TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Under IC 4-22-2-23, the Office of the Secretary of Family and Social Services intends to adopt a rule concerning the following:

OVERVIEW: Amends 405 IAC 5-3-13 to add partial hospitalization to services requiring prior authorization, to delete assertive community treatment from the list of services requiring prior authorization, and to replace community mental health rehabilitation services with Medicaid Rehabilitation Option (MRO) services. Amends 405 IAC 5-20-8 to exclude persons holding a master's degree in social work, marital and family therapy, or mental health counseling from being reimbursed for partial hospitalization services; defines the situations under which reimbursement for partial hospitalization will occur, the standards for partial hospitalization programs, and the exclusions to reimbursement for partial hospitalization services; and removes partial hospitalization as a general service that is not reimbursable by Medicaid except as provided under 405 IAC 5-21. Amends 405 IAC 5-21 to redefine Community Mental Health Rehabilitation Services as MRO services and define terms related to MRO services; to remove reimbursement for prehospital screening as a covered service; to set out reimbursement for MRO services; to define behavioral health rehabilitation services, including behavioral health counseling and therapy, medication training a support, skills training and development, behavioral health level of need redetermination, crisis intervention, child and adolescent intensive resiliency services, adult intensive resiliency services, intensive alcohol or drug, or both, outpatient treatment, alcohol or drug, or both, counseling, peer recovery services, case management services, and psychiatric assessment and intervention; to remove partial hospitalization from services offered under 405 IAC 5-21; to redefine case management services, including services, standards, and exclusions; to define eligibility criteria for the MRO program services, program standards, and provider types that may provide services; to define prior authorization requirements for MRO services; and to remove assertive community treatment intensive case management from reimbursed services. Questions and comments concerning the proposed rule may be sent to the Small Business Regulatory Coordinator for this rule. Statutory authority: IC 12-8-6-3; IC 12-8-6-5; IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3.

For purposes of IC 4-22-2-28.1, the Small Business Regulatory Coordinator for this rule is:

Kristina Moorhead

Office of Medicaid Policy and Planning

Indiana Family and Social Services Administration

Indiana Government Center South

402 West Washington Street, Room W374

Indianapolis, IN 46204

(317) 233-2127

kristina.moorhead@fssa.in.gov

DIN: 20091021-IR-405090851NIA

Composed: May 03,2024 2:40:07PM EDT

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