Common use of Behavioral Health Continuity of Care Clause in Contracts

Behavioral Health Continuity of Care. The Contractor shall utilize behavioral health case managers to monitor the care of members receiving behavioral health services who are new to the Contractor or who are transitioning to another MCE or other treatment provider, to ensure that medical records, treatment plans and other pertinent medical information follows each transitioning member. The Contractor shall notify the receiving MCE or other provider of the member’s previous behavioral health treatment, and shall offer to provide to the new provider the member’s treatment plan, if available, and consultation with the member’s previous treating provider. The Contractor and receiving MCE shall coordinate information regarding prior authorized services for members in transition. The Contractor shall require, through provider contract provisions, that members receiving inpatient psychiatric services are scheduled for outpatient follow-up and/or continuing treatment prior to discharge. This treatment shall be provided within seven

Behavioral Health Continuity of Care. The Contractor shall utilize behavioral health case managers to monitor the care of members receiving behavioral health services who are new to the Contractor or who are transitioning to another MCE or other treatment provider, to ensure that medical records, treatment plans and other pertinent medical information follows each transitioning member. The Contractor shall notify the receiving MCE or other provider of the member’s previous behavioral health treatment, treatment and shall offer to provide to the new provider the member’s treatment plan, if available, and consultation with the member’s previous treating provider. The Contractor and receiving MCE shall coordinate information regarding prior authorized services for members in transition. The Contractor shall require, through provider contract provisions, that members receiving inpatient psychiatric services are scheduled for outpatient follow-up and/or continuing treatment prior to discharge. This treatment shall be provided within seven