Other Medicaid Mental Health Services. For Medicaid recipients who are eligible for full Medicaid benefits and have an identified need for medically necessary mental health services other than Mental Health Rehabilitative Services and Targeted Case Management (such as counseling or physician’s services), Contractor shall remove them from the waiting list and provide these services to the individual or refer the individual to other local Medicaid providers. Contractor shall provide assistance with the referral if requested by the client. Contractor shall document actions taken on behalf of the client. If Contractor lacks the capacity to deliver the services and no qualified local Medicaid provider is available, Contractor shall identify the nearest qualified Medicaid provider of the needed service or services. If the distance to the nearest available non-local (more than 75 miles from the individual’s residence) provider is not, in the individual’s opinion, a barrier to the individual accessing services, then Contractor shall refer the individual to the available service provider. ATTACHMENT A01 PERFORMANCE CONTRACT NOTEBOOK (MH/PCN), VERSION 3 Contractor shall document the discussion with the individual, and the individual’s decision, regarding traveling to the non-local provider. Contractor may place an individual on a waiting list for the needed service only if Contractor lacks the capacity to provide the needed service and there are no other internal or external qualified or accessible providers available to deliver the needed service. In such cases, Contractor shall review the availability of the service monthly in order to ensure that the individual receives the needed service once it becomes available. Contractor shall document the steps taken in the client file.
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Samples: Health And, Health And, Health And
