medicaid’s addiction and recovery … health continuum of care ... office-based opioid treatment....
TRANSCRIPT
MEDICAID’S ADDICTION AND RECOVERY TREATMENT SERVICES (ARTS) BENEFIT
www.dmas.virginia.gov
Increasing Capacity of Medicaid Substance Use Disorder Services
Ashley Harrell, LCSW, Policy and Planning SpecialistKe’Shawn Harper, MS, SUD Analyst
Virginia Department of Medical Assistance Services
Medicaid and FAMIS Coverage for Individuals with SUD
SUD Service Children < 21 Adults* Pregnant WomenTraditional ServicesInpatient Detox X Added AddedOutpatient Therapy X X XMedication Assisted Treatment (MAT) Rate Increase Rate Increase Rate Increase
Community-Based ServicesResidential** Rate Increase Added Rate IncreasePartial Hospitalization Rate Increase Rate Increase Rate IncreaseIntensive Outpatient Rate Increase Rate Increase Rate IncreaseCase Management / Care Coordination Rate Increase Rate Increase Rate Increase
Peer Supports Not Covered Added Added*Dual eligible individuals have coverage for inpatient and residential treatment services through Medicare.**DMAS seeking to waive the CMS IMD ruling which limits coverage for RTC to facilities with 16 beds or fewer.Note: FAMIS and GAP coverage does not include residential treatment. GAP does not cover Inpatient Services or PHP.
Services Highlighted in Yellow were added by the 2016 Appropriations Act
All Community-Based SUD
Services are Covered by
Managed Care Plans
A fully integrated Physical and
Behavioral Health Continuum of Care
Magellan will continue to cover community-based substance use disorder
treatment services for fee-for-service members
Transforming the Delivery System for Community-Based SUD Services
ARTS4/1/17
Inpatient Detox
Residential Treatment
Partial Hospitalization
Intensive Outpatient Programs
Opioid Treatment Program Office-Based
Opioid Treatment
Case Management
Peer Recovery Supports
Effective July 1, 2017
3
Medicaid Members with Substance Use Disorder Diagnosis
Source: Department of Medical Assistance Services – claims/encounter data (November 3, 2016).Circles # of Medicaid recipients whose claims/encounter data included an addiction related diagnosis.
Medicaid Members with Substance Use Disorder Diagnosis
Source: Department of Medical Assistance Services – claims/encounter data (November 3, 2016).Circles # of Medicaid recipients whose claims/encounter data included an addiction related diagnosis.
Communities Impacted by Addiction
Source: Department of Medical Assistance Services – claims/encounter data (November 3, 2016) and 2010 U.S. Census Bureau Population.Circles % of Medicaid recipients whose claims/encounter data included an addiction related diagnosis respective to the total population in that zip code.
Communities Impacted by Addiction
Source: Department of Medical Assistance Services – claims/encounter data (November 3, 2016) and 2010 U.S. Census Bureau Population.Circles % of Medicaid recipients whose claims/encounter data included an addiction related diagnosis respective to the total population in that zip code.
Medicaid and FAMIS Coverage for Individuals with SUD
SUD Service Children < 21 Adults* Pregnant WomenTraditional ServicesInpatient Detox X Added AddedOutpatient Therapy X X XMedication Assisted Treatment (MAT) Rate Increase Rate Increase Rate Increase
Community-Based ServicesResidential** Rate Increase Added Rate IncreasePartial Hospitalization Rate Increase Rate Increase Rate IncreaseIntensive Outpatient Rate Increase Rate Increase Rate IncreaseCase Management / Care Coordination Rate Increase Rate Increase Rate Increase
Peer Supports Not Covered Added Added*Dual eligible individuals have coverage for inpatient and residential treatment services through Medicare.**DMAS seeking to waive the CMS IMD ruling which limits coverage for RTC to facilities with 16 beds or fewer.Note: FAMIS and GAP coverage does not include residential treatment. GAP does not cover Inpatient Services or PHP.
