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. Behavioral health services, with the exception of Medicaid Rehabilitation Option (MRO) and 1915(i) services as described in Section 3.11 Carved-Out Services, are a covered benefit under the HIP program. The Contractor shall be responsible for managing and reimbursing all such services in accordance with the requirements in this section. The Contractor shall provide timely access to behavioral health screening, assessment, referral and treatment services, including outpatient services as well as inpatient psychiatric hospital services, inpatient drug and alcohol detoxification, inpatient drug and alcohol rehabilitation, and residential treatment services for opioid use disorder (OUD) and substance use disorder (SUD) apart from treatment rendered in a State Hospital as described in Section 3.12.3. As described in Section 3.15, the Contractor is encouraged to develop and purchase enhanced services which can provide services in a less restrictive setting and/or which would result in improved outcomes for members. In furnishing behavioral health benefits, including any applicable utilization restrictions, the Contractor shall comply with the Mental Health Parity and Additions Equity Act (MHPAEA). In furnishing behavioral health benefits, including any applicable utilization restrictions, the Contractor shall comply with the Mental Health Parity and Addiction Equity Act (MHPAEA) prohibiting the application of more restrictive limits to mental health/substance use disorder benefits than to medical/surgical benefits. Compliance with the MHPAEA and State requirements includes, but is not limited to: ▪ Not applying any financial requirement or treatment limitation to mental health or substance use disorder benefits in any classification that is more restrictive than the predominant financial requirement or treatment limitation of that type applied to substantially all medical/surgical benefits in the same classification furnished to members (whether or not the benefits are furnished by the same Contractor) per 42 CFR 438.910(b)(1). ▪ If a member is provided mental health or substance use disorder benefits in any classification of benefits (inpatient, outpatient, emergency care, or prescription drugs), mental health or substance use disorder benefits shall be provided to the member in every classification in which medical/surgical benefits are provided per 42 CFR 438.910(b)(2). ▪ Not applying any cumulative financial requirements for mental health or substance use di...
Behavioral Health. Home (BHH) means a MHCP-enrolled provider certified by the STATE to provide services in accordance with Minnesota Statutes § 256B.0757. BHH is a mental health care coordination model that consists of the following services delivered by an inter-professional team: comprehensive care management; care coordination; health promotion services; comprehensive transitional care; referral to community and social support services; and individual and family support services. BHH services are available to Enrollees who have been determined eligible by the BHH provider in accordance with Minnesota Statute § 256B.0757, subd. 2, (4).
Behavioral Health. A group of interdisciplinary services concerned with the prevention, diagnosis, treatment, and rehabilitation of mental health and substance abuse disorders.
Behavioral Health. An all-inclusive term referring to mental health services provided through the mental health plan (MHP) or Contractor and substance use disorder services.
Behavioral Health. Mental health and/or substance use disorders and includes diagnoses and services related to mental health and/or substance use disorders.
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. 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, EXHIBIT 1.E
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. If applicable, Provider shall coordinate with behavioral health providers in the treatment of a Covered Person, including:
