Pennsylvania Behavioral Health HealthChoices

Back to the Drawing Board for PH-MCO Procurement

It looks like Pennsylvania will be heading back to the drawing board in the Physical Health Managed Care Organization (PH-MCO) procurement process. That’s because in April 2018, Commonwealth Courtruled in favor of the bidders protesting the contract award process; Aetna, United HealthCare and Vista Health Plan. The three insurers had filed suit challenging that (more…)

Pennsylvania Continues Efforts to Address the Opioid Epidemic

Pennsylvania continues to take steps to address the opioid epidemic by focusing on removing barriers to treatment. In late 2016, the state began implementing its Centers of Excellence program, with the goal of coordinating care for individuals with opioid use disorders and co-occurring behavioral and/or physical health conditions. Originally twenty centers were funded, with twenty-five additional centers implemented several months later. (more…)

Appendix R Update

In July, the Pennsylvania Department of Human Service (DHS) implemented revisions to Appendix R, Encounter Data Submissions Requirements and Accompanying Sanctions for Noncompliance. The focus of Appendix R is two-fold: DHS is interested in both the timeliness (more…)

Community HealthChoices – A Primer

NOTE: On November 6th, DHS announced it would delay the implementation of Phases 2 and 3 of the Community Health Choices program. Phase 1 will still begin as planned in 14 Southwestern Pennsylvania counties on January 1st. However, Phase 2 will now begin January 1, 2019 instead of July 1, 2018, and Phase 3 on January 1, 2020 instead of January 1, 2019.