Services Highlighted in Yellow were added by the 2016 Appropriations Act
All Community-Based SUD
Services are Covered by
Managed Care Plans
A fully integrated Physical and
Behavioral Health Continuum of Care
Magellan will continue to cover community-based substance use disorder
treatment services for fee-for-service members
Transforming the Delivery System for Community-Based SUD Services
ARTS4/1/17
Inpatient Detox
Residential Treatment
Partial Hospitalization
Intensive Outpatient Programs
Opioid Treatment Program Office-Based
Opioid Treatment
Case Management
Peer Recovery Supports
Effective July 1, 2017
9
ARTS and Managed CareThe MCOs, MMPs and the BHSA administer a comprehensive care coordination model: Comprehensive care coordination including coordination with Medicaid/FAMIS
managed care plans providing coverage of acute care services;
Promotion of evidenced based best practices and more efficient utilization of services;
Development and monitoring of progress towards outcomes-based quality measures;
Management of a centralized call center to provide eligibility, benefits, referral and appeal information with access to emergency services after hours;
Provider recruitment, issue resolution, network management, and training;
Service authorization;
Member outreach, education and issue resolution;
Claims processing and reimbursement for provision of ARTS benefits for enrolled members; and
Promotion of a comprehensive Recovery-Oriented System of Care.
10
Medallion 3.0 Managed Care Organizations
Medallion 3.0 is a statewide mandatory Medicaid program for Medicaid and FAMIS members. These Managed Care Organizations (MCOs) provide medical and traditional behavioral health services including psychiatric and therapy services in outpatient and inpatient settings, and pharmacy services to primarily children, pregnant women and adults who are not enrolled in Medicare. The program is approved by the Centers for Medicare & Medicaid Services through a 1915(b) waiver.
Effective April 1, 2017, the Medallion 3.0 MCOs under contract with DMAS are responsible for the management and direction of the ARTS benefit for their enrolled members.
Additional information about the Medicaid MCO Medallion 3.0 program can be found at http://www.dmas.virginia.gov/Content_pgs/mc-home.aspx.
Commonwealth Coordinated Care –Medicare and Medicaid Plans (MMPs)
The Commonwealth Coordinated Care (CCC) program is a demonstration program operating under a three way contract with DMAS, the contracted Medicare and Medicaid Plans (MMPs), and the Centers for Medicare and Medicaid Services (CMS) for individuals who are dually eligible for Medicare and Medicaid many of whom receive their services in a nursing facility or through a Home and Community Based Waiver. The program operates under 1932 (a) authority and includes the delivery of acute and primary medical care, behavioral health, pharmacy, and long-term services and supports.
Effective April 1, 2017, the CCC MMPs under contract with DMAS are responsible for the management and direction of the ARTS benefit for their enrolled members.
Please visit the website to learn more: http://www.dmas.virginia.gov/Content_pgs/altc-home.aspx
The NEW CCC Plus does not begin until August 1, 201712
Behavioral Health Services Administrator
Magellan Health serves as the DMAS contracted Behavioral Health Services Administrator (BHSA). The BHSA is responsible for the management of the behavioral health benefits program and ARTS benefit for fee-for-service members in Medicaid, FAMIS and the Governor’s Access Plan (GAP).
Providers under contract with Magellan of Virginia should consult Magellan’s National Provider Handbook, the Magellan Virginia Provider Handbook
Effective April 1, 2017, Magellan is responsible for the management and direction of the ARTS benefit for fee-for-service (straight Medicaid, FAMIS or GAP) enrolled members.
Contact Magellan of Virginia at 800-424-4536 or [email protected]
Visit the provider website at https://www.magellanprovider.com/MagellanProvider.
13
New with ARTS!
The MCOs/MMPs and Magellan will reimburse the Medicaid fee schedule for ARTS services. This is the baseline payment.
ARTS Attestation Forms, Staff Rosters and Credentialing Checklists are all accepted by all health plans and Magellan. One packet = all plans.
