RD134 - Redesign of Behavioral Health Services – April 1, 2021


Executive Summary:

DMAS received initial funding for the proposed Redesign of Behavioral Health Services through the 2020 Special Session I Amendments to the 2020 Appropriation Act Item 313.NNNN, though this funding was unallotted during the initial Public Health Emergency associated with COVID19. Funding was reinstated through the 2020 Special Session of the General Assembly, with an altered timeline and budget projection that accommodated for time lost due to the implementation being on hold while the Commonwealth responded to the immediate needs of the Public Health Emergency.

The 2020 Special Session I Amendments to the 2020 Appropriation Act Item 313.NNNN also included language that mandated DMAS to establish an advisory panel composed of behavioral health provider associations to address concerns related to the implementation of new services within managed care, including the process for service authorization, the interpretation of medical necessity criteria, and claims processing. In working with stakeholders named in the budget language, it was resolved that this panel would be an ongoing collaborative to be called the “Behavioral Health MCO Resolutions Panel." The initial meeting of the panel was on December 17, 2020 and included the Behavioral Health Provider Associations and internal DMAS Divisions including Behavioral Health, Healthcare Services and Integrated Care. This body will continue to meet on a bimonthly schedule and will consider the first six months a pilot process for the structure put in place, with a plan to evaluate its effectiveness and integrate feedback into a more permanent structure.