Behavioral Health Sample Clauses

Behavioral Health. Behavioral health services, with the exception of Medicaid Rehabilitation Option (MRO) and 1915(i) services, are a covered benefit under the Hoosier Healthwise program. The Contractor shall be responsible for managing and reimbursing all such services in accordance with the requirements in this section. In furnishing behavioral health benefits, including any applicable utilization restrictions, the Contractor shall comply with the Mental Health Parity and Additions Equity Act (MHPAEA). This includes, but is not limited to:  Ensuring medical management techniques applied to mental health or substance use disorder benefits are comparable to and applied no more stringently than the medical management techniques that are applied to medical and surgical benefits.  Ensuring compliance with MHPAEA for any benefits offered by the Contractor to members beyond those otherwise specified in this Scope of Work.  Making the criteria for medical necessity determinations for mental health or substance use disorder benefits available to any current or potential members, or contracting provider upon request.  Providing the reason for any denial of reimbursement or payment with respect to mental health or substance use disorder benefits to members.  Providing out-of-network coverage for mental health or substance use disorder benefits when made available for medical and surgical benefits. The Contractor shall assure that behavioral health services are integrated with physical care services, and that behavioral health services are provided as part of the treatment continuum of care. The Contractor shall develop protocols to:  Provide care that addresses the needs of members in an integrated way, with attention to the physical health and chronic disease contributions to behavioral health;  Provide a written plan and evidence of ongoing, increased communication between the PMP, the Contractor and the behavioral health care provider; and  Coordinate management of utilization of behavioral health care services with MRO and 1915(i) services and services for physical health.
Behavioral Health. 46.01 The Board is concerned with the problems of behavioral health and will continue to assist Employees in this regard.
Behavioral Health. The Contractor shall provide Behavioral Health Services to Members in the MississippiCAN Program. The Contractor shall comply with all requirements related to Care Management, access and availability with respect to Behavioral Health Services. All Behavioral Health Services covered by Medicaid that are medically necessary must be covered. All Contract requirements herein shall apply to the provision of Behavioral Health Services unless specified. Division policy regarding Behavioral Health Services is referenced in the Mississippi Administrative Code, Title 23, Part 206, but other sections of the code may also be referenced.
Behavioral Health. Contractor shall provide Behavioral Health services to Members in CHIP. Contractor shall comply with all requirements related to Care Management, access and availability with respect to Behavioral Health services. All Behavioral Health services covered by the State Child Health Plan that are medically necessary must be covered. All Contract requirements herein shall apply to the provision of Behavioral Health services unless specified.
Behavioral Health. 31.01 The Employer recognizes that alcoholism, drug addiction and mental illness are illnesses which can respond to therapy and treatment and that absence from duty due to such therapy or treatment shall be considered as sick leave, under the provisions set out in Article 23.
Behavioral Health. For the purposes of the Contract is inclusive of mental health and substance use disorders.
Behavioral Health. The Board is concerned with the problems of behavioral health and will continue to assist Employees in this regard. For the purpose of this Article, a behavioral health problem is defined as a physical or mental condition which affects the performance of an Employee so as to make his work unacceptable in a way that could be documented. Further, the Parties recognize a behavioral health problem as a condition which can respond to therapy and treatment; therefore, an absence from duty due to such therapy or treatment shall be subject to the sickness provisions of this Agreement provided the Board is satisfied the Employee is participating in a recognized program of therapy and treatment. The Parties further agree to an exchange of information where applicable, pertinent to the treatment and progress of an Employee during such treatment provided that such Employee consents to an exchange of information. ARTICLE