§ 12-15-1.3-25 — Certified community behavioral health clinics; implementation; certification; requirements; reimbursement for eligible services; demonstration program; rules

Indiana § 12-15-1.3-25

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 1.3: Medicaid Waivers and Plan Amendments

Text

(a) As used in this section, "certified
community behavioral health clinic" refers to a community behavioral
health clinic that has been certified according to criteria established
under Section 223 of the federal Protecting Access to Medicare Act of
2014 (42 U.S.C. 1396a note).
(b) The office may follow the following procedures for
implementing certified community behavioral health clinics that satisfy
all federal requirements necessary for certified community behavioral
health clinics certified under this section to be eligible for
reimbursement from the federal Substance Abuse and Mental Health
Services Administration (SAMHSA) or the federal Centers for
Medicare and Medicaid Services (CMS). The office may consult with
the certified community behavioral health clinics while establishing
and implementing changes to the certification process and
requirements to do the following:
(1) Establish Indiana specific certified community behavioral
health clinic goals.
(2) Conduct community needs assessments.
(3) Develop certified community behavioral health clinic criteria
and processes.
(4) Establish certified community behavioral health clinic
prospective payment methodology.
(5) Develop data collection and reporting capacities.
(c) After completing the processes described in subsection (b)(1)
through (b)(5), and not later than December 31, 2027 (if selected for a
demonstration program referenced in subsection (f)), or not later than
December 31, 2025 (if not selected for a demonstration program
referenced in subsection (f)), the office may apply for:
(1) an amendment to the state Medicaid plan; or
(2) a waiver or an amendment to an existing waiver;
to require reimbursement by the office of the secretary for eligible
certified community behavioral health clinic services provided by a
behavioral health professional, including a behavioral health
professional authorized to provide Medicaid services and employed by
a certified community behavioral health clinic.
(d) Reimbursement described in subsection (c) may include
reimbursement for at least:
(1) an initial assessment;
(2) intake;
(3) counseling;
(4) medication management;
(5) care coordination;
(6) peer services; and
(7) other services required by the division as provided in the state
plan amendment, waiver, or demonstration program;
in a certified community behavioral health clinic for an eligible
Medicaid recipient.
(e) The office of the secretary may adopt rules under IC 4-22-2
necessary to implement this section.
(f) The office may apply for, and if selected, participate in, the
expansion of a community mental health services demonstration
program under Section 223 of the federal Protecting Access to
Medicare Act of 2014 (42 U.S.C. 1396a note), as amended by the
Bipartisan Safer Communities Act (P.L. 117-159).

Legislative History

As added by P.L.162-2023, SEC.7.