AZBH

"15.  TRANSACTION OF TITLE XIX AND TITLE XXI MEMBERS
To ensure that Title XIX and Title XXI members who need behavioral health services receive them, ADHS and its subcontracted RBHA's shall cooperate when a transition from one subcontracted RBHA to another or to an ALTCS Program Contractor becomes necessary.

This shall include identification of transitioning members, provision of appropriate referrals and forwarding of the medical record...

16.  OUTREACH...
ADHS shall develop and implement a policy and procedure regarding outreach activities required of its subcontracted RBHA's and their providers, including required outreach in cases involving inter-RBHA transfers.  ADHS shall ensure that its subcontracted RBHAs and their providers actively participate in outreach activities to Title XIX and Title XXI members in high risk groups, including but not limited to… seriously mentally ill members, members with co-morbid medical and behavioral health disorders…"  Arizona Behavioral Health Contract, page 19.

FLMH

"2.10  Care Coordination and Management
The contractor shall be responsible for the coordination and management of mental health care and continuity of care for all enrolled Medicaid recipients through the following minimum functions:
A.  Minimizing disruption to the enrollee as a result of any change in service provider or mental health care case manager occurring as a result of the awarding of this contract." Florida Mental Health RFP, page 32.

MN

"Section 6.22.2. Transition Services. The HEALTH PLAN is responsible for care in the following situations…
E.  Mental Health Services. At the time of initial enrollment in PMAP, the HEALTH PLAN shall consider the individual Enrollee's prior use of mental health services and to develop a transitional plan to assist the Enrollee in changing mental health providers, should this be necessary, and to develop a plan to assure the need for continuity of care for any individual or family who is receiving ongoing mental health services. The HEALTH PLAN shall also develop a transitional plan for children who have previously been excluded from PMAP because they have been involved in the child protection system, placed in foster care or diagnosed as severely and emotionally disturbed…"  Minnesota Contract, page 72.

NEBH

"9.7 Transition Into Managed Care: The PHP shall work cooperatively with a client who notifies [MCO] that s/he is experiencing difficulty in transitioning to a managed care environment during the first sixty (60) days of enrollment.

9.7.1  PHP Requirements: The transitional period may require the PHP to do, but is not limited to, the following to ensure continuity of care and a smooth transition into managed care:
(a)  Providing enhanced case management and member services;
(b)  Contracting with out-of-network providers;
(c)  Continuing to provide a service(s) that was authorized by the Department or the Department’s designee prior to the client becoming enrolled with the PHP, until the PHP determines that the service no longer meets the definition of medical necessity or is no longer appropriate for the client;
(d)  Taking into consideration the unique needs of the client in understanding and following the managed care rules, e.g., relaxed referral and prior authorization requirements, retroactive authorizations;
(e)  Contacting the client’s medical/surgical plan and/or Primary Care Physician, as appropriate; and
(f)  Coordinating with the Enrollment Broker Services for a client who is  identified as having a special need, as appropriate."  Nebraska Behavioral Health Contract, pages 37-38.