Sec. FF-1. Behavioral health working group. The Commissioner of Administrative and Financial Services or the commissioner's designee shall convene a working group to facilitate improved claims processing and reimbursement for medically necessary behavioral health services, including but not limited to emergency and urgent care services, pursuant to the Maine Insurance Code and Bureau of Insurance Rule, Chapter 850. The working group must consist of the Commissioner of Professional and Financial Regulation or the commissioner's designee, the Commissioner of Human Services or the commissioner's designee, the Commissioner of Behavioral and Developmental Services or the commissioner's designee, the Superintendent of Insurance or the superintendent's designee, private health insurers, mental health providers and the business community. At a minimum, the working group shall address the following issues: (1) the identification of administrative mechanisms to assist mental health providers with claims submission to private insurers; (2) the contracting and credentialing of mental health provider agencies by private insurers; (3) appropriate coding and claims submission to reduce claims denials; (4) the provision of adequate telephone coverage for prior authorization of crisis services by private insurers; and (5) the coverage of evidence-based treatment services. The working group shall submit a report on or before January 15, 2005 on the resolution of these issues and whether targeted savings have been achieved to the joint standing committee of the Legislature having jurisdiction over appropriations and financial affairs matters and the joint standing committee of the Legislature having jurisdiction over insurance and financial services matters.
Sec. FF-2. Appropriations and allocations. The following appropriations and allocations are made.
BEHAVIORAL AND DEVELOPMENTAL SERVICES,
DEPARTMENT OF
Mental Health Services - Child Medicaid 0731
Initiative: Provides for the deappropriation of funds associated with the mental health parity provisions.
General Fund 2003-04 2004-05
All Other $0 ($771,750)
__________ __________
General Fund Total $0 ($771,750)
Mental Health Services - Community Medicaid 0732
Initiative: Provides for the deappropriation of funds associated with the mental health parity provisions.
General Fund 2003-04 2004-05
All Other $0 ($453,250)
__________ __________
General Fund Total $0 ($453,250)
BEHAVIORAL AND DEVELOPMENTAL
SERVICES, DEPARTMENT OF
DEPARTMENT TOTALS 2003-04 2004-05
GENERAL FUND $0 ($1,225,000)
__________ __________
DEPARTMENT TOTAL -
ALL FUNDS $0 ($1,225,000)
HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Provides for the deappropriation and deallocation of funds associated with the mental health parity provisions including the federal match for the Department of Behavioral and Developmental Services.
General Fund 2003-04 2004-05
All Other $0 ($300,000)
__________ __________
General Fund Total $0 ($300,000)
Federal Expenditures Fund 2003-04 2004-05
All Other $0 ($2,853,409)
__________ __________
Federal Expenditures Fund Total $0 ($2,853,409)
HUMAN SERVICES, DEPARTMENT OF
DEPARTMENT TOTALS 2003-04 2004-05
GENERAL FUND $0 ($300,000)
FEDERAL EXPENDITURES FUND 0 (2,853,409)
__________ __________
DEPARTMENT TOTAL -
ALL FUNDS $0 ($3,153,409)
SECTION TOTALS 2003-04 2004-05
GENERAL FUND $0 ($1,525,000)
FEDERAL EXPENDITURES FUND 0 (2,853,409)
__________ __________
SECTION TOTAL -
ALL FUNDS $0 ($4,378,409)
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