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06/15/2024 06:58 AM
Pennsylvania House of Representatives
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House of Representatives
Session of 2023 - 2024 Regular Session


Posted: March 28, 2024 02:21 PM
From: Representative Maureen E. Madden and Rep. James B. Struzzi, II
To: All House members
Subject: Ensuring our Centers of Excellence Remain Successful
In 2016, Governor Tom Wolf introduced Centers of Excellence (COE) for those with Opioid Use Disorder (OUD) to help address the opioid overdose crisis in Pennsylvania. The goal was to remove barriers to engaging and retaining those with OUD in treatment. COEs are set up to take care of the whole person, including OUD treatment, physical health treatment such as diabetes management, and mental health treatment such as anxiety or depression treatment. The approach taken in COEs has been widely regarded as a success.

COEs were originally funded through grants and operated with one set of requirements. In 2021, the Department of Human Services (DHS) began transitioning COEs from a directed payment model into managed care through the state’s Medicaid State Plan and Medical Assistance Program Fee Schedule. As we have heard from COEs themselves, this has resulted in disjointed, inconsistent guidelines, requirements, policies, and procedures.

To ensure the consistency of COE services across the Commonwealth and to maintain the integrity of the original model, we will be introducing legislation that would require DHS:

• To have one set of COE standards that primary contractors and their behavioral health managed care organizations (BH-MCOs) must use. 

• In collaboration with a work group of COEs, primary contractors and BH-MCOs, to develop one companion set of interpretive guidelines specifically detailing what all COEs must do in order to be considered in compliance with or meeting the standard set of requirements. 

This legislation would not preclude DHS from adding to or changing the requirements of the program to respond to emerging and evolving needs. 

Please join us in co-sponsoring this important legislation to ensure that our COEs can continue to effectively and efficiently provide greater access to treatment for those with OUD.