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What Do You Need to Know About Changes to 42 CFR Part 2?

The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services (HHS), has revised the Confidentiality of Substance Use Disorder Patient Records regulation known as 42 CFR Part 2.

SAMHSA says that this move is intended to aid care coordination between providers while still protecting client privacy.

What is 42 CFR Part 2?

Many individuals do not seek treatment for substance use disorders (SUDs) due to perceived bias from providers, peers, law enforcement, and others. The rule known as 42 CFR Part 2 was drafted in 1972 to protect patients from stigma or bias associated with substance abuse.

However, the rule carried strict requirements regarding the use and disclosure of records for SUD clients. These restrictions have been criticized for hindering provider efforts to treat patients with SUD.

In 2019, HHS proposed reforms to the rule, some of which SAMHSA has now adopted.

What is staying the same?

According to HHS, the basic framework for 42 CFR Part 2 remains unchanged.

Law enforcement is still prohibited from using the records of SUD patients in criminal prosecutions against those patients without a court order.
Disclosure of SUD treatment records without patient consent are still restricted, except with an appropriate court order, when statutorily authorized in a true medical emergency, or for scientific research, audit, or program evaluation.
The rule applies to patient records created by federally assisted SUD treatment programs.

What changed?

Several significant portions of the rule have changed. These areas include:


Treatment records created by non-Part 2 providers based on their own client encounters do not fall under Part 2, unless those records incorporate any SUD records previously received from a Part 2 program.

Client consent

An SUD client may consent to disclosure of their Part 2 treatment records to an entity without naming a specific disclosure recipient. This helps clients more easily apply for benefits and resources.

Records can also be disclosed for 18 activities that constitute “payment and health care operations,” with written consent. These now include care coordination and case management activities.

Disposition of records

If an SUD client sends an incidental message to the personal device of a Part 2 program employee, that employee can “sanitize” their device simply by deleting that message. This ensures that employees’ personal devices do not need to be confiscated or destroyed to stay compliant with Part 2.

Disclosures to Central Registries and Prescription Drug Monitoring Programs (PDMPs)

Treating providers who are not in an opioid treatment program (OTP) or central registry can still consult central registries to determine whether their clients are already receiving opioid treatment through a member program. OTPs can enroll in a state PDMP and report data into the program when prescribing or dispensing medications on Schedules II to V, consistent with state law. This change could help prevent duplicates in SUD enrollment, SUD treatment prescriptions, or adverse drug events related to SUD treatment.

Get the full list of changes from the HHS Fact Sheet.

It can be challenging to keep up with regulatory changes to SUD and addiction treatment services. BestNotes EHR solutions help you streamline your practice so you can stay profitable

date:  Aug 18, 2020
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How Behavioral Health Providers Can Get Reimbursed for Telehealth

If you offer telehealth at your behavioral health or addiction treatment practice, reimbursement can be difficult to navigate. This has become a particular issue during the COVID-19 public health emergency, when telehealth has exploded in popularity.

So how can you make sure that you are reimbursed for your behavioral telehealth services?

Working with Medicare reimbursement

Medicare typically reimburses telehealth services only for beneficiaries in certain rural or underserved areas. There are also limits on where the beneficiary is physically located, the type of technology used for the telehealth services, and the type of practitioner.

Since the COVID-19 pandemic, however, the Centers for Medicare & Medicaid Services (CMS) has relaxed many restrictions. This includes an expansion of the behavioral services that can be provided remotely, including depression screening, group psychotherapy, and certain types of behavioral health counseling.

In many cases, CMS is reimbursing telehealth visits at the same rate as in-person appointments during the public health emergency. Generally, any provider who can bill Medicare for their professional services is currently permitted to bill for telehealth.

When coding for a visit, provider organizations should include the place of service (POS) where the visit would have normally occurred, adding the modifier “95” to show that it was a telehealth visit. Some private payers follow this same process.

For more info, visit the U.S. Health and Human Services page for billing and reimbursement during COVID-19. Also check the list of payable telehealth services under Medicare.

Working with private payers

Most private health insurers have their own rules and requirements for behavioral telehealth reimbursement. For example, Humana will reimburse claims for telehealth services for as long as the COVID-19 public health emergency is in effect.

Contact each client’s insurance plan and ask about their approval and reimbursement for behavioral telehealth. When verifying your client’s coverage, be sure you have:

  • Client demographic and insurance information
  • Your National Provider Identifier (NPI) number and Tax ID
  • A copy of your client’s insurance card with contact information for providers

When verifying telehealth coverage, ask about:

  • Eligibility and benefits for outpatient behavioral health
  • Whether you are in the plan’s network
  • Whether the payer has approval for telehealth sessions; if so, ask what information is required to submit for reimbursement; if not, ask how to get approval for telehealth

Make sure you also confirm all claims submission information, including claims address and payer ID. Request a reference number for your call, and document it along with the date, time, and representative’s name.

