Mental Health/Substance Abuse. 4.8.7.1 The Contractor shall include in its network Core Service Providers (CSP’s) that meet the requirements of the Department of Human Resources and are located in its Service Region, provided they agree to the Contractor’s terms and conditions as well as rates; and presuming they meet the credentialing requirements established by the Contractor for that provider type.
Mental Health/Substance Abuse. A managed mental health and substance abuse program is provided to all participants enrolled in any Employer-sponsored health plan. Premiums for the managed mental health and substance abuse program shall be calculated and shall be added to the health plan premiums. The Employer shall contract for mental health and substance abuse benefits only under this program provided, however, that by agreement of the Director of DAS and the JHCC the benefit delivery system for this benefit may be changed. The managed care vendor shall provide quarterly reports to DAS, which shall share the reports with the JHCC, on utilization and treatment outcomes, and on the composition of its provider network (including contracted facilities). The vendor will also provide information about its programs for use in the participant education program. Programs must include the following features:
Mental Health/Substance Abuse. A managed mental health and substance abuse program is provided to all State employees enrolled in any Employer-sponsored health plan. Premiums for the managed mental health and substance abuse program shall be calculated and shall be added to the health plan premiums. The Employer shall contract for State employee mental health and substance abuse benefits only under this program provided, however, that by agreement of the Director of DAS and the JHCC the benefit delivery system for this benefit may be changed. Programs must include the following features:
Mental Health/Substance Abuse. Include a mental health/substance abuse assessment documenting pertinent findings. When there is an indication of possible MH/SA issues, a mental health/substance abuse screening tool(s) found in Section B.4.9 of the Appendices or a DHS - approved equivalent shall be used to evaluate the enrollee.
Mental Health/Substance Abuse. 4.8.8.1 The Contractor shall include in its network Community Service Boards (CSBs) that meet the requirements and are located in its Service Region. CONFIDENTIAL – NOT FOR CIRCULATION
Mental Health/Substance Abuse. Include the cost of all mental health and substance abuse services including inpatient, physician services, outpatient hospital, other professional services and other services associated with mental health or substance abuse treatment.
Mental Health/Substance Abuse. The base plan will pay for 30 days per calendar year in hospital. Major medical maximums for in-and-out-of-hospital are: lifetime - $70,000; calendar year - $10,000.
Mental Health/Substance Abuse. A managed mental health and substance abuse program is provided to all State employees enrolled in any State-sponsored health plan. See 20.03 (B) (3).
Mental Health/Substance Abuse. Network Inpatient Mental Health Inpatient mental health services will be reimbursed at 80% of allowable expenses after a $200 deductible per admission for a maximum of 30 days per covered individual, per health insurance contract year.
Mental Health/Substance Abuse. Non-Network Inpatient Mental Health Inpatient mental health stays will be reimbursed at 80% of allowable expenses after a $200 deductible per admission for a maximum of 30 days per covered individual, per health insurance contract year. Outpatient Mental Health Outpatient mental health visits will be reimbursed at $25 per visit to a maximum of 30 visits per covered individual, per health insurance contract year. Inpatient Alcohol/Substance Abuse Inpatient alcohol and substance abuse detoxification will be reimbursed for a maximum of 7 days at 80% of allowable expenses after a $200 deductible per admission. Outpatient Alcohol/Substance Abuse Outpatient alcohol and substance abuse visits will be reimbursed in an amount equal to the network allowance minus an $8.00 copayment to a maximum of 60 visits per health insurance contract year. Effective June 1, 2005, the copayment will be $10.00.
