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 to behavioral health providers. This, in turn, is anticipated to enhance recruitment and retention efforts within this vital workforce, addressing a persistent challenge in the sector.
Governor Josh Shapiro has consistently prioritized funding for behavioral health services since his tenure began. In collaboration with the General Assembly, he secured $20 million for county behavioral health programs in his first year—marking a significant increase after a decade-long funding stagnation. This funding was vital for county offices and local organizations, which often serve as initial contact points for individuals seeking behavioral health services.
Building on these efforts, the 2024-25 budget introduced an additional $20 million for county mental health programs, culminating in a $40 million annual increase compared to pre-Shapiro levels. The administration is also channeling $5 million into crisis stabilization walk-in centers, designed to provide prompt care during behavioral health emergencies and reduce unnecessary emergency room visits or public safety interventions. The investment will focus on underserved areas or those requiring resource expansion.
Moreover, an infusion of over $100 million from the American Rescue Plan Act, part of Pennsylvania’s Home and Community-Based Spending Plan, has been allocated to strengthen the behavioral health workforce. This funding supports recruitment, retention, and the expansion of telehealth capabilities, alongside training and development initiatives.
Governor Shapiro’s commitment to behavioral health is further cemented by an executive order establishing a Behavioral Health Council. This body is tasked with fostering stakeholder collaboration to inform future policies and improve service accessibility and quality across the Commonwealth.
These comprehensive measures reflect a robust approach to addressing the behavioral health needs of Pennsylvania’s Medicaid recipients and the broader community, ensuring that essential services remain accessible and effective in promoting the health and well-being of all residents.
If you or a loved one are experiencing a behavioral health crisis, it’s important to seek help immediately. You can call or text 988 to reach the Suicide and Crisis Prevention Lifeline, a confidential resource available 24/7. Trained professionals are ready to listen and provide support, guiding you through this challenging time. Remember, you’re not alone, and there are people who care and want to help.
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