Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter II - Specific Policies By Service › Section 144-101-II-65 - Behavioral Health Service › Subsection 144-101-II-65.02 - PROVIDER QUALIFICATIONS

Current through 2024-29, July 17, 2024
The following providers are qualified to provide
						Behavioral Health Services as listed in 65.13 Appendix I.
65.02-1
Independent Practitioner
is a Licensed Psychologist, Psychological Examiner, Licensed Clinical
					 Professional Counselor (LCPC), Licensed Clinical Social Worker (LCSW) or
					 Licensed Marriage and Family Therapist (LMFT) who practices independently, has
					 a Provider Agreement with DHHS, is Co-occurring Capable, knowledgeable in
					 Trauma Informed Care, practices within the scope of his or her licensure and
					 adheres to all state and federal rules and regulations concerning
					 confidentiality and the Americans with Disabilities Act.
65.02-2
Mental Health Agencies
are providers licensed by the Division of Licensing and Certification pursuant
					 to 34-B MRSA § 1203- A, contracted by DHHS, and enrolled as MaineCare
					 Providers. Mental Health Agencies provide covered adult and/or children's
					 mental health, substance use, or co-occurring mental health and substance use
					 services. In order for these agencies to provide adult mental health services
					 or children's mental health services, including Trauma Informed Care services,
					 they must have a current contract with DHHS, Office of Behavioral Health (OBH)
					 or Office of Child and Family Services (OCFS) to provide covered adult mental
					 health services or with co-occurring mental health and substance abuse
					 diagnosis. Agencies must adhere to the Rights of Recipients of Mental Health
					 Services (14-193 C.M.R. Ch. 1) and the Rights of Recipients of Mental Health
					 Services Who are Children in Need of Treatment (14-472 C.M.R. Ch. 1). Providers
					 must maintain all appropriate Licensing and Credentialing and must notify DHHS,
					 including the Office of MaineCare Services, OCFS and/or OBH of any changes in
					 Licensing or Credentialing status.
Only Mental Health Agencies that have a contract for
						specific covered services may provide covered mental health services for
						members in the care or custody of DHHS, Office of Child and Family Services.
						Providers of Functional Family Therapy (FFT) for members served by the
						Department of Corrections, Juvenile Services, must have a contract with the
						Department of Corrections, as described in Home and Community Based Treatment.
						Those agencies licensed by DHHS as an ambulatory health care unit, allied
						health care facility, or as a residential childcare facility must also have a
						mental health agency license to be reimbursable under this
						Section.
65.02-3
Substance Use Agencies
are providers who are licensed by the
					 Division of Licensing and Certification, who hold a current contract with DHHS,
					 the Office of Behavioral Health (OBH), and who are enrolled as MaineCare
					 Providers. Only providers who hold a valid contract to deliver covered services
					 to adults as described under this Section will be enrolled or continue to be
					 enrolled as MaineCare providers. Substance use agency providers deliver
					 substance use treatment services including services for members with
					 co-occurring mental health and substance use disorder diagnoses. OBH will
					 contract with any licensed provider willing to contract and able to meet
					 standard OBH contract requirements for substance use treatment services.
					 Providers must maintain all appropriate Licensing and Credentialing and must
					 notify DHHS, including the Office of MaineCare Services, OCFS and/or OBH of any
					 changes in Licensing or Credentialing status.
65.02-4
School
is a program that
					 has been approved by the Department of Education, as either a Special Purpose
					 Private School or a Regular Education Public School Program under 05-071
					 C.M.R., Chapter 101, § XII and 20-A MRSA § 7204(4), 7252-A and 7253,
					 and 05-071 C.M.R., Chapter 101, §
											12, or a program operated or
					 contracted by the Child Development Services System 20-A MRSA § 7001 (1-A)
					 that has enrolled as a provider and entered into a provider agreement, as
					 required by MaineCare. For the purposes of this rule, a school may provide the
					 following services:
(1) Neurobehavioral Status
					 Exam, Neuropsychological Testing and Psychological Testing, as described in
					 Section 65.05-7, and
(2) Children's
					 Behavioral Health Day Treatment, as described in Section 65.05-13.
All services must be provided by qualified staff, as
						described in the corresponding sections of this policy.