| Important Numbers Eligibility Verification System (EVS) 1-800-554-0042 Emergency Services Program (ESP) 1-877-382-1609 MassHealth Customer Service 1-800-841-2900 MBHP 1-800-495-0086 Integrated Care Management Program (ICMP) 1-800-495-0086, Ext. 454165 or (617) 790-4165 |
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Dear Primary Care Clinicians and Behavioral Health Providers:
Welcome to the new electronic format of the
Provider Connection newsletter!
We're thrilled to bring you PCC Plan information, updates, and resources for your practice in this easy-to-use electronic format. We welcome your feedback and suggestions. Drop us a line at
MBHPCommunications@beaconhealthoptions.com.
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Recommendations from Governor Baker's Opioid Working Group
Opioid abuse combined with the risk of overdose is a public health crisis that has garnered attention at all levels of government. In Massachusetts, the Governor's Opioid Working Group has developed a number of recommendations for medical providers to assist in combatting this epidemic, including: encouraging prescribers to treat addiction as a chronic disease; signing up for and checking the
Prescription Monitoring Program (PMP)
before prescribing medications with a risk of abuse; prescribing for shorter periods of time; and asking patients about their substance use history prior to prescribing. They should also consider educating patients and their families about Narcan, which can save lives when administered in the event of an opioid-related overdose.
Resources:
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| Substance Use Disorder Mandate
Massachusetts Chapter 258 of the Acts of 2014, effective October 1, 2015, seeks to improve access to substance use disorder treatment. MBHP, on behalf of the PCC Plan, is in full compliance with this law and does not require prior authorization for medically necessary acute treatment services and stabilization services. Additionally, MBHP will expand its network to include individuals with Licensed Alcohol and Drug Counselors I licensure.
Services impacted by this mandate include American Society of Addiction Medicine Levels 4, 3.7, and 3.5, and Enhanced Acute Treatment Services (E-ATS). Providers of these services must give MBHP notification of admission within 48 hours.
The Massachusetts Behavioral Health Partnership (MBHP)/Beacon Health Options offers a website to improve access to care with up-to-date information on bed availability for substance use disorder services. The
Massachusetts Behavioral Health Access (MABHA)
website, in use since July 2009, can be utilized by a variety of providers and entities, including Emergency Services Program (ESP), EDs, inpatient providers, and Children's Behavioral Health Initiative (CBHI) providers, to obtain service availability information across the state.
The search function on the MABHA website for substance use disorder services is also available to the general public and does not require a log in. The following substance use disorder services will be added to MABHA by February 28, 2016:
- Clinical Stabilization Services (CSS)
- Transitional Support Services (TSS)
- Level IV Detox
- Methadone providers
- Recovery Homes
- Structured Outpatient Addiction Programs (SOAP)
- Medication Assisted Treatment (MAT)
Visit the Massachusetts Behavioral Health Access Website |
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Resources on Integrating Mental Health and Substance Use Disorder/Addiction Services
The current opioid crisis has brought the issue of addiction into the national spotlight. Substance use disorders (related to
alcohol, tobacco, cannabis (marijuana), stimulants, hallucinogens, and opioids)
and mental illness frequently co-exist, and as the National Institute on Drug Addiction (NIDA) notes, when they do, it is important to address both issues concurrently. For more on this topic:
Massachusetts Bureau of Substance Abuse Services (BSAS): Practice Guidance: Ensuring Effective Treatment for Persons with Co-Occurring Disorders MBHP webinars and trainings on integration Substance Abuse and Mental Health Service Administration (SAMHSA) National Alliance on Mental Illness (NAMI): Dual Diagnosis National Institutes of Health (Medline Plus): Dual Diagnosis National Institute on Drug Addiction (NIDA): Comorbidity: Addiction and Other Mental Illnesses
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Applied Behavior Analysis (ABA) as a Covered Service
Effective October 1, 2015, the Massachusetts Behavioral Health Partnership (MBHP) began covering Applied Behavior Analysis (ABA) services to youth under the age of 21 years enrolled in MassHealth Standard and CommonHealth through Early and Periodic Screening, Diagnosis and Treatment (EPSDT) and to children under the age of 19 enrolled in MassHealth Family Assistance.
ABA is an evidence-based practice commonly used with individuals with a diagnosis of an Autism Spectrum disorder (DSM-V). Based on the science of learning and behavior, ABA is considered a "best" practice treatment by the US Surgeon General and by the American Psychological Association. Treatment is provided in a variety of settings, such as the home and in the community.