Be aware of differences between states.

Every state plan includes some telehealth services, but these can vary widely by state. Many states have also made their own reimbursement changes during the COVID-19 crisis. Be sure to check your own state’s reimbursement laws regarding behavioral telehealth and reimbursement.

You can find additional resources, including information specific to your state, at the American Telemedicine Association’s State Policy Resource Center.

COVID-19 telehealth reimbursement may become permanent.

Many recent changes to telehealth reimbursement are set to expire at the end of the COVID-19 public health emergency. Providers across the nation are calling for policymakers to keep many of these changes, such as payment parity. Be sure to check updates on policies that affect your practice.

Behavioral telehealth reimbursement can be complicated, but the rest of your practice doesn’t have to be. BestNotes EHR solutions were developed specifically for behavioral health and SUD treatment providers to help you stay compliant and profitable. Contact BestNotes today to learn more.

date:  Aug 03, 2020
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Ohio Behavioral Health: Overdose Deaths Rise, Telehealth Made Permanent, and Other News

Behavioral health and addiction treatment experts in Ohio are facing several issues that could impact their organizations. Here we highlight some of the latest behavioral health news from the Buckeye State.

Drug Overdose Deaths Increasing in Ohio

One year after seeing a decline in drug overdose deaths, Ohio is reporting a 5-percent increase for 2019. Fatal drug overdoses had declined 22 percent in 2018. Early state and local data indicate that the rate will continue to climb for 2020, driven primarily by anxieties, isolation, and disruptions surrounding the coronavirus and the state’s stay-at-home orders.

County coroners have reported 3,957 accidental drug deaths in 2019, up from 3,764 deaths in 2018, according to data collected by the Ohio Department of Health. Data from the CDC, however, are calculated differently from state data, and show that Ohio’s increase in overdose fatalities is 6.9 percent, ranking 25th in the nation for 2019.

Ohio Senate Passes Bill to Reform Drug Sentencing

The Ohio House of Representatives has introduced a bill, already passed in the Senate, that would reclassify low-level drug possession charges as misdemeanors instead of felonies. Senate Bill 3 also would encourage judges to send offenders to treatment rather than jail. This could help reduce overcrowding in Ohio correctional facilities and potentially reduce the chances of recidivism.

Senate Bill 3 also allows misdemeanor, fourth-degree, and fifth-degree felony drug possession charges to be sealed upon the successful completion of drug court or intervention. However, under the bill, a judge could still sentence low-level offenders to jail for up to one year if needed. The reclassification excludes fentanyl and sexual assault-enabling drugs.

Executive Order Expands Ohio Telehealth Services

Earlier this month, Ohio Gov. Mike DeWine issued an executive order (EO) that authorizes new and amended emergency rules for telehealth services in the state. Under this EO, the Ohio Department of Medicaid and the Ohio Department of Mental Health and Addiction Services can adopt amended versions of OAC 5160-1-18 and OAC 5122-29-31, respectively.

The amended rules provide expanded access to behavioral health services via telehealth. However, it is still required that a practitioner have a physical location in Ohio or have access to an Ohio location where individuals may opt to receive the services being offered through telehealth. Get details here.

Ohio Organizations Receive Grants to Address COVID-Related Issues

UnitedHealthcare is awarding nearly $600,000 in Empowering Health grants to seven community-based organizations. These grants will support programs to help Ohio residents struggling with challenges related to the COVID-19 pandemic, including behavioral health issues.

Some support will go to the Ohio Children’s Alliance, which is helping to equip nonprofit behavioral health providers to deliver behavioral telehealth services. Another grant will go to the Ohio Suicide Prevention Foundation for mental-health training, and another to the Better Health Partnership to improve mental and behavioral health screenings for children.

Will these headlines affect your behavioral health or addiction treatment practice in Ohio? The right software solutions can help you navigate any changes you face. BestNotes EHR solutions were designed with behavioral health in mind, to help you fulfill state requirements, stay profitable, and improve your client outcomes. Contact us to learn more.

date:  Jul 29, 2020
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How to Keep Marketing Your Behavioral Telehealth Services After COVID-19

Did your behavioral health practice recently launch telehealth services? As more behavioral health or addiction treatment locations resume in-person visits, it is important to continue to address the needs of clients who still prefer remote options.

Here’s how you can market your behavioral health practice and remind clients, both new and existing, that telehealth services remain available.

Ask some key questions for your marketing strategy.

