Western Highlands Network
Friday E-Mail Newsletter
Number 80
12/22/2006
The Friday E-Mail is a weekly update for providers by the Services Management Department of Western Highlands Network. Please distribute to all your staff.
NC Health Choice Recognizes Targeted Case Management for Children
The NC Health Choice Program, the Division of Public Health has added Targeted Case Management to the behavior health special needs package for NC Health Choice for Children, effective retroactively March 20, 2006.
The draft service definition for Targeted Case Management (TCM) for Mentally Retarded/Developmentally Disabled (MR/DD) services is currently under review by the Centers for Medicare and Medicaid Services (CMS). Until approved, the NC Health Choice for Children will operate under the existing Medicaid Targeted Case Management service definition.
The Western Highlands LME is not allowed to authorize services for children receiving the NC Health Choice benefit. All requests for authorization for TCM for children with NC Health should be directed to ValueOptions for authorization consideration.
ValueOptions will be conducting retrospective reviews for authorization beginning with dates of service Mar 20 – Dec 31, 2006. Providers wishing to request a retrospective review must submit all requests by no later then Feb 28, 2007. Late submissions will not be reimbursed by NC Health Choice for Children.
ValueOptions preauthorization begins prior to dates of service Jan 1, 2007. Subsequent authorizations must be received on or before the last date of the previous authorized period.
The reimbursement rate is the same as Medicaid, $22.66/15-minutes and billed as a T1017HI. Reimbursement should be sought from NC Health Choice for Children.
Guidance provided in this article is from the North Carolina Department
of Health and Human Services Division of Public Health, Women’s
and Children’s Health Section Memo, Dec 1, 2006. This memo is available
at http://www.dhhs.statenc.us/dma/cpcont.htm.
Smoking Cessation Intervention Benefits Patients With Psychotic Disorders
People with a psychotic disorder benefit from a smoking cessation intervention consisting of nicotine replacement therapy plus motivational interviewing/cognitive behavior therapy, according to a new study.
Despite extremely high rates of smoking among individuals with psychotic disorders and the associated financial and health costs, few studies have investigated the efficacy of smoking cessation interventions among this group," writes Dr. Amanda Baker, of the University of Newcastle, Australia, and colleagues in the November issue of the American Journal of Psychiatry.
In this study, the smoking cessation intervention consisted of nicotine replacement therapy, motivational interviewing, and cognitive behavior therapy. Outcome measures included continuous and point-prevalence abstinence rates, smoking reduction status, and changes in symptoms and functioning.
Nicotine replacement therapy commencement was associated with a net
reduction of five to eight cigarettes per day, suggesting that higher
doses or a longer duration of nicotine replacement therapy use may be
necessary to obtain additional benefits.( Am J Psychiatry 2006;163:1934-1942)
WHN Holiday schedule:
WHN will be closed on Monday, December 25 and Tuesday December 26 for the Christmas holiday. It is suggested that CS workers anticipate the need for Respite services over the holidays and submit those requests ASAP.
WHN will also be closed on Monday, January 1 for New Years.
Charlie Schoenheit
Director of Services Management
Western Highlands Network
356 Biltmore Avenue
Asheville, NC 28801
Telephone: (828)258-3511 x2219
FAX: (828) 225-2779
E-Mail: Charlie@westernhighlands.org
Website: westernhighlands.org
