Section 65 Behavioral Health Services, Behavioral Health Day Treatment Update: Previous Clarification Rescinded
Maine Department of Health & Human Services sent this bulletin at 04/28/2017 03:31 PM EDT
Section 65 Behavioral Health Services, Behavioral Health Day Treatment Update: Previous Clarification Rescinded
On March 24, 2017 the Department issued a MaineCare clarification regarding Section 65 Behavioral Health Services, Behavioral Day Treatment. Based on feedback and internal discussions, the Department is rescinding that clarification notice effective immediately. Any individuals who were affected by the clarification will be re-evaluated under the previously existing guidance and practices.
For more information, please see the MaineCare Benefits Manual Chapter II - Section 65: Behavioral Health Services.
ORIGINAL NOTICE BEING RESCINDED:
MaineCare Clarification: Section 65 Behavioral Health Services, Behavioral Health Day Treatment
The Office of MaineCare Services would like to offer a clarification regarding Behavioral Health Day Treatment services. Per Section 65.06-13, “Behavioral Health Day Treatment Services must be delivered with an educational program in a school as defined in 65.03-4.” The MaineCare member’s Individualized Education Program (IEP) or Individual Family Service Plan (IFPS) serve as the justification of medical necessity for Behavioral Health Day Treatment services. The frequency, intensity, and duration of the Behavioral Health Day Treatment services provided must be consistent with frequency, intensity, and duration recommended within the IEP or IFSP.
The member’s Individualized Treatment Plan (ITP) for Behavioral Health Day Treatment Services lists the target areas, goals, objectives, and description of the services to be provided. The frequency, intensity, and duration of services in the ITP must not exceed the level identified within the IEP or IFSP.
For more information, please see the MaineCare Benefits Manual Chapter II - Section 65: Behavioral Health Services. Contact Joshua Birdwell with questions through email at Joshua.birdwell@maine.gov or call him at (207)624-6938.