CBH, in partnership with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), maintains conscientious oversight and monitoring operations to ensure that individuals receive quality services across the provider network. Oversight and monitoring efforts minimize fraud, waste, abuse, and risk; guide policy and practices; and elevate industry standards.

CBH and DBHDIS rely on a multi-disciplinary, cross-departmental approach to oversight and monitoring. Involved departments include, but are not limited to Quality Management, Compliance, and the Network Improvement and Accountability Collaborative.

CBH Contract with State and Medicaid

Office of Behavioral Health-CBH 2019 Contract

HealthChoices 2019 Primary Contractor

HealthChoices 2019 Appendices

Pennsylvania Department of Human Services (DHS) Medical Assistance Bulletins

PA Code: Title 55

Network Improvement and Accountability Collaborative (NIAC)

NIAC is an interdisciplinary team comprising both CBH staff and other representatives of the DBHIDS network, thus allowing for a consistent approach to monitoring of behavioral health services across funding streams. NIAC re-credentials in-network providers through comprehensive site reviews; these include the self-appraisal, living reviews, clinical chart reviews, facility tours, interviews with executive and direct care staff members, discussions with individuals receiving services, staff file reviews, review of written policies, and observations of general operations.

NIAC uses the Network Inclusion Criteria (NIC) Standards for Excellence to guide provider re-credentialing processes.