ARTS Service Authorizations Forms are all accepted by all health plans and Magellan. ARTS Services Authorization Form = all plans.
Health plans may ask for additional documentation for credentialing and clinical documentation for service authorization.
14
Provider Network Relations Contacts
Magellan 800-424-4536 www.magellanofvirginia.com/for-providers-va/join-the-
network.aspx Aetna Better Health of Virginia
[email protected] Anthem HealthKeepers Plus
www.anthem.com/wps/portal/ahpprovider?content_path=provider/va/f6/s0/t0/pw_e228913.htm&rootLevel=5&state=va&label=Join
Humana John Strube, Network Manager
[email protected] Office: 804.793.0464 | m. 804.347.5160
15
Provider Network Relations Contacts
INTotal Mary Fountain, Director of Network Management Email- [email protected] Office: 800-231-8076
Kaiser Permanente http://www.providers.kaiserpermanente.org/html/cpp_mas/f
orms.html Fax Number: 855-414-2621 Email: [email protected]
16
Provider Network Relations Contacts
Optima Family Care Email: [email protected]
Virginia Premier Rick Gordon, Director, Medicare Duals Network Development Office: 804-819-5151 ext 55075 Fax: (804) 819-5366 Email: [email protected] Visit www.vapremier.com and select “Join our Network” under the
Provider tab, complete the recruitment request form and forward to the contracting team.
CCC Plus MCOs Contracting and Credentialing Information for Health Plans 5.04.17
17
Preliminary Increases in Addiction Providers Due to ARTS
18
Addiction Provider Type # of Providers before ARTS
# of Providers after ARTS
% Increase in Providers
Inpatient Detox (ASAM 4.0) Unknown 83 NEW
Residential Treatment (ASAM 3.1, 3.3, 3.5, 3.7)
4 79 ↑ 1525%
Partial Hospitalization Program (ASAM 2.5)
0 14 NEW
Intensive Outpatient Program (ASAM 2.1)
49 88 ↑ 16%
Opioid Treatment Program 6 35 ↑ 467%
Office-Based Opioid Treatment Provider
0 36 NEW
*NEW* ARTS Medicaid Provider Network AdequacyASAM 4 Inpatient Detox
Source: Department of Medical Assistance Services - ARTS provider network data (May 15, 2017). Circles are locations of Medicaid providers used in the network adequacy calculation. For a zip code to be deemed accessible, there must be at least two providers within 60 miles driving distance as calculated as the distance between the centroids of the zip code of the member andthe zip code of the provider.
20
Before ARTS Medicaid Provider Network AdequacyResidential Treatment
Source: Department of Medical Assistance Services - Provider Network data (March 20, 2017).Circles # of Medicaid providers included in network adequacy access calculation.Accessible is considered to be at least two providers within 60 miles of driving distance. Driving distance is calculated by Google services based on the centroid of each zip code.
After ARTS Medicaid Provider Network AdequacyASAM 3.1/3.3/3.5/3.7 Residential Treatment
Source: Department of Medical Assistance Services - ARTS provider network data (May 15, 2017). Circles are locations of Medicaid providers used in the network adequacy calculation. For a zip code to be deemed accessible, there must be at least two providers within 60 miles driving distance as calculated as the distance between the centroids of the zip code of the member andthe zip code of the provider.
*NEW* ARTS Medicaid Provider Network AdequacyASAM 2.5 Partial Hospitalization
Source: Department of Medical Assistance Services - ARTS provider network data (May 15, 2017). Circles are locations of Medicaid providers used in the network adequacy calculation. For a zip code to be deemed accessible, there must be at least two providers within 60 miles driving distance as calculated as the distance between the centroids of the zip code of the member andthe zip code of the provider.
