Category: Finance
Recorded: 3/7/23
In 2014, state legislation expanded coverage of mental health services to Medi-Cal beneficiaries with mild-to-moderate impairment of mental, emotional, or behavioral functioning resulting from a mental health disorders. As such, Medi-Cal Managed Care Plans (MCPs) assumed responsibility for treating Medi-Cal enrollees with “mild-to-moderate” mental health conditions. In California, there has been varied interpretation of the distinction between mild to moderate to severe across countries. So what is a “mild-to-moderate” mental health service? And what are allowable and billable codes? California is moving toward increasing access to mental health services and specifically those insured through Medi-Cal through the California Advancing and Innovating Medi-Cal (CalAIM) initiative. Specifically, CalAIM is looking to establish a no wrong door approach for enrollees to quickly and easily access mental health, including standardizing screening and transition tools to streamline criteria for accessing services. Panelists from Beacon Health Options shared how they, as a Managed Behavioral Health Organization, are working with their contracted providers to cover Non-Specialty Mental Health Services and responding to the new changes in CalAIM. Speakers discussed the administrative and payment structures to health centers that will include the “mild-to-moderate” mental health coverage requirements released by the California Department of Health CARE Services. Speakers also talked about the new Dyadic Care Services benefit that went live on January 1, 2023.
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