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DHS COVID-19 PROVIDER GUIDANCE // OMAP

Providing Direct Services in the School-Based ACCESS Program (SBAP) During the COVID-19 Emergency

Issued: May 28, 2020

Audience

Local Education Agencies (LEA) participating in the SBAP.

Discussion

All health-related services identified in a student’s IEP must be authorized or prescribed by a licensed practitioner, acting within their scope of practice and enrolled in the MA Program. Medically necessary services are ordered or prescribed through a prescription or the signed Medical Provider Authorization Form (MPAF) before they are eligible for MA payment. The prescription or MPAF must be concurrent with IEP and obtained on an annual basis, or whenever there is a change to the health-related services in the IEP. (For more details on the Medical Provider Authorization Form, please see Section 4.2 of the SBAP Provider Handbook.) 

During this public health emergency, many LEAs may have difficulty completing re-evaluations and/or obtaining signed, updated MPAFs within the usual timeframes. The Department of Human Services is providing the following guidance.

    • Prescriptions or MPAFs issued prior to the public health emergency will be considered current through the end date of the public health emergency.
    • LEAs will be granted a period of 60 days beyond the end date of the public health emergency to secure a new prescription or signed MPAF.
    • Any health-related services identified on the IEP and ordered or prescribed through a prescription or signed MPAF may continue to be delivered and billed throughout the public health emergency.
    • No action is required to be made by the LEA in PCG’s EasyTrac system to allow for services to be billed based on the current MPAF.
    • All newly identified health-related services added to a student’s IEP must be ordered or prescribed through a new prescription or MPAF, before the newly identified healthrelated services are compensable through SBAP.
    • Prescriptions and MPAFs may be completed using electronic signature. See Sections 4.2 and 5.3 the SBAP Provider Handbook for requirements for use of electronic signature.

This guidance will remain in effect while a valid public health emergency declaration by the Governor related to the COVID-19 virus remains in effect. 

Additional information is also available on the CDC website and through CMS

Information on MA Program coverage related to COVID-19, to include an FAQ document, can be found on the Department of Human Services website here. ​

The Pennsylvania Department of Health has a dedicated page for COVID-19 that provides regular updates. Click here for the most up to date information regarding COVID-19. 

If you have further questions related to submitting claims for direct services during this period of emergency, please email SBAPsupport@pcgus.com or call 1-866-912-2976.