23
Before ARTS Medicaid Provider Network AdequacyIntensive Outpatient Programs
Source: Department of Medical Assistance Services - Provider Network data (March 20, 2017).Circles # of Medicaid providers included in network adequacy access calculation.Accessible is considered to be at least two providers within 60 miles of driving distance. Driving distance is calculated by Google services based on the centroid of each zip code.
After ARTS Medicaid Provider Network AdequacyASAM 2.1 Intensive Outpatient
Source: Department of Medical Assistance Services - ARTS provider network data (May 15, 2017). Circles are locations of Medicaid providers used in the network adequacy calculation. For a zip code to be deemed accessible, there must be at least two providers within 60 miles driving distance as calculated as the distance between the centroids of the zip code of the member andthe zip code of the provider.
25
Before ARTS Medicaid Provider Network AdequacyOpioid Treatment Program
Source: Department of Medical Assistance Services - Provider Network data (March 20, 2017).Circles # of Medicaid providers included in network adequacy access calculation.Accessible is considered to be at least two providers within 60 miles of driving distance. Driving distance is calculated by Google services based on the centroid of each zip code.
After ARTS Medicaid Provider Network AdequacyOpioid Treatment Programs
Source: Department of Medical Assistance Services - ARTS provider network data (May 15, 2017). Circles are locations of Medicaid providers used in the network adequacy calculation. For a zip code to be deemed accessible, there must be at least two providers within 60 miles driving distance as calculated as the distance between the centroids of the zip code of the member andthe zip code of the provider.
*NEW* Medicaid Provider Network AdequacyOffice Based Opioid Treatment
Source: Department of Medical Assistance Services - ARTS provider network data (May 15, 2017). Circles are locations of Medicaid providers used in the network adequacy calculation. For a zip code to be deemed accessible, there must be at least two providers within 60 miles driving distance as calculated as the distance between the centroids of the zip code of the member andthe zip code of the provider.
DMAS ADDICTION AND RECOVERY TREATMENT SERVICES
ARTS Provider Qualifications
ARTS Provider Requirements
In addition to the ARTS provider licensure requirements, ARTS providers must also meet the training and experience as defined in the (ASAM) Criteria: Treatment Criteria for Addictive, Substance-Related and Co-occurring Conditions, Third Edition, as published by the American Society of Addiction Medicine.
To be a network provider of ARTS with the DMAS contracted MCOs, MMPs and BHSA, providers must be credentialed and enrolled according to all applicable MCO, MMP, BHSA and DMAS standards.
Providers are subject to applicable Department of Health Professions (DHP), Department of Behavioral Health and Developmental Services (DBHDS) and/or Virginia Department of Health licensing requirements.
29
Provider Enrollment
To initiate the application process or for questions related to contracting and the credentialing process, providers should contact the specific MCOs, MMPs and the BHSA.
All providers of the ARTS services for ASAM Level 2.1 to 4.0, OTPs and OBOTs, shall submit the appropriate ARTS Attestation Credentialing Packet to the MCOs, MMPs and the BHSA to initiate the credentialing process.
All health plans and Magellan accept the ARTS Attestation Packets – no separate application!
30
Provider Enrollment-Attestation
To initiate becoming a participating ARTS provider, submit to the health plans with whom you wish to credential and Magellan: ASAM Levels 2.1/2.5/3.1/3.3/3.5/3.7
ARTS Attestation Form for ASAM Level 2.1 to 3.7 ARTS Organizational Staff Roster with licensed providers Copy of relevant licenses
• Substance Use Residential/Inpatient Services (ASAM Levels 3.1, 3.3, 3.5, and 3.7) (DBHDS license); and • Substance Use Intensive Outpatient and Partial Hospitalization Programs (ASAM Level 2.1 and 2.5)
(DBHDS license).
Opioid Treatment Program ARTS Attestation Form for Opioid Treatment Programs ARTS Organizational Staff Roster and copy of relevant DBHDS OTP license
Office Based Opioid Treatment (OBOT) – updated as of 3/10/17 ARTS Attestation Form for Office Based Opioid Treatment (OBOT) Programs ARTS OBOT Organizational Staff Roster ARTS OBOT Credentialing Checklist
31
Residential Certification Process
DMAS has contracted with vendor to provide an ASAM Level of Care certification to residential providers.
