RCPA - Rehabilitation and Community Providers Association


TSS Prior Authorization Required Beginning March 1
January 3, 2001

The final draft of the TSS Prior Authorization Bulletin has been released. Providers in the fee-for-service area must follow the new bulletin. Minor changes were made to the bulletin following the last draft, but none that affect the substance of activities now required.

Providers must submit the Request for Prior Authorization thirty (30) days in advance of the start date of services. For dates of service beginning March 1, providers should submit requests by February 1. This will assure timely processing and avoid any breaks in provision of approved services. Requests received later than 30 days prior to the start date will still be processed within the Department of Public Welfare's Office of Medical Assistance Programs (OMAP) 21-day time frame for review and disposition.

PCPA and the Office of Medical Assistance Programs are in the process of rescheduling the training for the bulletin that was canceled in December 2000. The training will be scheduled as soon as possible so that providers have the opportunity to review with OMAP the procedures and context in which TSS Prior Authorization Services will be implemented. PCPA anticipates the training to be scheduled for the end of January or the beginning of February, 2001. OMAP has requested that PCPA provide questions prior to the training so that the answers can be incorporated as a part of the presentation. If there are specific questions that you would like answered, please e-mail them to Lisa Lowrie no later than January 10. If you are unable to e-mail the questions, FAX them to Lisa's attention at 717-657-3552.

Providers can access the final bulletin at the OMAP web site at www.dpw.state.pa.us/omap/provinf/mabull/omapbullmain.asp.

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