HARRISBURG, PA — In a strategic move aimed at enhancing access to critical mental health and substance use disorder services, the Pennsylvania Department of Human Services (DHS) has revealed plans to increase payment rates within its Behavioral HealthChoices program. This adjustment, contingent upon approval by the federal Centers for Medicare and Medicaid Services (CMS), will be retroactively applied from July 1, 2024, aligning with the current contract agreements DHS holds with Behavioral HealthChoices Managed Care Organizations (BH-MCOs). DHS Secretary Val Arkoosh highlighted the importance of this initiative, stating, “Access to mental and behavioral health care is essential to our overall health and wellbeing.
If we cannot get the care we need, our ability to participate in and engage fully in our responsibilities like work, school, and family will not be possible. Maintaining access to care requires rates that reflect the cost of providing care, and this mid-year adjustment for Behavioral HealthChoices managed care organizations (BH-MCOs) is necessary to maintain a Medicaid program that meets our current needs and challenges, and helps Pennsylvanians continue to get the care they deserve.” The increase follows a thorough mid-year review of managed care organizations’ enrollment and the services most frequently utilized by beneficiaries.
If sanctioned by CMS, the revised rates will bolster the financial capacity of MCOs, enabling them to offer better compensation.