Providers shared several strategies for managing PASSE cost containment issues related to therapy at ADDT programs:

1. **Thorough medical necessity documentation**: Ensure therapy evaluations and progress notes clearly document functional deficits, goals, and the clinical rationale for continued services.
2. **Care coordinator engagement**: Work proactively with the client’s PASSE care coordinator to support prior authorization requests — they can be an advocate within the PASSE.
3. **Peer-to-peer review**: If a prior authorization is denied, request a peer-to-peer review between your therapist and the PASSE’s clinical reviewer. Providers reported this often reverses denials.
4. **Physician documentation**: Involve the client’s primary care physician or specialist in documenting medical necessity, as physician-supported requests carry more weight in the authorization process.
5. **Formal appeals**: Use the PASSE’s formal grievance and appeal process for denials — document everything.
6. **DDPA advocacy**: Report systemic cost containment patterns affecting multiple providers to DDPA, which can escalate concerns collectively to DHS.