Certification by the DMAS contracted vendor is required prior to contracting as an ARTS Level 3 provider.
ASAM Level 3.1-3.7 providers must file an application with DMAS at [email protected] and be certified with a designated ASAM Level of Care by the DMAS contracted vendor.
Facilities should also begin the credentialing process with the MCO’s, MMP’s and Magellan at that time.
The MCO’s, MMP’s and Magellan will not finalize the credentialing process until the ASMA certification has been finalized.
32
AGENCY QUALIFICATIONS FOR ARTS COVERED SERVICES
33
ASAM Inpatient and Residential LOC VDH/DBHDS License
4Medically Managed Intensive Inpatient
• Acute Care General Hospital (12VAC5-410)
3.7Medically Monitored Intensive
Inpatient Services (Adult) Medically Monitored High-Intensity
Inpatient Services (Adolescent)
• Freestanding Psychiatric Hospital with a DBHDS Medical Detoxification License or Managed Withdrawal License;
• Inpatient Psychiatric Unit with a DBHDS Medical Detoxification License or Managed Withdrawal License;
• Substance Abuse Residential Treatment Services (RTS) for adults/children with a DBHDS Medical Detoxification License;
• Residential Crisis Stabilization Unit with a DBHDS Medical Detoxification License;• Substance Abuse Residential Treatment Services (RTS) for Women with Children
with a DBHDS Medical Detoxification License; • Level C or Mental Health Residential Children with a substance abuse residential
license and a DBHDS Medical Detox license; • Managed Withdrawal-Medical Detox Adult Residential Treatment Service (RTS)
License; or• Medical Detox/Chemical Dependency Unit for Adults.
3.5Clinically Managed High-Intensity
Residential Services (Adults) / Medium Intensity (Adolescent)
• Substance Abuse Residential Treatment Services (RTS) for Adults or Children;• Freestanding Psychiatric Hospital or Inpatient Psychiatric Unit that have substance
abuse on their license or within the “licensed as statements”;• Substance Abuse RTS for Women with Children;• Substance Abuse and Mental Health Residential Treatment Services (RTS) for Adults
that have substance abuse on their license or within the “licensed as statements.”; or• Level C or Mental Health Residential Children that have substance abuse on their
license or within the “licensed as statements.” • Medical Detox License required for 3.2 WM
3.3Clinically Managed Population-Specific
High-Intensity Residential Services (Adults)
• Substance Abuse Residential Treatment Services (RTS) for Adults; • Substance Abuse Residential Treatment Services (RTS) for Women with Children; • Substance Abuse and Mental Health Residential Treatment Services (RTS) for Adults
that have substance abuse on their license or within the “licensed as statements.” or• Level C or Mental Health Residential Children that have substance abuse on their
license or within the “licensed as statements.” • Medical Detox License required for 3.2 WM
ASAM 3.1 Residential and Community Based DBHDS/DHP License
3.1Clinically Managed Low-Intensity
Residential Services
• Mental Health & Substance Abuse Group Home Service for Adults or Children; or
• Supervised Residential Treatment Services for Adults.
2.5Partial Hospitalization Services
• Substance Abuse or SA/Mental Health Partial Hospitalization (2.5)• Outpatient Managed Withdrawal Service Licensed required for 2WM
2.1Intensive Outpatient Services
• Substance Abuse Intensive Outpatient for Adults, Children and Adolescents (2.1)
• Outpatient Managed Withdrawal Service Licensed required for 2WM
1Outpatient Services
• Outpatient Services (Agency Option)• Individual or Groups of Licensed Clinicians
0.5Early Intervention • N/A; All Licensed Providers
Opioid Treatment Program (OTP) • Medication Assisted Treatment/Opioid Treatment Services
Office-Based Opioid Treatment (OBOT) • Buprenorphine-Waivered Physician with Individual or Groups of Licensed Clinicians in a variety of office settings.
