Health Insurance Portability and Accountability Act (HIPAA, COVID-19 Public Health Emergency Suspended Regulations List. For Intensive Case Management licensed under 55 Pa. Code Chapter 5221, DHS suspended the requirements for caseload size, supervisor-to-staff ratio, and supervisory contact. Care managers are available to providers 24 hours a day, 7 days a week, 365 days a year. For regulations that have not been suspended, entities may submit a waiver request to OMHSAS to request temporary relief from other regulatory requirements to be considered on a case-by-case basis. C=55 M=60 Y=65 K=40 0.000000 C=40 M=65 Y=90 K=35 100.000000 0.000000 The goal of the partial hospitalization program is to resolve or stabilize an acute episode of mental illness. Similarly, payment will be made until January 17, 2021, to an agency that was approved to provide BHRS as of October 19, 2019, and otherwise complies with Chapters 1155 and 5240. 125 -Laboratory ServicesChap. Chap. 105 -Admission and DischargeChap. x\[OK~Ga:B"$9ar EMNb pi(/tY}6/gf}__.>n/6O_OOYLiLkv~{|svO^ 30r)9}cnlg f0-gxO?y=>?%fy(rS%{fBo{bObTJv6}zKE]Fuyurt.11d}2%TrGT>':{PTt`p?NO~DS9I*}euxb/~:XeZ+A=(34EvdyfG-gpU 5MlEdZ4Rqi?9{99K[4w1A>c1gba)&][4 H)itW'E bTM!#}x*ml:1n8o`5/;"! 0.000000 Requirements for obtaining verbal consent and documentation of the verbal consent remain and must be included in the medical record for every occurrence of a new and updated treatment plan. 0.000000 HS has suspended the requirements for the number of staff, but the CRR must take due diligence to maintain required direct-care staffing and have a conditional plan approved by OMHSAS. The requirement that individual and group services be provided in the facility or in the community is also suspended; these can be provided via telehealth when appropriate. CMYK Group 1 Paragraph. :4sqYu4S^5HLJ_#mMIhrFm:gm}FqQok8%q6FkqC(6xR|WK^7P(NG50!-~~|siXe[teu`6PM|ur>.o8$C+G&mV9UcQ_a+1-DQ!S1b]-;M0A3I0Z]_9c9n[ng:dc c WY@Bf6*3'K3p-c}3mC+K 30.000002 hW-~am *>:?XjW9137| 1Z~T~,?=Z*? "Published Edition". As part of your partial hospitalization program, Medicare may cover these: Occupational therapy that's part of your mental health treatment. 10.000002 It is not an official legal edition of the CFR. 0.000000 Requirements regarding staff supervision. Navigate by entering citations or phrases Medication-assisted treatment, if necessary. 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)*. CMYK 1031, unless otherwise noted. 0.000000 C=0 M=0 Y=0 K=70 Partial Hospitalization Programs provide therapeutic environments for children and adolescents ages 6 to 18 in a year-round school setting. Level 2 programs provide essential addiction education and treatment components and have two gradations of intensity. 39.999996 30.000002 Providers may utilize telehealth to develop the initial service plan and for the subsequent reviews of the plan. Pennsylvania Code (Rules and Regulations) . gcPrJR^66f4Wl\F 3&YT.'3}-}^P Z,W2hyBpp2]z3^Pp@i+RSz^.um;_l2YrH0%)o6]_%barQQ PROCESS 5 0 obj pf2IL%g2/EQEQEQu,0}Mq}YtDk|~t(((:e These services include therapeutic milieu; nursing . 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. CMYK CMYK 0.000000 Additionally, the requirement in 55 Pa. Code 1153.14 that MA payment will not be made for a covered partial hospitalization service conducted over the telephone also . Timelines until which MA payments will be made to certain unlicensed providers. The in-page Table of Contents is available only when multiple sections are being viewed. PROCESS uuid:1467FB186413E011AD869AF47E7E6FD4 PROCESS This is an automated process for 50.000000 Requirements regarding the number of direct-care staff persons have been suspended; however, a conditional plan for direct care staffing must be submitted to OMHSAS for review and approval. 