Being a professional organization for behavior analysts, VABA does not purport to be experts on this virus or what to do. However, as other organizations have done, we wanted to provide some resources to help our members, and those who are a part of the profession.
Below are some questions and answers. If you have questions you would like to see added, please email firstname.lastname@example.org.
Below the Q&A are some resources
This must be answered on a case-by-case basis, but if an insurance company has authorized the service, then it is safe to say it is medically necessary. But medically necessary services and essential services are different things.
See Executive Order 53, specifically page 3 #9
Also see this guidance from DBHDS
Executive Order 60 (Immunity from Liability) appears to include BCBAs, however, it is difficult to see how it would apply except if you had an employee who was providing necessary treatment who then infected the client or the client’s family. As always, check with a lawyer!
That is an individual decision that should be made for each client on a case-by-case basis.
Here are two risk/benefit tools that may help you
Tool developed by a group of people from the state associations and presented through SCABA Webinar (3/27)
“With the exception of prescribing controlled substances, the Virginia General Assembly has not established statutory parameters regarding the provision and delivery of telemedicine services. Therefore, practitioners must apply existing laws and regulations to the provision of telemedicine services. The Board issues this guidance document to assist practitioners with the application of current laws to telemedicine service practices.” (emphasis added)
Click here for the link to our regulations
As stated above, “practitioners must apply existing laws and regulations to the provision of telemedicine.” Unlicensed persons cannot practice behavior analysis (via telehealth or otherwise) as defined in our scope of practice, but can deliver services under the supervision of the Licensed Behavior Analyst or Licensed Assistant Behavior Analyst as appropriate based on each client, the experience and ability of the unlicensed person, and following the Professional and Ethical Compliance Code for Behavior Analysts (BACB) and BOM regulations.
APBA has been giving guidance on this subject.
See the current guidance from the Board of Medicine:
We did receive some clarification when asking specifically about behavior analysts:
DMAS has confirmed that MCOs will be paying for ABA provided by telehealth. There is no need to bill any differently than you would have done face-to-face, but it must be identified in the notes that the service was provided through telehealth due to the COVID-19 pandemic. In addition, authorizations are extended by 14 days (in that you can start or continue services for 14 days prior to receiving authorization). Please click here for more information. and see this clarification memo distributed on 3/30.
DBHDS has confirmed that they will pay for Therapeutic Consultation delivered by telehealth including telephone services, with the exception of direct behavioral services with the individual. See this page for more information. They have updated the claim form on the portal to include a location of 02 – telehealth.
VABA and other organizations are working with the Governor and private insurers to make sure that ABA is included in the changes that are being made to help alleviate problems caused by the pandemic. Check with your private insurance companies on a regular basis and work with them to get the necessary services for your clients. We will update you as we know more. Remember to use the correct modifiers when billing because most private insurers are not waiving that requirement like DMAS did.
VABA and our lobbyist are also sitting on a task force through the Commonwealth and will be updating information as it is received as well as advocating for ABA.
See the HHS guidance on telehealth during the pandemic. But make sure to do your due diligence, such as getting informed consent and putting in as many safety protocols as possible to protect personal health information (PHI).
It would be best for you to check with your specific policy. CPH has said that they do have telehealth plans available.
Loans are being distributed via the CARES Act. Your business should apply see below for some places to help:
Click here for information from the Small Business Association
Click here for information from the US Chamber of Commerce
Click here for a fact sheet on small business loans during the pandemic
The Governor has made several decisions affecting the near future of the Commonwealth:
Postponed elective surgeries until May 1
Postponed May 5 election to May 19
Postponed June 9 election to June 23
Decreed certain businesses to remain closed through May 15
Announced stay at home order through June 10, but may be lifted May 15
The decisions as to when to relax which restrictions are based on data and are therefore fluid. For more information about the data, see this May 5 presentation from the VA Dept of Health.
Providers need to continually assess the situation and determine how to best meet the needs of clients based on the phase that we are in. ABA providers are considered essential workers, but a risk/benefit analysis is always a necessity.
Do you need PPE (Personal Protection Equipment) and can’t find it? Try contacting your Local Department of Health. Tell them you are a health care provider and they may be able to assist. Also Click here for vendors who provide PPE (Personal Protective Equipment).
Want to find a testing site? Here is a list
Want to do telehealth, but your clients don’t have wifi? Here are some hotspots.
