Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.18-018 - Adult Behavioral Health Services for Community Independence Manual

Current through Register Vol. 49, No. 6, June, 2024
Section II Adult
			 Behavioral Health Services for Community Independence
200.000
ADULT BEHAVIORAL HEALTH
			 SERVICES FOR COMMUNITY INDEPENDENCE
GENERAL INFORMATION
201.000
Introduction
Medicaid (Medical Assistance) is designed to assist eligible
				Medicaid beneficiaries in obtaining medical care within the guidelines
				specified in Section I of this manual. Adult Behavioral Health Services for
				Community Independence are covered by Medicaid when provided to eligible
				Medicaid beneficiaries by enrolled providers.
Outpatient Behavioral Health Services may be provided to
				eligible Medicaid beneficiaries at provider certified/en roiled sites.
				Allowable places of service are found in the service definitions located in the
				Reimbursement section of this manual.
202.000
Arkansas Medicaid
			 Participation Requirements for Adult Beliavloral 3-1-19
IHeaith Services for Community Independence
All Behavioral iHealth Agencies that provide Aduit Behavioral
				Health Services for Community Independence must meet specified qualifications
				for their services and for their staff. Providers with multiple service sites
				must enroll each site separately and reflect the actual service site on billing
				claims.
Behavioral Health Agencies that provide Adult Behavioral Health
				Services for Community Independence 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 Arionsas
				Medicaid Program:
A. Providers must be
			 located within the State of Arkansas.
B. A provider must be certified by the
			 Division of Provider Services and Quality Assurance (DPSQA). (See Section
			 202.100 for specific certification requirements.)
C. A copy of the current DPSQA certification
			 as a Behavioral Health Agency must accompany the provider application and
			 Medicaid contract.
D. 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.
DWIS 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
			 violatlon(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.
202.100
Certification Requirements by the Division of Provider Services and
			 3-1-19
Quality Assurance (DPSQA)
A Behavioral Health Agency must be certified by DPSQA in order
				to enroll into the Medicaid program as a Behavioral Health Agency participating
				in the Medicaid Adult Behavioral Heaith Services for Community Independence
				Program must be certified by the DPSQA. The DPSQA Certification Rules for
				Providers of Outpatient Behavioral Health Services is located at
http://humanservices.arkansas.gov/dbhs/Pages/dbhs
docs.aspx
.
Behavioral Health Agencies must have national accreditation
				that recognizes and includes all of II le applicant's pruyrams, services and
				service siles. Any Behavioral HealLh Agency service site associated with a
				hospital must have a free-standing behavioral health outpatient program
				national accreditation. Providers must meet all other DPSQA certification
				requirements in addition to accreditation.