Every community is different, so be prepared to tailor your marketing strategy to address local needs. Ask yourself some of these questions:

  • What are the best communication channels for reaching clients? Are they more traditional, such as newspapers and radio, or digital, like social media?
  • What potential partners, like social service agencies or emergency physicians, could help you reach new clients?
  • If you have staff, how can they refer clients to your telehealth services?
  • What telehealth benefits would most attract your ideal clients?

Update all online and offline materials.

Your website, social media pages, emails, and other digital marketing materials should inform clients and potential clients that you are still offering telehealth services. In many cases, a simple sentence like “Online sessions now available,” clearly displayed, is enough.

Put up posters and signs in your office, especially the registration or waiting areas, to let visitors know that remote visits are an option. If you offer pamphlets and other “take-away” materials, make sure they also mention your telehealth features.

Inform clients verbally.

Demand for mental health services continues to increase after COVID-19. As your practice grows, new clients may not always be aware of telehealth options.

When making their first appointment, you may ask clients if they are interested in a remote visit. Do the same thing if a current client needs to cancel or rebook an appointment, or at the end of an in-office visit.

Develop a post-COVID telehealth plan.

Eventually, we will be able to put the COVID-19 public emergency behind us. This means you should establish a long-term, post-COVID plan for your telehealth program.

Under this plan, you should aim to create the best user experience by going above and beyond the bare minimum of telehealth services.

  • Consider offering additional telehealth services, such as client education and remote monitoring. Include these services in your marketing.
  • Focus on delivering an optimal telehealth experience for clients and partners, including increased bandwidth to reduce technical problems.
  • Take all necessary steps to protect and back up health information.

Stay up-to-date on telehealth policy and practices.

By following national updates and best practices for telehealth policy, you can be better prepared to respond to changes and overcome challenges. This will keep clients informed, increasing their satisfaction, and help your practice stay competitive.

Some helpful resources include:

Whether you are launching or continuing your telehealth services, your EHR software should support your practice. BestNotes EHR solutions have been developed specifically for behavioral health and addiction treatment providers, with support for many low-cost telehealth options. Contact us today to learn more, or schedule a free demo.

date:  Jul 21, 2020
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Four Big Challenges to Launching a Behavioral Health Practice (and What to Do About Them)

As mental health needs continue to grow across the United States, more clinicians may see a need for independent behavioral health services. However, launching your own practice is also full of challenges. Here’s how to address some of those.

1. Lack of clinical experience

If you are a recent graduate, newly licensed, or have been out of the workforce for a while, you may wonder if you have the professional experience to open an independent practice. In many cases, it is beneficial to join a group practice first to build up your experience and skills.

Make sure that your licensing, clinical hours, and other professional requirements are up-to-date, as well. Additional training and continuing education credits can help get you the experience you need.

2. Lack of business experience

Opening a behavioral health practice requires both entrepreneurial and clinical skills. Fortunately, there are many ways for clinicians to learn how to operate a business:

  • Connect with other independent clinicians, locally or online.
  • Ask your local chamber of commerce for business resources.
  • Join local groups for business owners.
  • Online classes and tutorials, from accounting to marketing, can give you basic business education.

If you are new to running a business, there are other things you should keep in mind:

  • Create a business plan right away.
  • Set aside portions of your day or week for business-only tasks, including learning to run your business and addressing paperwork, such as taxes and reimbursement.
  • Consider outsourcing administrative tasks so you can concentrate on more clinical tasks.

3. Financial limitations

There are startup costs of launching a private behavioral health practice, though it can vary depending on a variety of factors. Fortunately, starting costs for many behavioral health providers can be relatively low compared to other types of businesses.

Here are some ways to keep costs down:

  • Keep a careful, ruthless budget. Some expenses are non-negotiable, like taxes, licensing fees, and Internet service. Others may be more flexible, such as your insurance coverage and whether you hire employees.
  • Consider subletting your office space, or working out of your home. If possible, you might try using remote-only services.
  • Use a “side hustle,” such as teaching or a group practice, to supplement your income while you build your independent practice.
  • Calculate the bare minimum you need to stay in business, and focus on just making that much for the first few months.
  • Keep your expectations realistic; you don’t need a fancy office right away.
  • Get used to charging a fee that accurately reflects the worth of your services.

4. Getting new clients

Exceeding your clinical requirements and possessing flawless business knowledge doesn’t guarantee you will have clients to serve when you open your practice. The best way to overcome this challenge is by learning to sell yourself and your practice with excellent sales and marketing skills. This includes:

  • Community activity, such as giving talks or volunteering
  • A strong website that attracts clients and explains exactly what you do
  • Building a referral network, either with other local professionals or through online portals like Psychology Today

Ready to launch your independent behavioral health practice? The right software can make the difference between frustrating disorganization and streamlined profitability. Contact the team at BestNotes to learn how our software can help your practice start out strong.

date:  Jul 13, 2020
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