0.000000 You may be trying to access this site from a secured browser on the server. 95.000000 Note: If you see an asterisk next to a service, this means that this service is not offered in all Magellan counties. This content is from the eCFR and is authoritative but unofficial. PROCESS 51 FR 41339, Nov. 14, 1986, unless otherwise noted. 146 - Infection Control. 0.003099 0.000000 0.000000 0.000000 Signature requirements, including signatures for treatment plans and written consent, have been suspended. 2&rf=,0J )F]GjRS-'u%)3X]f"/[>Ty h^KO0=Pd5-,Wg'pzAC Notes of Decisions The Department's addition of the requirement of JCAH accreditation for for-profit providers sub- . Due to HIPAA regulations, our staff is unable to . 51 -General ProvisionsChap. xmp.iid:F77F1174072068118A6DF0C37545496F 100.000000 h}a:] 8@p 8 CMYK 4. <<690F30FA3816B046A3F2C5243FD12EBB>]/Prev 57889>> 0.000000 Title 42 was last amended 4/12/2023. This document is available in the following developer friendly formats: Information and documentation can be found in our PROCESS PROCESS 100.000000 The Office of Mental Health and Substance Abuse Services (OMHSAS) originally issued this memorandum on August 14, 2020, to inform BH-MCOs, County Mental Health/Intellectual Disability Offices and behavioral health providers that specified regulatory provisions in 55 Pa. Code Chapters 1151, 1153, 1155, 1223, 5100, 5200, 5210, 5221, 5230, 5310, 5320 and 5240 have been temporarily suspended during the COVID-19 disaster emergency declaration period. endstream endobj 800 0 obj <. C=75 M=0 Y=75 K=0 CMYK PROCESS PROCESS Nomenclature changes to part 410 appear at 62 FR 46037, Aug. 29, 1997. trailer Partial hospitalization services Medicare-Medicaid plans under Amerigroup STAR+PLUS MMP (Medicare-Medicaid Plan) follow . Based on the annual ICD-10 updates for 2022, R45.88 was added to ICD-10 Codes that Support Medical Necessity, Group 1. 0.000000 Philadelphia, PA. Partial hospitalization must be a separate, identifiable, organized program . PROCESS C=25 M=25 Y=40 K=0 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. or existing codification. 2010-12-29T10:57:37-05:00 nitial assessments may be completed within 7 days of admission instead of on the day of admission. CMYK CMYK Chap. 30.000002 A listing of all suspended regulatory requirements for DHS licensees will be posted to the DHS website after all DHS program offices have provided appropriate notification and guidance to their impacted licensees. These services may be provided via telehealth/telephone if clinically appropriate to do so. CMYK CMYK CMYK (ii) Occupational therapy requiring the skills of a qualified occupational therapist, provided by an occupational therapist, or under appropriate supervision of a qualified occupational therapist by an occupational therapy assistant as specified in part 484 of this chapter. 0.000000 November 7, 2019 Updated Policy for Provider Rate Request. CMYK e requirements for annual and routine exams and medical and dental care for residents have also been suspended. Requirements for staff-to-patient ratios. If you would like to comment on the current content, please use the 'Content Feedback' button below for instructions on contacting the issuing agency. 0.000000 |g ,EQEQEQE%}l~u3NEQEQEQs_Init,AYc%EQEQEQE)In^^[i7^s(Tk6?r?T.I)PN CMYK hVnJ}+hWb2#' 1:08 . 100.000000 0.000000 Chap. OMHSAS does not require a letter of support from the county for those individual waiver requests. 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. 0.000000 1 CFR 1.1 PROCESS The CPT /HCPCS codes listed in Group 1: Codes describe covered services when performed in the context of partial hospitalization.
pa regulations for partial hospitalization programs