Physician Qualifications for ARTS
“Addiction Credential Physicians” have achieved professional recognition in the treatment of addiction and have been certified for their expertise in treating addiction by one of the following three pathways:
• any physician who has completed an addiction medicine fellowship or met other eligibility criteria and then by examination, received certification and diplomate status from the American Board of Addiction Medicine; or
• a psychiatrist who completed a fellowship in addiction psychiatry and then by examination, became certified by the American Board of Psychiatry and Neurology; or
• a doctor of osteopathy (DO) who received certification in addiction medicine through examination and certification by the American Osteopathic Association.
• In situations where a certified addiction physician is not available, physicians treating addiction should have some specialty training and/or experience in addiction medicine or addiction psychiatry. If treating adolescents, they should have experience with adolescent medicine.
“Physician Extenders” are licensed nurse practitioners and physician assistants.
Clinician Qualifications for ARTS
Credentialed Addiction Treatment Professionals• Addiction-credentialed physicians or physicians with
experience in addiction medicine• Licensed psychiatrists• Licensed clinical psychologists • Licensed clinical social workers • Licensed professional counselors• Licensed psychiatric clinical nurse specialists• Licensed psychiatric nurse practitioner• Licensed marriage and family therapist• Licensed substance abuse treatment practitioner
Clinician Qualifications for ARTS Covered Services
Credentialed Addiction Treatment Professionals cont.• “Residents” under supervision of licensed professional counselor,
licensed marriage and family therapist or licensed substance abuse treatment practitioner approved by the Virginia Board of Counseling
• “Residents in psychology” under supervision of a licensed clinical psychologist approved by the Virginia Board of Psychology
• “Supervisees in social work” under the supervision of a licensed clinical social worker approved by the Virginia Board of Social Work
• An individual with certification as a substance abuse counselor (CSAC) or certified substance abuse counselor-assistant (CSAC-A) under supervision of licensed provider and within scope of practice
DMAS ADDICTION AND RECOVERY TREATMENT SERVICES
Assessment, Service Planning and Service Requirements Overview
ASAM Continuum of Care
ARTS Medical Necessity Criteria
At least one diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for Substance-Related and Addictive Disorders with the exception of tobacco-related disorders, caffeine use disorder or dependence, and non-substance-related addictive disorders Or be assessed to be at risk for developing substance use disorder for youth under the age
of twenty-one using the ASAM multidimensional assessment). Meet the severity and intensity of treatment requirements for each service level
defined by the most current version of the American Society of Addiction Medicine (ASAM) Treatment Criteria for Addictive, Substance-Related and Co-Occurring Conditions (Third Edition, 2013). Medical necessity for ASAM levels of care shall be based on the outcome of the member’s documented multidimensional assessment. Overview summary on pages 174-178 of the ASAM Manual).
Members younger than the age of 21 who do not meet the ASAM medical necessity criteria upon initial assessment, a second individualized review by a licensed physician shall be conducted to determine if the member needs medically necessary treatment under the Early Periodic Screening Diagnosis and Treatment (EPSDT) benefit described in Social Security Act § 1905(a) to correct or ameliorate defects and physical and mental illnesses and conditions, including SUD, discovered by the screening.
Co-Occurring Disorders
Members who are experiencing a co-occurring substance use and mental health disorder may experience greater impairments in functioning.
Providers shall be trained and practicing within the scope of their practice, in working with members with both substance use and mental health disorders should ensure both conditions are addressed in treatment. If not available, should be referred to an appropriate service provider with a
current signed consent and authorization to exchange/disclose personal health information
Both providers should collaborate to coordinate effective treatment. Persons with co-occurring psychiatric and substance abuse conditions,
providers are expected to integrate the treatment needs. There may be concurrent authorizations for psychiatric services and
substance abuse services if medical necessity criteria are met for the requested service.
