of Louisiana Bureau of Health Services Financing LOUISIANA MEDICAID PROGRAM ISSUED: 12/13/17
More informationCONSULTATION SERVICES POLICY
CONSULTATION SERVICES POLICY UnitedHealthcare Oxford Reimbursement Policy Policy Number: ADMINISTRATIVE 256.3 T0 Effective Date: October 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 APPLICABLE
More informationJohn W. Steele, Ph.D., Licensed Psychologist 1285 Fairfield Drive, Boulder, CO 80305
John W. Steele, Ph.D., Licensed Psychologist 1285 Fairfield Drive, Boulder, CO 80305 PSYCHOLOGIST-CLIENT DISCLOSURE STATEMENT AND SERVICES AGREEMENT Welcome to my practice. This document (the Agreement)
More informationThe Basics of Health Care Facilities Licensure in Pennsylvania
The Basics of Health Care Facilities Licensure in Pennsylvania Victoria Heller Johnson, Esq. March 13, 2018 2018 Fox Rothschild Role of Licensure Oversight Mechanism Ensure services are provided by properly
More informationSUPPLEMENTAL NOTE ON SENATE BILL NO. 449
SESSION OF 2016 SUPPLEMENTAL NOTE ON SENATE BILL NO. 449 As Amended by House Committee on Health and Human Services Brief* SB 449, as amended, would standardize regulatory statutes administered by the
More informationUPMC RECEIVED. University of Pittsburgh Medical Center UPMC SENIOR COMMUNITIES SEP 1 5 REC'D. September 15, 2008 INDEPENDENT REGULATORY
Sna From: Pacella, Kathy [pacellakb@upmc.edu] Sent: Monday, September 15, 2008 4:37 PM To: IRRC; cquinnan@pahouse.net; Sharon Schwartz; mhansarick@pasen.gov; cduncan@pasenate.com Cc: Sander, Mary Ann Subject:
More informationMandatory Reporting: Child Abuse and Neglect in Indian Country
Mandatory Reporting: Child Abuse and Neglect in Indian Country Mandatory reporting requires that anyone with knowledge that a minor/child is being harmed or may be harmed must inform the legal authorities.
More informationThe Pennsylvania School-Based ACCESS Program
The Pennsylvania School-Based ACCESS Program A 2008-2009 review for the Pennsylvania Department of Education May 2010 Presented by 2010 Leader Services SBAP 2008-2009: A Year in Review Reimbursement Claims
More information1 MINNESOTA STATUTES J.692
1 MINNESOTA STATUTES 2015 62J.692 62J.692 MEDICAL EDUCATION. Subdivision 1. Definitions. For purposes of this section, the following definitions apply: (a) "Accredited clinical training" means the clinical
More informationConsolidated Community Reporting Initiative (CCRI) Provider Enrollment Frequently Asked Questions
10/23/2015 Consolidated Community Reporting Initiative (CCRI) Provider Enrollment Frequently Asked Questions What is the CCRI enrollment process? To ensure continuity, the CCRI county representative will
More informationRULE PROPOSALS INTERESTED PERSONS
RULE PROPOSALS INTERESTED PERSONS The Department of Corrections provides notices of rule proposals in the New Jersey Register (N.J.R.), a semi-monthly official publication of the Office of Administrative
More informationASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS Susan Bonilla, Chair AB 705 Eggman As Introduced February 25, 2015
Page 1 Date of Hearing: April 7, 2015 ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS Susan Bonilla, Chair AB 705 Eggman As Introduced February 25, 2015 SUBJECT: Psychologists: licensure exemption. SUMMARY:
More informationPROVIDER REQUIREMENTS. Providers must meet the following requirements in order to participate in the program:
Standards of Participation PROVIDER REQUIREMENTS Providers must meet the following requirements in order to participate in the program: Possess a current license for Personal Care Attendant Services issued
More informationGENERAL ASSEMBLY OF NORTH CAROLINA SESSION HOUSE DRH70279-RJf-8 (05/04) Short Title: Behavior Analysis Practice Act.
H GENERAL ASSEMBLY OF NORTH CAROLINA SESSION HOUSE DRH0-RJf- (0/0) H.B. 1 May, HOUSE PRINCIPAL CLERK D Short Title: Behavior Analysis Practice Act. (Public) Sponsors: Referred to: Representatives Parfitt,
More informationPENNSYLVANIA DEPARTMENT OF HUMAN SERVICES OFFICE OF LONG-TERM LIVING OBRA. Preadmission Screening Resident Review Identification Form.
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES OFFICE OF LONG-TERM LIVING OBRA Preadmission Screening Resident Review Identification Form (Level I Tool) April 2017 1 Objectives for this Webinar Overview of
More informationScope of Service Home Delivered Meals
Scope of Service Home Delivered Meals SPC: 402 Provider Subcontract Agreement Appendix N Purpose: Defines requirements and expectations for the provision of subcontracted, authorized and rendered services.
More informationStark, False Claims and Anti- Kickback Laws: Easy Ways to Stay Compliant with the Big Three in Healthcare
Stark, False Claims and Anti- Kickback Laws: Easy Ways to Stay Compliant with the Big Three in Healthcare In health care, we are blessed with an abundance of rules, policies, standards and laws. In Health
More information