This Bulletin is being issued as an addendum to Bulletin 20-14.

The addendum to this Bulletin is being issued to highlight the following: CBH has developed a form for providers to utilize as a mechanism for submitting written notice to their assigned CBH Provider Relations Representative. The form will collect information about service locations affected, effective and target date, person responsible for monitoring the plan, and will also allow for an upload of the required supporting documentation on official company letterhead which must include details around the barriers to access as well as the detailed plan for reconciling the barriers. This form is available for immediate use by the provider network; however, all Providers are expected to utilize this mechanism for notification, effective October 9, 2021.

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