Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 29 - Division of Medical Services › Rule 016.29.22-016 - Rebalancing Services for Clients with Intellectual and Developmental Disabilities and Behavioral Health Needs

Current through Register Vol. 49, No. 6, June, 2024
SECTION
			 II
- COUNSELING SERVICES
200.000
COUNSELING SERVICES GENERAL
			 INFORMATION
201.000
Introduction
Medicaid (Medical Assistance) is designed to assist eligible
				Medicaid clients in obtaining medical care within the guidelines specified in
				Section I of this manual. Counseling Services are covered by Medicaid when
				provided to eligible Medicaid clients by enrolled providers.
Counseling Services may be provided to eligible Medicaid
				clients at all provider certified/enrolled sites. Allowable places of service
				are found in the service definitions located in Section 252 and Section 255 of
				this manual.
202.000
Arkansas Medicaid Participation Requirements for Counseling
			 Services
All behavioral health providers approved to receive Medicaid
				reimbursement for services to Medicaid clients must meet specific
				qualifications.
Providers must meet the Provider Participation and enrollment
				requirements contained within Section 140.000 of this manual as well as the
				following criteria to be eligible to participate in the Arkansas Medicaid
				Program:
A. Providers must be located
			 within the State of Arkansas.
B.
			 Must be certified by the Divisions of Provider Services and Quality Assurance
			 (DPSQA) as a Behavioral Health Agency, a Community Support Systems Agency-
			 Intensive or Enhanced, be certified by the Dept. of Education as a school-based
			 mental health provider or be independently licensed as a:
1. Licensed Clinical Certified Social Worker
			 (LCSW)
2. Licensed Marital and
			 Family Therapist (LMFT)
3. Licensed
			 Psychologist (LP)
4. Licensed
			 Psychological Examiner - Independent (LPEI)
5. Licensed Professional Counselor
			 (LPC)
6. Licensed Alcohol and Drug
			 Abuse Counselor (LADAC)
C. The provider must give notification to the
			 Office of the Medicaid Inspector General (OMIG) on or before the tenth day of
			 each month of all covered health care practitioners who perform services on
			 behalf of the provider. The notification must include the following information
			 for each covered health care practitioner:
1.
			 Name/Title
2. Enrolled site(s)
			 where services are performed
3.
			 Social Security Number
4. Date of
			 Birth
5. Home Address
6. Start Date
7. End Date (if applicable)
Notification is not required when the list of covered health
				care practitioners remains unchanged from the previous notification.
DMS shall exclude providers for the reasons stated in
				42 U.S.C. §
													1320a-7(a) and implementing
				regulations and may exclude providers for the reasons stated in
				42 U.S.C. §
													1320a-7(b) and implementing
				regulations.
The following factors shall be considered by DHS in
				determining whether sanction(s) should be imposed:
A. Seriousness of the offense(s)
B. Extent of violation(s)
C. History of prior violation(s)
D. Whether an indictment or information was
			 filed against the provider or a related party as defined in DHS Policy 1088,
			 titled DHS Participant Exclusion Rule.