26B-3-219. Reimbursement for crisis management services provided in a behavioral health receiving center -- Integration of payment for physical health services.

274 words·~1 min read·/ut/title-26b/chapter-3/26b-3-219

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 5/3/2023

(1)As used in this section:

(a)"Accountable care organization" means the same as that term is defined in Section 26B-3-204 .

(b)"Behavioral health receiving center" means the same as that term is defined in Section 26B-4-114 .

(c)"Crisis management services" means behavioral health services provided to an individual who is experiencing a mental health crisis.

(d)"Managed care organization" means the same as that term is defined in 42 C.F.R. Sec. 438.2.

(2)Before July 1, 2020, the division shall apply for a Medicaid waiver or state plan amendment with CMS to offer a program that provides reimbursement through a bundled daily rate for crisis management services that are delivered to an individual during the individual's stay at a behavioral health receiving center.

(3)If the waiver or state plan amendment described in Subsection

(2)is approved, the department shall:

(a)implement the program described in Subsection

(2); and

(b)require a managed care organization that contracts with the state's Medicaid program for behavioral health services or integrated health services to provide coverage for crisis management services that are delivered to an individual during the individual's stay at a behavioral health receiving center.

(a)The department may elect to integrate payment for physical health services provided in a behavioral health receiving center.

(b)In determining whether to integrate payment under Subsection (4)(a) , the department shall consult with accountable care organizations and counties in the state.

Renumbered and Amended by Chapter 306 , 2023 General Session