Collaboration and coordination of care among all treating practitioners shall be documented.
42
Multidimensional Assessment
DMAS requires a multidimensional assessment which shall be completed and documented by a credentialed addiction treatment professional within the scope of their practice, as defined in 12VAC30-130-5020, for ASAM levels of care 2.1 through 4.0.
The multidimensional assessment shall be maintained in the member's medical record by the provider.
Medical necessity for all ASAM levels of care shall be determined based on the outcome of the member's multidimensional assessment.
The level of care determination, Individual Service Plan (ISP) and recovery strategies development shall be based upon this multidimensional assessment.
43
ASAM AssessmentCriteria
ARTS SERVICE AUTHORIZATION
45
Service Transitions
Always verify eligibility prior to the start of services and monthly
Magellan of Virginia and Managed Care Organizations Will follow the current continuity of care
requirements which honor authorizations issued by preceding plan for the duration of the Service Authorization or until medical review can be completed, whichever comes first.
46
ARTS Service Review
DMAS contracted MCOs, MMPs and the BHSA shall apply the ASAM criteria to review and coordinate service needs when administering ARTS benefits.
The MCOs, MMPs and the BHSA shall use an ARTS care coordinator (licensed behavioral health professional), a licensed physician or medical director employed by the MCO, MMP or BHSA to perform an independent assessment of all requests for ARTS residential treatment services (ASAM Levels 3.1, 3.3, 3.5, 3.7) and ARTS inpatient treatment services (ASAM Level 4.0).
The length of treatment and service limits shall be determined by the ARTS care coordinator, a licensed physician or medical director employed by the BHSA, MMP or MCO who is applying the ASAM criteria.
ARTS Service Authorization
Providers need to verify the member’s benefit eligibility prior to initiating services to ensure the service being requested is covered under the particular benefit. This is required as GAP (Magellan/FFS only) and FAMIS
members are not eligible for all ARTS benefits as noted earlier in this Chapter under “Eligibility for ARTS Benefits”.
The medical record content shall corroborate the information provided to the DMAS service authorization contractor, contracted MCO, or MMP, or BHSA.
48
ARTS Service Authorization
49
Service Time Frame for Submission to MCO/MMP/BHSA Form
Substance Use Case Management 2 business days from service initiation.
MCOs and MMPs: ARTS Substance Use Case Management Registration FormMagellan: Virginia DMAS Registration Form
ASAM 2.1 to 4.0 – Initial Request
1 business day from service initiation but no greater than 5 calendar days prior to service initiation.
ARTS Service Authorization Request
ASAM Level 2.1 to 4.0 –Extension Request
Submitted prior to current service authorization ending but no greater than 5 calendar days prior to service authorization end date. If submitted after the current service authorizations ends, MCOs/MMPs/BHSA will honor begin date of extension, based on the day of receipt.
ARTS Service Authorization Request for Extensions
Service Authorization Requirements
50
ASAM Level of Care ASAM Description Service
Authorization
4.0 Medically Managed Intensive Inpatient Yes3.7 Medically Monitored Intensive Inpatient Services Yes3.5 Clinically Managed High-Intensity Residential Services Yes
3.3 Clinically Managed Population-Specific High-Intensity Residential Services Yes
3.1 Clinically Managed Low-Intensity Residential Services Yes2.5 Partial Hospitalization Services Yes2.1 Intensive Outpatient Services Yes1.0 Outpatient No0.5 SBIRT NoOTS OTP/OBOT Non/a Medication Assisted Treatment (non-OTP/OBOT) Yesn/a SUD Case Management Registrationn/a Peer Support Services Registration
ARTS Service Authorization Form
51
The ARTS Service Authorization Review Form for initial requests as well as the ARTS Service Authorization Extension Review Form for requests for extensions for the same ASAM level are located in online.
Providers should submit to the health plans via the fax number listed for the appropriate health plan on the service authorization form, and upload the service authorization form to Magellan for fee-for-service members.
