Relating to reimbursement rates for providers of substance use disorder treatment services and behavioral health services

This bill relates to reimbursement rates for providers of substance use disorder treatment services and behavioral health services. Division I of the bill requires the department of human services (DHS) to establish an integrated provider network provider as a participating provider type under the Medicaid program consistent with the community mental health system provider type. The bill requires DHS to reimburse the integrated network provider type consistent with the Medicaid community mental health center enhanced fee schedule. Division II of the bill relates to reimbursement rates for providers of substance use disorder treatment services and behavioral health services. Division II requires the department of public health (DPH), in collaboration with DHS, to review and make recommendations for Medicaid 1915(b)(3) waiver reimbursement rates for substance use disorder intensive outpatient and residential treatment services using a projected cost report agreed upon by the departments and the integrated provider network providers. The departments are required to establish time frames for release of the agreed-upon projected cost report form to providers and the deadline for submission of the completed projected cost reports by providers to the departments, to allow sufficient time for review and adjustments to reimbursement rates for Medicaid integrated provider network service providers. Division II also requires DPH, in collaboration with DHS and behavioral health services providers, to review reimbursement rates for behavioral health services and Medicaid 1915(b)(3) waiver services using the projected cost report agreed upon. Again, the departments shall establish time frames and deadlines for the cost reports to allow sufficient time for the departments to review and make recommended adjustments to the reimbursement rates and the behavioral health services fee schedule. Finally, the division directs DPH in collaboration with DHS to establish an ongoing plan for regular review of reimbursement rates for providers of substance use disorder treatment services and behavioral health services and to provide information to the governor and the general assembly in a timely manner to allow for the provision of appropriate funding for any change in reimbursement rates.