AZBH
"14. COORDINATION
WITH AHCCCS ACUTE CARE CONTRACTORS
ADHS and its
subcontracted RBHAs are responsible for coordination of care with the AHCCCS
acute contractors. ADHS shall establish policies and procedures for
ensuring implementation and monitoring of communication and coordination
between acute care and behavioral health contractors and subcontracted
RBHAs." Arizona Behavioral Health Contract, page 18.
FLMH
"2.5 Minimum
Staffing and Access Standards...
Recipients
under the plan may not be admitted to or transferred to a public receiving
facility without contractual arrangements for payment of the public receiving
facility by the prepaid provider..." Florida Mental Health, pages
27, 30.
ORMH
"g. Medicare
payers and Providers
Contractor
shall coordinate with Medicare payers and providers as Medically Appropriate
to coordinate the care and benefits of OMAP Members who are eligible for
both Medicare and Medicaid.
h. OMAP
Members in Extended Care Settings
Contractor
shall coordinate with the ECMU of Division and extended care service providers
to integrate services for OMAP Members in Extended Care Programs.
ECMU shall determine, after collaborating with Contractor and the Extended
Care Program, when OMAP Member is ready for discharge from the extended
care program. Contractor shall ensure that such OMAP member receives Covered
Services following discharge to ensure timely discharge." Oregon
Mental Health Contract, pages 18-19.
UTMH
"Article III
SCOPE OF SERVICES...
A. Covered
Services...
5.
Emergency Services...
g.
The CONTRACTOR must reimburse hospitals for the first 24 hours of emergency
care provided in an inpatient psychiatric unit as long as the hospital
has made a good faith effort to obtain approval from the CONTRACTOR within
24 hours of the time of admission. Occasionally there may be extenuating
circumstances that may preclude the hospital from meeting the requirement.
In such instances the CONTRACTOR agrees to review the care and reimburse
the provider when it is reasonable to do so." Utah Mental Health
Contract, page 5.
"Coordination
- The CONTRACTOR will provide access to a coordinated, comprehensive, and
continuous array of needed services through coordination with other appropriate
entities.
a.
Medicaid Prepaid Mental Health Plan (PMHP) Enrollees may also be enrolled
in another managed care plan, such as an HMO or primary care physician
program, that will be responsible for directing the physical health needs
of the individual. The CONTRACTOR will coordinate the provision of
covered mental health services with the Enrollee's HMO or primary care
physician...
b.
The CONTRACTOR will educate HMOs and primary care physicians on the diagnosis,
treatment, and referral of behavioral health disorders commonly seen in
primary care." Utah Mental Health Contract, page 11.