It Is Monday!

August 23, 2021

Two items that came to our attention this weekend:

First – a small effort toward expanding the pool of professionals who can provide outpatient psychiatric services was made by DMAS with the release of a Medicaid Memo which authorizes licensed school psychologists as outpatient service providers.   This will, if only slightly, enlarge the pool of possible clinicians who can provide Outpatient Services.

Second – many of you may have received an encrypted query from the Office of Integrated Health regarding their review of CHRIS reporting of hospital admissions or ER visits between July 1, 2020 and September 30, 2020.  This activity, another requirement of DOJ, utilizes a comparison of CHRIS reports and Medicaid claims.  This is not an unreasonable way of approaching the question, though they should leave open the possibility of a claim being coded incorrectly, and responses should be fairly straight forward.  We expect that there may be some confusion based on the fact that the switch from “not needing to report if the visit was in lieu of a visit to the PCP” to “report all ER visits as a Level II incident” occurred on August 1, 2020 (which appears to be mid-way through their review period).   This is compounded by how free-standing hospital units (which look a lot like and Urgent Care Center, but my in fact be licensed as an ER) are perceived.