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coronavirus ask?

  • 1.  coronavirus ask?

    Posted 03-04-2020 13:36

    What are folks asking their states to address with respect to coronavirus planning?

     

    In Maryland, Medicaid doesn't allow reimbursement for telehealth interventions when the patient is at home. We are considering asking the state to allow reimbursement for home-based telehealth AND telephonic services if telehealth unavailable in the event of quarantine situations.

     

    Curious to know what things other folks are requesting and/or what your states are willing to consider.

     

     

     

    Shannon Hall

    Executive Director

    Community Behavioral Health Association of Maryland

    (410) 788-1865

     

     

     



  • 2.  RE: coronavirus ask?

    Posted 03-04-2020 15:56

    Hello All,

    At this point, I don't have anything enlightening to offer or suggest. We'll do some probing with our state Health Care Authority and see what plans or options might be possible to pursue.

    Ann  

    Ann Christian | CEO
    Washington Council for Behavioral Health

    P 206 628 4608 | F 206 448 2448

    achristian@thewashingtoncouncil.org
    600 Stewart Street, Suite 202

    Seattle, Washington 98101
    thewashingtoncouncil.org



    ------------------------------
    Ann Christian
    Chief Executive Officer
    Washington Council for Behavioral Health
    Seattle WA
    206-628-4608
    ------------------------------

    Original Message


  • 3.  RE: coronavirus ask?

    National Council Staff
    Posted 03-04-2020 16:29

    I think it definitely makes sense to ask your state Medicaid office. However they may feel constrained without the general support of CMS so I would also send the request your regional CMS office. There is a national group called Alliance for Connected Care requesting similar changes in response to coronavirus so I think it definitely makes sense to at least ask.

     

                                    Best regards – Joe

     

    Joe Parks
    Vice President, Practice Improvement & Medical Director
    National Council for Behavioral Health
    1400 K Street NW Suite 400, Washington, DC 20005
    Direct: (202) 629-5791
    Email: JoeP@TheNationalCouncil.org
           
    www.TheNationalCouncil.org  
    Conf20!

    https://www.facebook.com/TheNationalCouncil
    https://twitter.com/nationalcouncil
    https://www.youtube.com/user/nationalcouncil
    https://www.linkedin.com/company/1784305/
    		 
     



    Original Message


  • 4.  RE: coronavirus ask?

    National Council Staff
    Posted 03-04-2020 16:30

    Hello Shannon,

     

    I think it certainly makes sense for anyone to ask this kind of accommodation of their state Medicaid agency but I would recommend also CCing your regional Medicaid office with the request. It's something a local Medicaid office would feel anxious doing without CMS support. There is a national group called Alliance for Connected Care that is asking for similar accommodations due to coronavirus.

     

                    Best regards – Joe           

     

    Joe Parks
    Vice President, Practice Improvement & Medical Director
    National Council for Behavioral Health
    1400 K Street NW Suite 400, Washington, DC 20005
    Direct: (202) 629-5791
    Email: JoeP@TheNationalCouncil.org
           
    www.TheNationalCouncil.org  
    Conf20!
    https://www.facebook.com/TheNationalCouncil
    https://twitter.com/nationalcouncil
    https://www.youtube.com/user/nationalcouncil
    https://www.linkedin.com/company/1784305/
    		 
     



    Original Message


  • 5.  RE: coronavirus ask?

    Posted 03-04-2020 16:50
    Thanks, Joe. Good advice!

    ------------------------------
    Shannon Hall
    Executive Director
    Community Behavioral Health Association of Maryland
    Catonsville MD
    410-788-1865 ext 2
    ------------------------------

    Original Message


  • 6.  RE: coronavirus ask?

    Posted 03-05-2020 11:46
    Vermont has this language in our payment reform agreement with the State that we hope will be useful if we end up with low utilization rates related to COVID -19

    "Separate from individual outlier payments and from changes made as a result of the annual case mix review, a mid-year adjustment may be made to the case rate in catastrophic circumstances. Should unforeseen circumstances significantly impact utilization, the DA/SSA and DMH may review and revise the contractual cap and case rate or make a one-time adjustment through general funds. Unforeseen circumstances may include, but are not limited to, natural disaster, facility closure, or adverse community events on such a scale that they are not accounted for in the trends that went into design of the case rate."