Other considerations as ABA Agencies get back to work:
– If you took a payroll loan you will have to bring back the same number of Full-time Equivalents (FTEs) in order for the loan to be forgiven. Make sure to talk with your bank.
– Ensure that your employee and parent policies are up-to-date and appropriate in the context of the pandemic. Revise contracts as needed
– Get the signatures that you missed when you were not seeing clients in person
More links as you are thinking of reopening:
Here is a link to the Virginia Department of Health’s Information: http://www.vdh.virginia.gov/coronavirus/
Click here to be directed to the Centers for Disease Control
Click here to be directed to the World Health Organization
Here is a link to the worldwide and statewide dashboards: https://www.knowi.com/coronavirus-dashboards/
Some more data: http://covid19.healthdata.org/united-states-of-america/virginia
Information from the Medical Society of VA: https://www.msv.org/resources/hot-topics/coronavirus-disease-2019-covid-19 and https://www.msv.org/msv-covid-19-webinars
Here is a link to information from the Council of Autism Service Providers (CASP): https://casproviders.org/telehealth-and-crisis-management-guidelines/
Click here for Practice Guidelines from APBA
Click here for resources from the Behavior Analysis Advocacy Network
Click here for federal information based on advocacy from Autism Speaks
Click here for vendors who provide PPE (Personal Protective Equipment)
Information from ABAI:
ABAI Practice Board: https://www.abainternational.org/constituents/practitioners/practice-home.aspx
ABAI Billing Codes Commission: https://www.ababillingcodes.com/resources/important-covid-19-update-use-of-telehealth-2/
Working in another state?
You may be in a situation where you are treating a client who is not currently in Virginia due to the COVID-19 crisis. Do you need to be licensed in that state?
Chances are, like VA, the other state has relaxed enforcement of licensing laws. However, you should investigate.
Here are the links to licensing agencies for nearby states:
DC (no license)
West Virginia (no license)
Click here for information from the Small Business Administration including paycheck protection loans, https://www.sba.gov/page/coronavirus-covid-19-small-business-guidance-loan-resources
for information from Fisher Phillips on Congress’ COVID 19 Act
Click here for Inc.’s resource list for businesses
Click here for a document on Employer Obligations under the new Family First Act from JacksonLewis
Two acts that affect small business in times of COVID-19 are the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES).
HHS has relaxed enforcement of HIPAA regulations during the pandemic. This does NOT mean that you shouldn’t do everything you can to protect the personal health information for your clients, because you definitely should! It just means that they won’t be going after providers who don’t sign business associate agreements (BAAs) with providers and other possible breaches. There are many approved telehealth service providers (such as doxy.me, Zoom, WebEx, and more) that will sign BAAs with providers! Please do everything possible to protect your client’s information. You should not be using public facing tools such as Facebook for telehealth.
The Mid-Atlantic Telehealth Center is an excellent resource that is not specific to behavior analysis – www.matrc.org
Virginia’s Web site on telehealth – https://www.ehealthvirginia.org/
APBA – The Association for Professional Behavior Analysts (www.apbahome.net) has been providing webinars and resources on telehealth and business matters
CASP – The Council of Autism Service Providers (casproviders.org) has many webinars and resources on telehealth
BHCOE – The Behavioral Health Center of Ethics (www.bhcoe.org) has also been providing webinars and resources on telehealth and business matters
Click here for a resource from Empowered to guide your decision making on telehealth
https://www.vahp.org/covid-19-update/ – this breaks down the statements from various insurance providers
Telehealth Info specific to insurance company (as of 4/23/20)
Click here for information on payers who are authorizing Telemedicine
for information from TRICARE
Click here for information for providers from Anthem
Click here for information from Optum/United Healthcare
Click here for information from Optima
Here is billing info from Optima:
Click here for the information from the Joint Commission
Click here for a memo from DMAS (3/19). It talks about providers ability to do telemedicine with behavioral therapy and therapeutic consultation. Contact them with specific questions using this form. Form works best in Chrome or Firefox browsers. Here is their Web page on the subject.
Click here for a memo on provider flexibilities (Dated 4/22)
Click here for information on Medicare and Telehealth and scroll down to information on Medicaid
Click here for information from Medicaid on telemedicine not specific to ABA
Click here to see DBHDS answers to specific questions about COVID 19. It was shared that Therapeutic Consultation can be done through electronic means or telephone for the time being as long as it’s not direct behavioral intervention. All the other covered practices would be up to the discretion of the provider. Make sure to document COVID 19 Pandemic in the note. See the DMAS memo above for confirmation.
