Will this service, if approved also provide treatment for individual's with eating addictions?

1. The OBOT supplement changes refer to a discharge note saying "the provider must document the following in the member's record" when the patient is discharged.  Does this refer to the prescribing provider or the behavioral health provider? The changes do not indicate which one has the requirement.
2. the manual says that a diagnostic assessment is required.  Who is required to do the diagnostic assessment?  The BH or the Medical provider?
3.  It states the CSAC can do the multidimensional assessment but there is no method of billing for this service.  I have been told before that this service is wrapped up in the overall rate.  However, OBOTs do not have and "overall rate" like an IOP or inpatient.  Instead, it is per service.  How does CSAC's multidimensional assessment get reimbursed for in an OBOT?
4. It seems that the changes making it clearer that a CSAC can be the primary counseling component of an OBOT as long as they are supervised by a licensed person.  Is this correct?

Thank you for responding to my questions.  I see several good things in the changes.  I am also hopeful that OBOTs will eventually become OBATs and extend their reach for people with any SUD.  

Clients need access to care but sadly even with the advent of Medicaid transport, it is still not possible for most of our underserved community. How can we help? Is there a bus token system where these client can use as an option when they have been waiting for hours and no medication transport shows?

DMAS team,

Thank you for this public comment forum. In reviewing the 2021 DRAFT of the 2017 updated manual, two questions came to mind.  ISPs are completed at initiation of OBOT services and then IPOCS are completed every 90 days. Please maintain the frequency of required IPOC review as every 90 days to help decrease this time intensive process completed by clinicians.

To preserve clinician time for patient care,  please eliminate the need for patients to sign the IPOC. Please consider that patients consent to the plan of care as confirmed by their ongoing attendance at appointments.

The draft manual states that the ISP must be rewritten annually.  If a patient has remained in care, and IPOCS are consistently completed, patient plan of care, diagnoses are updated routinely. Is a separate new ISP needed?

Looking forward to feedback.

Sincerely,

Marjie

VCU Health System

Perinatal Addiction Program Coordinator

Fairfax- Falls Church Community Board Services agrees and supports the comments to date below:

1. Opioid Treatment Services/Medication Assisted Treatment- Page 26:

The foundation of the Preferred OBOT model is to provide the medical and behavioral health services within the same location, have in-person interactions with the member and provide the high-touch care coordination to support the member in their recovery. DMAS recognizes that there may be situations that telehealth is necessary to engage the member in treatment and recovery. Thus Preferred OBOT services may be provided via telehealth based on the individualized needs of the member and must have supporting documentation of why the in-person interactions are not meeting the member’s specific needs. The primary means of services delivery shall be in-person for the Preferred OBOT model with the exception of telehealth for specific member circumstances (such as transportation issues, childcare, employment, co-morbidities, distance, etc.) that impede their access to treatment. Providers delivering services using telemedicine shall use the modifiers GT (interactive audio and video telecommunications system) or GQ (asynchronous telecommunications system).

• Comments/feedback: Please allow and consider the use of the 95 modifier, as opposed to changing the modifier to GT and GQ,  which are both Medicaid specific. The proposed change will be detrimental to servicing agencies who currently use the 95 modifier if it is changed to GT and GQ.