    ------------------------------
    Julie Tessler
    Executive Director
    Vermont Care Partners
    Montpelier VT
    (802)223-1773
    ------------------------------

    Original Message


  • 7.  RE: coronavirus ask?

    Posted 03-11-2020 10:56
    Massachusetts already allows telehealth for BH in the home.  The guidance is here if it is a helpful framework to look at: https://www.mass.gov/files/documents/2019/01/23/all-provider-bulletin-281.pdf.  We will be asking for telephonic allowances because many of our organizations have not moved into this.  Will certainly update if it moves forward.

    ------------------------------
    Lydia Conley
    President/CEO
    Association for Behavioral Healthcare
    Natick MA
    508-647-8385
    ------------------------------

    Original Message


  • 8.  RE: coronavirus ask?

    Posted 03-11-2020 13:23

    In Ohio, Medicaid will cover services delivered by "interactive videoconferencing" for the majority of covered services.  However, we have also asked for consideration of service delivery via telephone to support access to treatment during this public health emergency since not all providers have access to telehealth services and in rural areas internet access is spotty at best. 

     

    Teresa Lampl, LISW-S, CEO 

    The Ohio Council of Behavioral Health & Family Services Providers

    35 E. Gay Street, Suite 401, Columbus, OH  43215 

    lampl@theohiocouncil.org   |  614-228-0747  |  www.theohiocouncil.org     

     

    Advocating Today for a Healthy Tomorrow

     

     




    Original Message


  • 9.  RE: coronavirus ask?

    Posted 03-12-2020 09:40

    In a meeting with the Medicaid Director yesterday on the discussion of COVID-19, he let me know telehealth for BH in the home would be authorized.  There is nothing yet in writing.  I will share when it becomes available.

     

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    Original Message


  • 10.  RE: coronavirus ask?

    Posted 03-13-2020 09:00

    Our Board of Behavioral Sciences put out a communication to all licensees clarifying who can provide services within the state via telehealth: https://bbs.ca.gov/pdf/coronavirus_statement.pdf

     




    Original Message


  • 11.  RE: coronavirus ask?

    Posted 03-13-2020 12:25
    Maryland Medicaid put out guidance yesterday allowing the use of telehealth in patient homes or "any other secure location." However, they excluded residential group homes for SUD and SMI from the use of telehealth, while it appears that non-BH congregate care settings can use it.

    We got a limited telephonic allowance for targeted case management providers, but nothing telephonic for other levels of service.

    Policy development is evolving, so we are continuing advocacy on both of these issues. If anybody else has success in the telephonic coverage requests, please let me know.

    Shannon Hall
    CBH

    ------------------------------
    Shannon Hall
    Executive Director
    Community Behavioral Health Association of Maryland
    Catonsville MD
    410-788-1865 ext 2
    ------------------------------

    Original Message


  • 12.  RE: coronavirus ask?

    Posted 03-13-2020 12:25
    Hi all, we are also asking for the capacity to use telephone only also as many in our rural areas cannot access televideo level internet. Our Medicaid office is considering it. Will keep you all posted. 

    ---

    Malory Otteson Shaughnessy, MPPM

    Executive Director

    Alliance for Addiction and Mental Health Services, Maine

    & Maine Behavioral Health Foundation

    295 Water Street, Suite 307 | Augusta, Maine 04330

    Office: 207.621.8118 | Cell: 207.242.0303 | Fax: 207.621.8362

    mshaughnessy@masap.org | theAllianceMaine.org




    Original Message


  • 13.  RE: coronavirus ask?

    Posted 03-14-2020 10:00
    Yesterday Massachusetts allowed telephonic encounters "Billing for Covered Services Delivered via Telehealth.  