Click here for Information on Eligibility, Enrollment, and Appeals
The DMAS web-page for provider and member guidance can be found here:
Provider and MCO Information:
You can sign up to start receiving automatic notifications of guidance posted by going to this link:
May 14 Communication from DMAS:
The Governor has shared a “Blueprint for Easing Public Health Restrictions” with a start date of Friday, May 15, 2020. DMAS understands that some providers may be eager to resume delivering more face to face services and supporting members in a more traditional manner. In the context of these dynamics, DMAS underscores that the provider flexibilities, allowances, directives, and limitations related to the delivery of behavioral health and ARTS services as stated in the March 27, 2020 memo, extend through the duration of the declared State of Emergency in Virginia, until otherwise formally notified. DMAS providers, managed care organizations (MCOs), and the Behavioral Health Services Administrator (BHSA) shall continue to operate under the published guidance, memos, and directives issued by DMAS until notified otherwise.
In preparation for Virginia’s phased re-opening process, DMAS is collaborating with multiple state agencies and provider associations regarding best practices for the implementation of this process for behavioral health services, keeping the safety of the members we serve and the providers that partner with us in that service as a priority. DMAS is striving to be strategic, responsive, and responsible as we move forward with issuing guidance to assist with directing providers on how and when to resume activities and services. Any changes or updates to current memos would be issued to providers through a formal memo, email blast, and provider notification.
Providers and stakeholders are encouraged to sign up to start receiving automatic notifications of guidance posted by going to this link: https://public.govdelivery.com/accounts/VADMAS/subscriber/new?qsp=VADMAS_2. For copies of all previously posted Behavioral Health and ARTSs COVID-19 guidance, directives, recordings, webinars, and FAQs, remaining effective until the state of emergency ends or otherwise notified, please visit: https://www.dmas.virginia.gov/#/emergencywaiver.
We look forward to speaking with you during our next stakeholder call on May 20, 2020 at 11:00 am.
WebEx Information: 1-866-692-4530
Access code: 611 901 975
Magellan Complete Care: https://www.mccofva.com/coronavirus-alert/
Magellan Health (BHSA):
United Healthcare: https://www.uhccommunityplan.com/va
COVID-19 Response DMAS Behavioral Health Provider & Stakeholder Call
When: Wednesday, June 3, 2020
Time: 11:00 am
Call In: 1-866-692-4530
Access code: 619 279 252
COVID-19 Response DMAS Behavioral Health Provider & Stakeholder Call
When: Wednesday, June 17, 2020
Time: 11:00 am
Call In: 1-866-692-4530
Access code: 618 574 465
This was sent from Magellan on behalf of the Virginia Department of Medical Assistance Services (DMAS).
Hello behavioral health stakeholders,
Thank you for participating in our behavioral health stakeholder’s WebEx sessions, consistently attending, and for passing on the information. Click here for the materials we reviewed during the call on May 6, 2020. Providers are now able to access available recordings from previous sessions, including this one, at https://go.magellanhealth.com/e/703943/–emergencywaiver/hldl1/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas.
In addition to the materials from the calls, this email includes a schedule for Substance Abuse and Mental Health Services Administration (SAMHSA) “Training and Technical Assistance Related to COVID-19.”
*Check it out! We have reorganized our COVID-19 webpage: https://go.magellanhealth.com/e/703943/–emergencywaiver/hldl1/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas. On this page you will find guidance documents for all providers and a behavioral health specific section with general, behavioral health, and ARTs FAQs posted!
* During these calls we will discuss FAQs, guidance, and technical assistance. We will not be doing service specific Q & A during the call.
The DMAS webpage for provider and member guidance can be found here:
- Member Information: https://go.magellanhealth.com/e/703943/id19-One-Pager-English-4-9-pdf/hldl7/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas
- Provider and MCO Information: https://go.magellanhealth.com/e/703943/–emergencywaiver/hldl1/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas
- You can sign up to start receiving automatic notifications of guidance posted by going to this link: https://go.magellanhealth.com/e/703943/AS-subscriber-new-qsp-VADMAS-2/hldl9/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas
- Have other questions about how Medicaid is improving access to care in response to COVID-19? Contact DMAS at https://go.magellanhealth.com/e/703943/contactforms—general/hldlc/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas or COVIDemail@example.com.
