Region 10 PIHP Policies

Governance

---

01.01.01 Region 10 PIHP Board  (Revised 08/2017)

01.01.02 Board Member Per Diem and Travel Reimbursement  (Revised 08/2017)

01.01.03 Substance Use Disorder Oversight Policy Board  (Revised 01/2016)

01.01.04 Regulatory Compliance Committee (Revised 01/2021)   

Compliance

---

01.02.01 Corporate Compliance Program  (Revised 01/2021)

01.02.03 Conflict of Interest  (Issued 09/2013)

01.02.04 Freedom of Information Act Requests  (Issued 10/2013)

01.02.05 Corporate Compliance Complaint, Investigation, & Reporting Process  (Revised 04/2017)

01.02.06 Disclosure of Information  (Revised 10/2021)

General Operations

---

01.03.01 Event Notifications  (Revised 05/2016)

01.03.02 Medicaid Provider Manual: Mental Health and Substance Abuse  (Revised 05/2016)

01.03.03 Policy Procedure Development & Approval  (Issued 07/2016)

01.03.04 Succession of CEO Administrative Responsibilities (Issued 03/2018)

Quality Management

---

01.04.01 Quality Assessment & Performance Improvement Program  (Revised 03/2019)

01.04.02 Input from Persons Served  (Issued 09/2013)

01.04.03 Satisfaction Surveys  (Revised 03/2019)

01.04.04 Behavior Management Review  (Revised 05/2016)

01.04.05 Performance Requirements for Prevention Services (SUD)  (Issued 10/2015) 

Utilization Management

---

01.05.01 Utilization Management Program  (Revised 3/2024)

01.05.02 Indicia Inter-Rater Reliability  (Issued 12/2023)

Provider Network

---

01.06.01 Procurement  (Revised 10/2020)

01.06.02 PIHP Network of Service Providers  (Revised 02/2023)

01.06.03 Contract Management  (Revised 05/2016)

01.06.04 Delegation and Contract Monitoring  (Revised 04/2019)

01.06.05 Credentialing and Privileging  (Revised 02/2021)

01.06.06 Staffing Requirements for Prevention Services (SUD)  (Issued 10/2015)

01.06.07 Reporting Requirements for Prevention Services (SUD)  (Issued 01/2023)

01.06.09 Network Directory and Network Reporting Obligations (Issued 04/2019)

01.06.10 Direct Care Worker Wages  (Issued 09/2023)

Personnel

---

02.01.02 Training (Issued 10/2022)

02.01.03 Employee Travel and Expense Reimbursement (Issued 07/2019)

Technology

---

03.01.01 Computer Information Systems  (Revised 07/2019)

03.01.02 Integrity of Electronic Data  (Revised 07/2019)

03.01.03 Data Warehouse and Data Analytics  (Revised 07/2019)

03.01.05 Information Systems Security and Protection  (Revised 04/2019)

03.01.06 Health Information Exchange  (Revised 04/2019)

03.01.07 E-Mail and Instant Messaging Use  (Revised 07/2019)

03.01.08 Internet Use  (Revised 07/2019)

03.01.09 Care Connect 360 User Guidelines (Issued 07/2019) 

03.01.11 Telecommuting (Issued 11/2020)

Data Management

---

03.02.01 Procedure Codes and Definitions  (Revised 07/2019)

03.02.02 Demographic Data Collection  (Revised 07/2019)

03.02.03 Data Submission of Prevention Services (SUD)  (Revised 07/2019)

Health Records

---

03.03.01 HIPAA Privacy & Security Measures  (Revised 03/2023)

03.03.02 HIPAA Privacy Measures - Protected Health Information  (Revised 04/2023)

03.03.03 Behavioral Health Consent Form  (Revised 02/2019) 

03.03.04 HIPAA Breach Notification (Revised 03/2022) 

03.03.05 Release of Record Information (Revised 07/2021)

Budget

---

04.01.01 Budgeting  (Revised 11/2020)

04.01.02 Expense Management  (Issued 11/2013)

04.01.03 Revenue Management  (Issued 11/2013)

04.01.04 Performance Based Incentive Fund Requests (Issued 8/2020)

Accounting

---

04.02.01 Auditing  (Issued 11/2013)

04.02.02 Fixed Assets  (Issued 11/2013)

04.02.03 Credit Card Usage  (Issued 09/2014)

04.02.04 Ability to Pay for SUD Services  (Revised 05/2017)

Reimbursement

---

04.03.01 Denial of Claims Payment Appeal Process  (Revised 05/2016)

04.03.02 Claims Verification  (Revised 05/2016)

04.03.03 CMHSP Provider Advance  (Reviewed 12/2020)

04.03.04 SUD Provider Advance (Issued 4/2020)

Access to Services

---

05.01.01 Access to Services  (Revised 05/2023)

05.01.02 Limited English Proficiency (LEP)  (Issued 02/2014)

05.01.03 Cultural Competency  (Issued 02/2014)

 05.01.04 SUD Waitlist  (revised 05/2023)

Customer Services

---

05.02.01 Customer Services  (Revised 02/2019)

05.02.02 Community Living - Releasing Individuals from State Institutions  (Issued 10/2013)

05.02.03 Community Living - ADA Mandates with Community Integration  (Issued 10/2013)

Care Delivery

---

05.03.01 Self-Determination and Choice Voucher  (Issued 10/2013)

05.03.02 Habilitation Supports Waiver  (Revised 11/2023)

05.03.03 Interpretation and Language Services  (Issued 02/2014)

05.03.04 Language & Technical Requirements for Informational Materials  (Revised 05/2016)

05.03.05 Employment and Community Activities  (Issued 03/2014)

05.03.06 SUD Women's Specialty Services  (Revised 02/2019)

05.03.10 Autism Benefit  (Revised 01/2022) 

05.03.11 Clinical Practice Guidelines   (Revised 03/2022) 

05.03.13 Children’s Waiver Program Prior Review and Approval Request   (Issued 07/2020)

05.03.14 Home & Community Based Services Provisional Approval Process   (Issued 07/2020)

05.03.16 Opioid Health Home Benefit (Issued 09/2021)

05.03.17 Emergency and Post-stabilization Services (Issued 09/2023)

05.03.18 Communicable Disease (Issued 10/2023)

Health Care

---

06.02.01 Collaborative Work Between Health Care  (Revised 03/2019)

06.02.02 MHP-PIHP Coordination and Integration of Care (Issued 03/2019)

Individual Rights

---

07.01.02 Enrollee Information Rights  (Revised 10/2021)

07.01.03 Sentinel Events Critical Incidents and Risk Events  (Revised 03/2023)

Grievances and Appeals

---

07.02.01 Grievance and Appeal System (Revised 03/2022)