BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER SERVICES
Virginia Medicaid provides an array of behavioral health (mental health and substance use disorder) services through fee-for-service reimbursement and through managed care companies under contract with DMAS. For information about Medicaid managed care, please use this link:
Behavioral health services reimbursed as fee-for-services are the responsibility of the DMAS Behavioral Health Unit.
ANNOUNCEMENTS and CURRENT PROJECTS
The Department of Medical Assistance Services (DMAS) is seeking public comment in relation to future DMAS initiatives to improve Medicaid service benefits
and delivery systems for individuals with substance use disorders (SUD), including ensuring that a more robust continuum of care is available to
effectively treat the physical, behavioral, and mental dimensions of SUD. Additional information is provided at the links below:
Substance Use Disorder Benefits Presentation, Facts and Proposed Changes
SUD Public Hearings Scheduled for January 5th and January 7th,
Opportunity for SUD public comment notice
Changes to the Community Mental Health Rehabilitative Services (CMHRS) Regulations are effective as of January 30, 2015. A copy of the regulations can be located at http://townhall.virginia.gov/L/ViewStage.cfm?stageid=6536. Providers are strongly encouraged to review all regulations and definitions pertaining to any service that they provide as these regulations are currently in effect.
Medicaid Memo Regarding Changes to Community Mental Health Rehabilitation Services
Overview of Changes to Level C Residential Treatment and Level A and Level B Group Homes
CMHRS Education and Outreach
To find details on all upcoming trainings please refer to: http://magellanofvirginia.com/for-providers-va/training.aspx.
Information regarding upcoming trainings will be posted to the DMAS and Magellan of Virginia websites. Recorded trainings will also be posted to both websites. Additional online training resources will be announced once the effective dates are finalized.
GAP PROGRAM INFORMATION
GAP - Governor’s Access Plan for the Serious Mentally Ill :
DMAS BEHAVIORAL HEALTH UNIT
Mission: To provide high quality, consumer-focused, recovery-based and appropriate behavioral health services to Virginia Medicaid and CHIP members.
The Behavioral Health Unit is staffed with knowledgeable and experienced employees functioning as a multi-disciplinary team responsible for the following functions:
Policy Interpretation and Development - staff serve as a resource regarding Medicaid covered behavioral health services for internal and external stakeholders, workgroups and committees.
Regulations and Provider Manuals-staff are responsible for the following Medicaid Provider Manuals that can be found on the DMAS Provider web
State regulations related to behavioral health services can be found in the Virginia Administrative Code:
Community Mental Health Rehabilitative Services
Mental Health Clinic
Behavioral Health Services Administrator Contract Monitor-The Behavioral Health Unit is responsible for monitoring the DMAS contract that provides a single entity to handle network management (provider enrollment, credentialing, contracting, development), service authorizations, quality of care, and claims for fee-for-service behavioral health services. DMAS contracted with Magellan of Virginia to conduct these activities:
Magellan of Virginia-Providers are encouraged to contact Magellan with questions about provider enrollment, provider contracts, covered behavorial health services,
service authorizations, Magellan provider handbook, and claims at http://magellanofvirginia.com,
and grievances/complaints at firstname.lastname@example.org
Virginia Department of Behavioral Health and Developmental Services (DBHDS) at
DBHDS Office of Licensing
DBHDS Office of Human Rights
Virginia Department of Health Professions
DMAS Managed Care
DMAS Commonwealth Coordinated Care
DMAS Behavioral Health Unit has discontinued the cmhrs email box. Please direct your questions regarding DMAS behavioral health services to the DMAS Behavioral Health Services Administrator, Magellan of Virginia.
For General questions, comments, quality of care concerns, call: 1-800-424-4046
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