For DBHDS updates and guidance, please visit the DBHDS COVID-19 resource page: https://go.magellanhealth.com/e/703943/covid19/hldlf/104543248?h=mIxkT2QKkLXLC3sFBwo5D70xMq-xufeTNyt5Yq8isas
We look forward to speaking with you on Wednesday, May 20, 2020 at 11 a.m.
In service with you,
The Department of Medical Assistance Services, Division of Behavioral Health
A few ABAI colleagues have graciously offered to volunteer some time for those who may need support with online instruction – if interested, please contact Bryan Blair Ph.D., LABA, BCBA (firstname.lastname@example.org)
The Council for Higher Education Accreditation (CHEA) has linked all regional accrediting body’s updates here: https://www.chea.org/chea-and-usde-recognized-accreditors-and-covid-19-information
And, the U.S. Department of Education has resources for schools and school personnel here: https://www.ed.gov/coronavirus
Resources provided by the VA Department of Education: The VDOE Special Education and Student Services Frequently Asked Questions provides some additional information and guidance. Specifically, the requirements of school divisions as it relates to providing a free and appropriate education (Question 1) and the impact of the extended closure on services to students in private day settings (Question 10). Additionally, VDOE and CSA released Joint Guidance for Student Placements Reimbursed by the Children’s Services Act.
Federal DOE Fact Sheet
Click here for info from Autism Speaks.
Click here for the Autism Society’s toolkit
Click here for resources from VCU ACE
Click here for resources from the University of North Carolina
Click here for resources from the Arc
Click here for a Townhall from Behavioral Autism Therapies and Autism Business Association
Magellan is offering free Smart Phones to adults 18 and over. Click here for more info.
Click here for a handout on Social Insurance and Benefit Programs
Note from Medicaid:
On March 16, 2020, the Centers for Medicare and Medicaid Services (CMS) provided guidance to the Department of Medical Assistance Services (DMAS) that no Medicaid individuals are to experience a closure in their case due to the current state of emergency due to COVID-19. In addition, DMAS and the Virginia Department of Social Services implemented system changes to prevent automatic disenrollment for certain groups of Medicaid-eligible individuals due to life events, such as attaining a maximum age for certain covered groups or having reached the end of the two month post-partum period for pregnant women. Unfortunately, due to the timing of these events, some Medicaid individuals experienced disenrollment from their existing enrollment, either reducing or ending their Medicaid benefits starting April 1, 2020.
DMAS is currently working to reinstate all of these enrollments that were closed effective March 31, 2020. A mass re-enrollment process will occur prior to the normal cut-off date, April 16, 2020, for these individuals. This re-enrollment will retroactively reinstate coverage starting April 1, 2020 and going forward and will re-enroll these individuals in their previous managed care health plan.
DMAS is committed to ensuring that providers rendering services for the impacted members will be reimbursed for the members with an existing, open service authorization. Please continue to provide the same level of service that you previously had been for these individuals. Information regarding these closures and re-enrollments is being sent in a letter to the affected individuals (see attached). If one of your clients has been affected by a closure during this state of emergency, you may view the provider portal periodically to check that the individual is reinstated.
It is still possible for manual closures to occur, although these numbers should be small. DMAS teams will be monitoring any closures each week and will re-enroll individuals who have been erroneously removed from coverage through the end of the emergency. DMAS will also continue to communicate with local DSS agencies to give clear direction throughout the emergency. If you or one of your clients receives notification of an individual’s eligibility being terminated during this state of emergency, please have the affected individual contact his or her local department of social services. Please be aware that once this public health emergency has ended, individuals may experience a change in their Medicaid coverage based on program requirements.
Alyssa M. Ward, Ph.D., LCP
From CA Human Services: The Governor’s Office is helping to coordinate the implementation and expansion of food and nutrition programs to meet the demand during Virginia’s response and recovery from COVID -19.
If you or someone you know need meals, follow the instructions below:
Children: 0-18 years old
Text “Food" or “Comida" to 877-877
Visit www.doe.virginia.gov for daily meal distribution location updates
Thank you to the programs supporting the demand.
