Human Services Organizations

Behavioral Health HealthChoices

In 1997 the Commonwealth of Pennsylvania, Department of Public Welfare (DPW) implemented a mandatory Behavioral Health Managed Care Program for Medical Assistance (MA) recipients, called the Behavioral Health HealthChoices (HealthChoices) Program. This program was designed to assist individuals with mental retardation, other mental health issues, and substance abuse. It is governed by Title 55 of the Pennsylvania Code regarding public welfare standards, and Chapter 4300 Regulations, a code which specifies the fiscal requirements for county mental health and mental retardation programs.

The Binkley Kanavy Group (BKG) currently operates the largest HealthChoices auditing practice within the Commonwealth of Pennsylvania. Our practice serves primary contractors providing behavioral health managed care; our practice represents approximately 67% of Pennsylvania counties.

The growth of the HealthChoices practice has not spurred our passion for the program, but instead, our passion for this program has fueled the growth of our HealthChoices practice.

We are not only experts in the HealthChoices requirements and attestation standards according to DPW regulations, but we are expert MHMR consultants who use our knowledge to help our clients reach their personal and entity goals while managing such a complex program in an even more complex environment.

• Financial Schedule Examinations
• Compliance Examinations
• Policies and Procedures Development
• Internal Control Assessments
• Reinvestment Program Agreed-upon Procedures
• HealthChoices Training Services
• Readiness Review Assessments
• Medical Claim Reviews and Audits
• Medical Claim Liability Analysis
• Capitation Analysis
• Implementing Monitoring Tools
• Subrecipient Monitoring Plans

• Our HealthChoices clients are Primary Contractors representing 45 of 67 Pennsylvania counties
• Our practice includes all current Behavioral Health Managed Care Organizations currently serving the HealthChoices system outside of Philadelphia
• Our HealthChoices practice started in DPW’s second phase of their statewide rollout in 1999
• Over half of the primary contractors joining the HealthChoices program in July 2007 utilized the Binkley Kanavy Group for training and readiness review consulting

• HealthChoices Behavioral Health Publications