If you would like more information about ABA services, including how to access services, visit the
MBHP website
or call our Community Relations Department at 1-800-495-0086 (press 1 for the English menu or 2 for the Spanish menu, then 3 then 1 to skip prompts)
, Monday through Thursday, 8:00 a.m. to 5:00 p.m., and on Fridays from 9:30 a.m. to 5:00 p.m.
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New Director of Dental Services
 Dr. Donna C. Jones, DMD, MPH, serves as Director of Dental Services for MassHealth. She provides programmatic guidance and collateral agency support within the Massachusetts Executive Office of Health and Human Services on oral health matters. Dr. Jones' 33 years of experience as an executive in clinical, community health center administration, and managed care gives her a unique perspective. She received her dental degree from the University of Pennsylvania and her master's degree in public health from Temple University. One of her many interests include integrating oral health into primary care.
Tooth decay is America's number one chronic childhood disease, 100 percent preventable and five times more common than asthma. MassHealth primary care providers can promote oral health for their patients by incorporating into their care plans the following tips:
- Routinely screen patients for gum disease and decay
- Familiarize yourself with MassHealth dental community resources
- Ask when they've last seen a dentist
*MassHealth Members who need help finding a dentist can call
1-800-207-5019.
In collaboration with the MassHealth Dental Program, physicians and qualified staff can partner with a dentist to reduce decay in MassHealth Members by taking a "Fluoride Varnish Training for Health-Care Professionals." This is an office or web-based training using Smiles for Life National curriculum.
Upon completion of the training, 1.5 CME credits are available. To schedule an office-based training, contact Megan Mackin, DentaQuest Outreach Coordinator/MassHealth Dental Program, at Megan.Mackin@dentaquest.com or 617-886-1728.
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ICD-10 Implementation
MassHealth Provider Relations conducted 28 live ICD-10 information sessions across the state as well as nine webinars. The live information sessions and webinars were to educate providers on the ICD-10 implementation and the operational impacts to the Provider Online Service Center (POSC). The goals of the sessions were to assist providers on how to transition from ICD-9 to ICD-10 and to educate providers on claims testing prior to the implementation.
Four post-ICD-10 implementation Q&A webinars were conducted to discuss any questions, concerns, or issues providers may have encountered after the October 1 implementation. All the sessions were very well attended and well received.
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Resources to help with delivering care measured by pediatric HEDIS© measures
Looking for resources to help deliver care being measured by pediatric HEDIS measures? MassHealth has created topic-specific resource lists for measures in these clinical areas:
- ADHD medication
- BMI assessment
- Immunizations
The resource lists link to websites with information for both practices and families. If you are working on these clinical areas, we hope you find these resources helpful! Resource sheets for these measures can be found on the MBHP website.
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Focus on Pregnancy and Your Member
Text4baby - A tool to support your patients
Women who sign up by texting BABY (or BEBE for  Spanish) to 511411 receive free text messages each week through their pregnancy and baby's first year, timed to their due date or baby's birthday. Independent research demonstrates that Text4baby increases users' health knowledge, facilitates interaction with providers, and improves appointment and immunization adherence. Learn more >
MassHealth Voluntary Reporting of Postpartum Depression Screening
In October 2015, MassHealth implemented a voluntary reporting process for standardized perinatal depression screening. PCCs are encouraged to report screens delivered during prenatal/postpartum or pediatric visits for infants aged 0-6 months using HCPCS code S3005 and U modifiers. Please refer to All Provider Bulletin 254 for more information and resources.
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| Flu Vaccine Recommendations 2015-2016
While influenza vaccination rates in Massachusetts are mostly higher than the national average, there is still room for improvement. Please keep in mind that everyone age six months and older should receive a flu vaccine as soon as they are able, especially those in the high-risk groups, including:
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pregnant women
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those with medical problems that increase their risk for complications from flu, including children and adults with neurological and neuromuscular conditions
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those 65 years of age and older
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those living in long-term care facilities
In addition, health care workers, household contacts, and others caring for those in the high-risk groups are a priority for flu vaccination. Vaccination optimally should occur before onset of influenza activity in the community and as soon as the vaccine becomes available. Vaccination should be offered as long as influenza viruses are circulating. In New England, influenza activity usually peaks in January, February, or later, and lasts through April and May. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations.
Influenza vaccine is available free of charge from the Massachusetts Department of Public Health to PCC Plan Members under the age of 19. For Members over the age of 19, you may purchase flu vaccine directly from the manufacturer and submit the claim to MassHealth for reimbursement. Refer to the appropriate billing instructions for your provider type.
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