COVID-19 / Providers (Archived)

PRIOR AUTHORIZATION DURING THE COVID-19 DISASTER EMERGENCY DECLARATION PERIOD

• Provider Authorizations Alert (May 21, 2020)
• OMHSAS Prior Auth Under COVID-19 Memo (May 18, 2020)
• Carelon Health of Pennsylvania Provider Registration Forms for COVID-19

ALTERNATIVE PAYMENT ARRANGEMENTS UNDER COVID-19

Carelon and our primary contractors continue to work with providers who qualified for COVID-19 alternative payment arrangements (APAs) to allow providers to restructure services in a way that maintains consistency of services for members during this emergency declaration. Along with OMHSAS and our partners, Carelon frequently assesses the situation and the emergency declaration guidelines. Carelon will continue to monitor providers’ financial needs and will notify qualified providers as appropriate and throughout the emergency declaration.

Coronavirus (COVID-19)

Carelon is actively monitoring the COVID-19 (coronavirus) pandemic along with all recommendations from the CDC and state and local public health officials. The safety of our members, providers and employees is our primary concern. As such we have taken measures to ensure business continuity during this time.

Carelon hosts regular meetings with all of our in-network providers to discuss issues as they emerge during the COVID 19 crisis. We will continue this and other gatherings as long as is necessary. We are looking to hear your experiences, needs, barriers, as well as sharing what our interventions and strategies are to support our providers and members during this time from Carelon and primary contractors. If you have not already received an invitation, please contact your Provider Field Coordinator and ask for the link to join the meeting. To ensure your email is a part of our distribution list for all electronic communications and invitations going forward, please join our mailing list to receive the latest updates, including our monthly provider newsletter, ValueAdded.

Carelon wants to provide you with information on local resources, give you tips and answer some common questions. These resources may be helpful to you.

Keep Kids Safe – Child Abuse Hotline 
1-800-932-0313   TTY 1-866-872-1677

PA Child Welfare Information Solution
1-800-932-0313   TTY 1-866-872-1677

National Domestic Violence Hotline 
1-800-799-7233    TTY 1-800-787-3224

PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES

• OMHSAS-22-02: Revised Guidelines for the Delivery of Behavioral Health Services Through Telehealth (July 1, 2022)
  • OMHSAS Behavioral Health Telehealth FAQs (August 16, 2022)
• OMHSAS-21-09: Guidelines for the Delivery of Behavioral Health Services Through Telehealth (September 30, 2021)
  • OMHSAS Behavioral Health Telehealth FAQs (October 29, 2021)
• OMHSAS Behavioral Health Telehealth Information (August 26, 2021)
• Reinstatement of Suspended Regulations Due to the COVID-19 Pandemic (August 6, 2021)
• MA Bulletin 99-21-01: Restoration of Provider Revalidation Requirements (March 23, 2021)

PENNSYLVANIA DEPARTMENT OF HEALTH

• Universal Testing in Long-Term Care Facilities FAQ (May 19, 2020)

CARELON OF PENNSYLVANIA CORRESPONDENCE

• Resources for the Unwinding of the Public Health Emergency (August 2022)
• Governor Wolf Signs Bill Extending Waivers (June 30, 2022)
• Pennsylvania Provider FAQ (April 22, 2021)
• Provider Alert: COVID-19 Guidelines in Ambulatory and Community-Based Care Settings (February 3, 2021)
• Provider Alert: COVID-19 Guidelines in Congregate Care Settings (February 3, 2021)
• Provider Alert: COVID-19 Reporting Tool for All Carelon In-Network Providers (September 24, 2020)
• Carelon Health Options of Pennsylvania COVID-19 Reporting Form (September 24, 2020)

CARELON INFORMATION

• Telehealth 101: What you need to know to get started (PowerPoint) (April 8, 2020)
• Carelon Provider COVID-19 Update: Specific Action Steps and Mitigation Preparation (March 6, 2020)

NATIONAL COUNCIL FOR BEHAVIORAL HEALTH (BH) 

• COVID 19 Guidance for BH Residential Facilities

DEPARTMENT OF DRUG AND ALCOHOL PROGRAMS

• National Guidance and Resources
• 42 CFR Clarification (March 20, 2020)
• Telehealth Bulletin for Gambling 20-01 (March 20, 2020)

DRUG ENFORCEMENT ADMINISTRATION

• Use of Telemedicine While Providing Medication Assisted Treatment (MAT)

U.S. ATTORNEY’S OFFICE OF WESTERN DISTRICT OF PENNSYLVANIA

• Formation of Joint Western Pennsylvania COVID-19 Task Force

CARELON APPRECIATES YOU!

Carelon recognizes the hard work our providers have given for extraordinary work in these trying times. Below are photos and videos showing your experiences and how you’ve continued to persevere through this pandemic with all its challenges. If you or your organization would like to be included in a photo essay telling the story of COVID-19 from a provider perspective, please send your photo(s)/videos to lisa.ciccarelli@carelon.com. Include your name/organization as the submitter and briefly describe the photo. Please do not include photos of the persons you are serving so that we may be respectful of their confidentiality. We look forward to seeing your submissions and celebrating all that you do!

• Achieving True Self
• AMI, Inc
• The Center for Community Resources
• Chestnut Ridge Counseling Services
• Gateway Rehab
• Glade Run Lutheran Services
• Human Services Center
• Southwestern Pennsylvania Human Services (SPHS)
• Wesley Family Services