VDOE : National School Lunch Program (NSLP), Summer Food Service (SFSP) Child and Adult Care Food Program At At-risk Afterschool Program (CACFP)
VDSS : Supplemental Nutrition Assistance Program (SNAP), Pandemic EBT
VDH : Women, Infants and Children Program (WIC), Child and Adult Care Food Program for early care (CACFP)
DARS : Senior Nutrition Program (SNP), Home Home-delivered Meal Services (HDM)
DACS : The Emergency Feeding Assistance Program (TEFAP), Commodity Supplemental Food Program (CSDP)
Non -profits and community organizations : Food banks, Food pantries, Community kitchens, Meals on Wheels.
Relias has many Webinars regarding the virus and VABA Members get a discount for those that aren’t already free! (see member page for details)
BHCOE Presents “How Businesses Can Prepare for the Impact of COVID-19" (Presented March 17 – see their Virtual Academy
CASP Presents: “What Employers Need to know about COVID-19/Coronavirus Response" (Presented March 18 – see their Web site for viewing options)
Supporting IEPs During Distance Learning (March 19)
REthink Presents: ABA Telehealth Free Resources for Supporting Families Remotely
ASAE Presents “Remote Work during COVID-19: Human Resource and Technology Considerations" (March 20)
Virginia Department of Health Presents “COVID-19: A Briefing for Assisted Living Facilities, PACE Sites, Adult Day Centers and Group Homes" (March 20 – postponed from March 18)
Advocating 4 Kids, Inc and FACES Present: Virtual FAPE Checkin during the COVID 19 Outbreak (March 20)
CalABA Presents: Information on the Family First Act (March 25)
APBA Presents: Telepractice of ABA during the pandemic (March 25 – sold out and March 28)
NTACT Presents: Providing Transition Focused Activities Online and At Home
The Daily BA Presents: Telehealth and ABA (podcast)
Recording of CEC Webinar: Teaching Special Education Online during COVID-19
Materials from SCABA Telehealth Webinar (3/27/20)
Recording of JacksonLewis Webinar on Employment Law
Webinar on Telehealth from Imbueity
with the link below to hold your space for our first lab
May 21, 2020 from 12 p.m. – 1p.m.!
We look forward to seeing you there!
Project ECHO COVID-19 Infection Control & Best Practices in Clinic Settings
May 21, 2020
12 p.m. to 1 p.m.
Register in advance for this meeting:
After registering, you will receive a confirmation email containing information about joining the meeting.
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Meeting ID: 965 9887 9179
Find your local number: https://go.magellanhealth.com/e/703943/u-ad6KvTlcGj/hqvc5/106078342?h=eM9OO–oUZFi2oDyfuOqozafSnq_FByoeUA6N7Yo0vk
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Meeting ID: 965 9887 9179
Physicians, Registered Nurses, Nurse Practitioners, Physicians Assistants, non-licensed health care providers.
Dr.Costi Sifri, Director of Hospital Epidemiology at the University of Virginia
At the end of the entire seven series session, participants will be able to:
- Identify one piece of new piece of knowledge related to best practices in COVID-19 case management after participation in this program
- Develop a plan for utilization and reimbursement of COVID-19 telehealth to enable continued care of your patients
- Formulate a process for screening and referring patients at risk for adverse health consequences of COVID-19 and related issues including Substance Abuse/Suicide Prevention, Shaken Baby Syndrome, Domestic Violence/Intimate Partner Violence, Social Determinants of Health-Loss of job, housing
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Medical Society of Virginia through the joint providership of Carilion Clinic’s CME Program and the Virginia Department of Health.
Carilion Clinic’s CME Program is accredited by The Medical Society of Virginia to provide continuing medical education for physicians. Carilion Clinic’s CME Program designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This nursing continuing professional development activity was approved by the Virginia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Dr. Costi Sifri reported no relevant relationships/affiliations with any entity producing, marketing, and re-selling or distributing health care goods or services consumed by, or used on patients.
The Planning Committee: Carole Pratt, DDS; Lisa Wooten, MPH, BSN, RN and Jean Hoyt, CMA, reported no relevant relationships/affiliations with any entity producing, marketing, re-selling or distributing health care goods or services consumed by, or used on patients.
TO OBTAIN YOUR CONTINUING EDUCATION UNITS
At the close of the session, you will receive a link to complete your evaluation. Instructions for receiving your education units will be provided in the evaluation link.
Acknowledgement: Funding received from the Public Health Emergency Funding