    Relevant part of the guidance is here:
    To mitigate the spread of COVID-19, MassHealth is committed to enabling members to remain in
    their homes to reduce exposure and transmission,to the extent possible, and to preserve health
    system capacity for the duration of this public health emergency. To that end, and for as long as this
    bulletin remains effective, MassHealth will permit qualified providers to deliver clinically
    appropriate, medically necessary MassHealth-covered services to MassHealth members via
    telehealth (including telephone and live video)in accordance with the standards set forth in
    Appendix A and notwithstanding any regulation to the contrary, including the physical presence
    requirement at 130 CMR 433.403(A)(2).
    MassHealthis notimposing specific requirements for technologies used to deliver services via
    telehealthand will allow reimbursement for MassHealth covered services delivered through
    telehealthso long as such services are medically necessary and clinically appropriate and comport
    with the guidelines set forth in Appendix A to this bulletin. Providers are encouraged to use
    appropriate technologies to communicate with individuals and should, to the extent feasible, ensure
    the same rights to confidentiality and security as provided in face-to-face services. Providers must
    inform members of any relevant privacy considerations.
    Rates of payment for services delivered via telehealthwill be the same as rates of payment for
    services delivered via traditional (e.g., in-person) methods set forth in the applicable regulations.
    Providers must include Place of Service Code 02 when submitting a claim for services delivered via
    telehealth. Providers will be able to bill MassHealth for these services delivered via telehealth
    beginning April 1, 2020,for dates of service beginning March 12, 2020."

    Guidance is here:  https://www.mass.gov/doc/all-provider-bulletin-289-masshealth-coverage-and-reimbursement-policy-for-services-related-to/download

    ------------------------------
    Lydia Conley
    President/CEO
    Association for Behavioral Healthcare
    Natick MA
    508-647-8385Lydia Conley
    President/CEO
    Association for Behavioral Healthcare
    Natick MA
    508-647-8385
    ------------------------------

    Original Message


  • 14.  RE: coronavirus ask?

    Posted 03-14-2020 14:12
    Florida Medicaid issued a policy transmittal  on Thursday to all managed care plans authorizing the use of telehealth and telephonic services during the public health emergency for ALL services, including the in lieu of services. They have this flexibility under the 1115 Waiver for managed care.  Medicaid was waiting on the President to declare a national public health emergency and then they intend (or so I'm told) to use the 1135 authority to employ the same flexibility in Fee for Service and state plan services. However, Providers have to document in detail the reason for the use of telephonic or telehealth services (in addition to the public health emergency). The plans are concerned with the use of telephonic services and the potential for fraud.

    Relevant language:

    Other Contractual Provisions that Require Face-to-Face Contact with Enrollees :

    Until further notice, the managed care plan may satisfy any face-to-face contact requirements (e.g., perinatal home visits, interagency staffing meetings, etc.) in the SMMC Contract telephonically or using audio/visual technology.

     

    Telemedicine:

    The SMMC contract requires the managed care plan to provide coverage, when appropriate, for services provided through telemedicine in compliance with 45 CFR 164.312 for services covered under this contract, to the same extent the services would be covered if provided through a face-to-face encounter with a practitioner. (Attachment II, Section IV.D.4.) These telemedicine provisions include store-and-forward and remote patient monitoring services. (Attachment II, Section VI.F.7.) During the state of emergency, the Agency encourages the managed care plan to maximize the use of telemedicine (as appropriate), including remote patient monitoring, in order to minimize public exposure and to promote access to health care services to the fullest extent possible. The managed care plan must comply with all state and federal requirements related to the of telemedicine/telehealth.

    Nothing in this policy transmittal should be construed to limit the managed care plan's contractual responsibilities relating to provider networks, utilization management, and coverage of services. This policy transmittal does not relieve the managed care plan of its obligation to provide emergency services in accordance with the contract. (Attachment II, Exhibit II-A, Section VI.A.1.a.(6))

     
    Thanks,
    Melanie

    MELANIE BROWN-WOOFTER

    President/CEO
    Florida Behavioral Health Association



    ------------------------------
    Melanie Brown-Woofter
    President/CEO
    Florida Behavioral Health Association
    Tallahassee FL
    850-224-6048
    ------------------------------

    Original Message