AmeriHealth Caritas Informational Sessions
As announced, Partners For Kids has entered into an agreement with AmeriHealth Caritas, one of the plans selected by the Ohio Department of Medicaid as a Next Generation contract payer. To answer your questions, we will host two information sessions with the AmeriHealth Caritas team:
- Tuesday, January 31, noon to 1 p.m.
Wednesday, February 1, noon to 1 p.m.
Invitations will be emailed. Reach out to Partners For Kids Provider Relations at PFKProRelations@childrensdayton.org with questions.
Additionally, go live for Ohio Department of Medicaid’s NextGen is February 1. Partners For Kids intends to contract with all Ohio managed Medicaid plans.
Supplemental Security Income (SSI)
Your patients and their families may qualify for additional financial support known as Supplemental Security Income or SSI. Patients who demonstrate financial hardship and have a diagnosis that can impact their daily lives may qualify for up to $914 a month. Partners For Kids has partnered with Centauri Health Solutions to help patients through the application process. If you want print materials for your clinic, please reach out to your Partners For Kids Provider Relations Representative. Find out more information on who qualifies and how to refer.
Care Navigation Rights and Responsibilities
Partners For Kids recently published current rights and responsibilities for patients enrolled within the Partners For Kids Care Navigation program. This document highlights what a parent or guardian participating in the program can expect and details the parent or guardian’s responsibilities. View the document and feel free to share with your patients enrolled in Partners For Kids Care Navigation.
Educate Patients About Medicaid Re-Enrollment
As you know, every person covered by Medicaid must have their eligibility determined annually, but that process has been suspended during the federal public health emergency of COVID-19. It is now expected that the public health emergency will end in mid-April 2023 and the re-enrollment (also called redetermination) process will resume. You have an essential role in making sure your patients stay covered. Partners For Kids has developed resources to help you make sure they know how to keep their coverage. Learn more.
New Lead Screening Measure for 2023 Primary Care Provider Incentive Plan
Lead poisoning continues to be a hazard for many Ohio children. Because of this, lead screening has been introduced as a new measure to the 2023 Primary Care Provider Incentive Plan. The criterion is one lead screening completed before a child’s second birthday. Although Partners For Kids will be incentivizing one completed screen before a child’s second birthday, please remember that Ohio law requires screening of children at age 1 and 2 (or up to age 6 if no previous test has been completed for specific high-risk children). The measure will be reviewed after the child’s second birthday by pulling CPT code 83655. As long as the code has been billed by a medical office, lab or professional before the child’s second birthday, the attributed provider will receive credit for completing the measure.
Invasive Group A Strep Infections On The Rise
Last month, the CDC announced a Health Alert Network (HAN) Advisory highlighting a recent rise in invasive Group A strep infections in children located throughout multiple areas of the U.S. Dayton Children's has seen a recent increase in the number of children admitted to the hospital with invasive Group A strep infections, consistent with the CDC HAN Advisory. The HAN Advisory urges healthcare providers to "consider invasive Group A strep disease as a possible cause of severe illness, including in children and adults with concomitant viral respiratory infections. Illness due to invasive Group A strep in people with known viral infections may manifest as persistent or worsening symptoms following initial improvement of the viral respiratory illness."
PFK Behavioral Health in Primary Care Symposium Interest Survey
Partners For Kids is hosting its first Behavioral Health in Primary Care Symposium on October 4 at Nationwide Children’s Hospital for providers across Ohio. To ensure the symposium is as fruitful as it can be, we want to hear from YOU! Please fill out this survey to have your voice heard on things like logistics and topics. For questions regarding the symposium, contact PFKProRelations@childrensdayton.org
Quality Improvement Spotlight: Depression Screening and Management in Primary Care
One of every five teens will experience clinically significant depression during adolescence, but only half of these are diagnosed before adulthood, and of those diagnosed, only 50% will receive appropriate treatment. The Partners For Kids depression QI project assists practices with the implementation of universal depression screening for adolescents and supports the use of evidence-based treatment strategies within the primary care setting when clinically significant depression is identified. Learn more here.
If you would like further information on this project, have questions, or would like to begin this work please reach out to the PFK QI Team at PFKQICoaching@childrensdayton.org.
SparkRx Pilot Program
With a rise in phone apps in the mental health space it can be overwhelming to look through every app to see which ones would benefit your patients. Partners For Kids is looking for primary care partners who would like to participate in a pilot program for SparkRx. SparkRx is a product from Limbix Health Inc. that focuses on supporting youth ages 13-21 with depression symptoms. The pilot is free to both practices and patients to participate in.
If your practice is interested in learning more about the app and/or the pilot, please email PFKProRelations@childrensdayton.org.
Pharmacy & Prescribing Updates
Prescribing Guidance During Antibiotic Shortages Your local pharmacies may be experiencing shortages of several antibiotics used to treat common pediatric infections. A resource was developed to assist in selecting alternative dosage forms or alternative antibiotics when preferred oral beta lactam antibiotics are not available at community pharmacies. For any further questions about Partners For Kids prescribing resources or guidelines, contact PFKPharmacy@childrensdayton.org.
Highlights for the first quarter UPDL:
- Ventolin® and Proventil® albuterol metered dose inhaler brands are preferred. Proair® brand has been discontinued.
All methylphenidate products will have a PA-required designation for patients younger than 6 years old.
For questions about coverage resources, please contact PFKPharmacy@childrensdayton.org
January Managed Care Plan Updates
CareSource has published a variety of updates and policy changes. Click here to view a comprehensive overview
January 31, noon to 1 p.m..: AmeriHealth Caritas Information Session
- February 1, noon to 1 p.m.: AmeriHealth Caritas Information Session
Forgot to bookmark the Partners For Kids provider portal? You can always access it through our resource page – just search “provider portal.” If you would like to know more about the Partners For Kids provider portal or information on accessing the provider portal, reach out to your Partners For Kids provider relations representative!
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