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BHRS - Kirk T. Settlement Amended
February 19,2004

The Department of Public Welfare (DPW) and the Kirk T. plaintiffs have reached an agreement amending the reporting requirements under Kirk T.

Background: In June 2003, the Kirk T. plaintiff’s attorneys acted to reopen the settlement agreement from November 2000. The Kirk T. Settlement Agreement was intended to compel and monitor timely access to children’s Medicaid behavioral health services and to increase the labor pool of trained staff available to provide Therapeutic Staff Support (TSS) services in the Commonwealth. An extensive data reporting system impacting DPW, HealthChoices behavioral health managed care organizations (BHMCOs) and Behavioral Health Rehabilitation Services (BHRS) providers was established under that agreement. On January 6 the court approved an amended agreement between the parties. The amended agreement substantially reduces DPW’s required data reporting to the Kirk T. plaintiffs.

Changes in DPW’s Reporting Requirements
In the Fee For Service Regions, DPW will now report

  • Total number of TSS Services authorized and
  • Total number of TSS paid claims for each month

In the HealthChoices regions, DPW will now report

  • Total number of hours of TSS Services authorized for the full authorization period, for authorizations ending in the month and
  • Total number of hours of (authorized) TSS Services for which claims were paid, reported by county.

This agreement DOES NOT change DPW and BHMCO requirements for provider reporting. It is PCPA’s expectation that, in due time, this change will substantially reduce the amount of complex data reporting for which BHRS providers are responsible.

Other significant elements of the original settlement agreement are unchanged.

PCPA will track and report on the implementation of this change and its impact. For more information and to report local impact of this change contact Connell O’Brien.

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