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OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Notice of Proposed Reimbursement Methodology for Behavioral and Primary Healthcare Coordination
Service Providers


In accordance with public notice requirements of 42 CFR 447.205, the Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) publishes this notice of the proposed reimbursement methodology for Behavioral and Primary Healthcare Coordination (BPHC) services.

The OMPP proposes to add BPHC as a covered service and to reimburse providers for these BPHC services, for consumers who meet specific criteria for eligibility and level of need under an approved assessment tool developed by the FSSA Division of Mental Health and Addiction. This rule is necessary in order to provide continued Medicaid eligibility and access to intensive community-based mental health services for approximately 4,600 individuals with serious mental illness.

It is estimated that the fiscal impact for the added service will result in an increase in state and federal expenditures of approximately $9.76 million for State Fiscal Year (SFY) 2014 and $39.83 million for SFY 2015. This service is being implemented as a component of the state's transition to 1634 status, as enacted by the Indiana General Assembly under IC 12-15-3-1.5 and IC 12-15-2-3.5, in order to prevent a gap in coverage for individuals with serious mental illness. This transition, without administrative costs, is projected to result in state and federal savings of $2.7 million in SFY 2014 and $35.7 million in SFY 2015 when the costs of BPHC are included. The proposed effective date for addition of the new reimbursable service is April 1, 2014. The proposed rates will be the same as those for similar services offered under the Medicaid Rehabilitation Option and Adult Mental Health Habilitation.

The proposed addition of the new reimbursable service will be addressed in a proposed rule that will be published at a later date. A public hearing will be held after publication of the proposed rule. A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451, Indianapolis, Indiana and is open for public inspection. Also, a copy of this notice is now available and may be inspected by contacting the local county office of the FSSA Division of Family Resources, except in Marion County where public inspection may be made at 402 West Washington Street, Room W374, Indianapolis, Indiana.

Anyone who wishes to comment on this matter may submit written comments to: IFSSA, Office of Medicaid Policy and Planning, Attention: Matthew P. Cesnik, 402 West Washington Street, Room W374, P.O. Box 7083, Indianapolis, IN 46207-7083. Correspondence should be identified in the following manner: COMMENT RE: BEHAVIORAL AND PRIMARY HEALTHCARE COORDINATION. Written comments received will be made available for public display at 402 West Washington Street, Room W374, Indianapolis, Indiana.

Debra F. Minott
Secretary
Office of the Secretary of Family and Social Services Administration

Posted: 12/11/2013 by Legislative Services Agency

DIN: 20131211-IR-405130539ONA
Composed: Oct 01,2014 4:47:52PM EDT
A PDF version of this document.