The conversion from ICD 9/DSM 4-TR to ICD 10/DSM 5 has come and gone. Many RCPA members are reporting claims denials for billing codes related to the Schizophrenia NOS and PTSD NOS. The reason is that the DSM 5 only offers the Schizophrenia NOS code but the ICD 10 offers seven other choices for Schizophrenia and similarly for PTSD. Clinicians are using the DSM 5 for documentation and choosing the available option; however, when converted to ICD 10 for billing and payment, the person does not meet the criteria for Schizophrenia NOS – therefore, CMS is denying payment. And if you think you are out of the woods in the substance abuse arena, think again; those problems are forthcoming.
RCPA is pleased to offer this webinar: DSM 5/ICD 10 Troubles: Understanding and Rectifying Revenue Problems, by Lisette Wright of Behavioral Health Solutions, P.A. Wright is author of the published curriculum ICD-10 and DSM-5: Coding, Documentation and Clinical Diagnostic Criteria Training, and has trained close to 13,000 clinicians across the country. Her soon-to-be-published graduate level test is titled Coding and Documentation Compliance for the ICD and DSM: A Comprehensive Guide for Clinicians, Routledge, late fall 2016.
Wednesday, June 1, 2:00 – 3:30 pm
Member Registration: $25
Non-Member Registration: $40
Register here no later than Monday, May 30, 2016
RCPA will host its annual conference at the Hershey Lodge on September 27–30, 2016. At this large-scale, statewide event, the RCPA board of directors wants to continue the important tradition of recognizing individuals and organizations/facilities for their dedication and commitment to service. The following award categories have been created for this event and recognition:
At this time, RCPA is accepting nominations through an open solicitation of members (e.g., designated contact person, CEOs/executive directors, staff) and RCPA committees. Members may nominate one or more individuals/organizations in one or more categories. Nominations will be reviewed by a sub-group of the board of directors to make recommendations for final selection and approval by the full board.
Include the name/organization (if applicable) of the nominee, the award category, and a statement about why you believe the individual/organization should be honored. Nominations should be made by Monday, May 16. Please send nominations to Cindy Lloyd.
Award recipients are not limited to RCPA members and every award may not be presented annually. Please join the association in continuing this tradition and in offering nominations for those who deserve recognition for their significant contributions.
SAMHSA and the Centers for Medicare & Medicaid Services (CMS) invite you to join a presentation of the final rule on mental health and substance use disorder parity for Medicaid and CHIP, to be held on Thursday, April 14, 1:00 – 2:00 pm.
This rule implements the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) for 23 million beneficiaries enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and the Children’s Health Insurance Program (CHIP), ensuring that benefits for mental health and substance use disorder treatments and services are offered on equal footing with medical and surgical benefits. This presentation will include a discussion of the application of parity to Medicaid and CHIP programs, key changes from the Notice of Proposed Rulemaking, and answers to frequently asked questions.
The Department of Drug and Alcohol Programs (DDAP) is requesting that all drug and alcohol treatment facilities complete this survey, regardless of whether they participated in any previous survey sent out.
The Department of Human Services (DHS) has announced the selection of 16 locations to participate in the Certified Community Behavioral Health Clinic (CCBHC) planning grant. The federal grant encourages states to adopt innovative approaches to community-based behavioral health services.
This initiative will further the Wolf Administration’s goal of improving the delivery of care for behavioral health and substance use treatment in the community where people live, providing Pennsylvanians with easier and more consistent access to the services they need. In an effort to provide CCBHC access to all affected Pennsylvanians, the 16 locations are comprised of both rural and urban locations throughout the state.
The federal Excellence in Mental Health Act established the CCBHCs as a way to improve quality and use evidenced-based practices in behavioral health.
The CCBHCs will provide nine core services:
The following clinics were selected:
As part of being selected as a CCBHC, the CCBHC Assessment and Readiness Review webinar is taking place on Friday, April 8 at 9:00 am. You are welcome to join DHS in person in the Clothestree Conference Room. To join via webinar, please register using this link. Once registered, you will receive a confirmation email with your connection link. Please note, this link will be unique to you and should not be shared with others.
RCPA, through the National Council, will be offering support to all selected CCBHCs. In addition, all selected CCBHCs are welcome to attend a monthly nationwide call with National Council and state leaders. More information will be available later this week.
RCPA congratulates all selected CCBHC providers. Please contact Sarah Eyster for more information.
Audits Every Two Years for Best Facilities/Notice of Changes
The Department of Drug and Alcohol Programs (DDAP) proposes to amend §709.11 and §709.14 (relating to the General Standards for Freestanding Treatment Facilities). The proposed amended language to §709.11 (application for license) seeks to enlarge the amount of time between inspections from one year to up to two years for the free standing drug and alcohol facilities that, for the prior two years, have not had any citations in four critical areas. Specifically, facilities that have been cited in the last two years for conduct or omissions that: 1) jeopardized the safety of any persons, 2) compromised the quality of treatment provided, 3) violated a client’s confidentiality rights or resulted in treatment being provided without informed consent, are not eligible to have the annual inspection time extended. In addition, facilities that have failed to take reasonable and timely remedial measures as requested by the department are not eligible for this extension.
Increasing the time between inspections serves as an incentive and rewards the best of the facilities by reducing the administrative burden associated with an annual inspection. In addition, the proposed amended language to §709.14 (restriction on license) requires drug and alcohol facilities to inform DDAP of major changes in ownership, location, or operations, 30 days before such an occurrence, rather than 90 days after the occurrence.
DDAP is requesting comments on the preliminary proposed regulations before moving forward with the formal IRRC process. Written comments are due by Wednesday, April 27, 2016. A stakeholder meeting will be held on Monday, May 2, at 11:30 am, at the University of Pittsburgh Child Welfare Research Center, 403 East Winding Hill Road, Mechanicsburg, PA 17055.