Providers are encouraged to submit the completed service authorization forms prior to or at initiation of services.
Requests for service authorizations that do not meet the ASAM requirements for the requested level of care will not be approved.
COVERED SERVICES AND LIMITATIONS
Covered Services and Limitations
In order to be covered, ARTS Services (as defined in 12VAC30-130-5000 et al) shall meet medical necessity criteria based upon the multidimensional assessment completed by a credentialed addiction treatment professional, within the scope of their practice.
ARTS Services shall be accurately reflected in provider medical record documentation and on providers' claims for services by recognized diagnosis codes that support and are consistent with the requested professional services.
53
Covered Services and Limitations
These ARTS services, with their service definitions, shall be covered*: Medically Managed Intensive Inpatient Services (ASAM Level 4); Substance Use Residential/Inpatient Services (ASAM Levels 3.1, 3.3, 3.5, and
3.7); Substance Use Intensive Outpatient (ASAM Level 2.1) Substance Use Partial Hospitalization Programs (ASAM Level 2.5 ); Opioid Treatment Services (Opioid Treatment Programs (OTP) and Office
Based Opioid Treatment (OBOT); Substance Use Outpatient Services (ASAM Level 1); Early Intervention Services/SBIRT (ASAM 0.5); Substance Use Care Coordination; and Substance Use Case Management Services.
*Support Systems, Staff and Therapy requirements must follow ASAM
54
Peer Support Services
A Peer Recovery Specialist (PRS) is a self-identified individual with lived experience with mental health or substance use disorders, or co-occurring mental health and substance use disorders who is trained to offer support and assistance in helping others in the recovery and community-integration process.
Available to individuals who have mental health conditions and/or substance use disorders
Established in response to a legislative mandate
Supported by the Governor’s Task Force on Prescription Drug and Heroin
Addiction
Supported by The Centers for Medicare & Medicaid Services (CMS) as “…an important component in the
State’s delivery of effective treatment.”
55
Effective July 1, 2017
Peer Support: Targeted Populations
56
ADULTS* Over 21
“Peer Support
Services”
ARTS
Mental Health
*Allowance for 18-20 year olds
YOUTHUnder 21
“Family Support
Partners”
ARTS
Mental Health
*Individuals 18-20 years old who meet the eligibility criteria for Peer Support Services in ARTS or MH, who would benefit from receiving peer supports directly, and who choose to receive Peer Support Services directly instead of through their family are permitted to receive Peer Support Services by an appropriate Peer Recovery Specialist.
Governor’s Access Plan for the Seriously Mentally Ill and ARTS
A targeted benefit package for uninsured, low income Virginians who have a serious mental illness (SMI).
The GAP provides basic medical and targeted behavioral health care services through an integrated and coordinated delivery model to qualifying individuals with SMI.
Currently covers ARTS Outpatient, Intensive Outpatient and Medication Assisted Treatment.
ARTS coverage expanding to include Partial Hospitalization and Residential Treatment Services 10/1/17!
Reimbursement Information
Service reimbursement details can be found on the DMAS website :http://www.dmas.virginia.gov/Content_atchs/bh/ARTS%20Reimbursement%20Structure%2002242017.pdf
58
Resources and Upcoming Events
Service Requirement details can be found on the DMAS website in the ARTS Program Manual: http://www.dmas.virginia.gov/Content_Pgs/bh-sud.aspx
Peer Webinar – June 28 1:00 – 2:30 Zoom webinar registration link:
https://magellanhealth.zoom.us/webinar/register/bea8345b1e123555c5b9141539e44ee6
Weekly ARTS provider technical assistance calls Every Thursday from 2 p.m. to 3 p.m.
Conference call: 1-866-842-5779Conference participant code: 7143869205
59
QUESTIONS
For more information, please contact:[email protected]
http://www.dmas.virginia.gov/Content_pgs/bh-sud.aspx
BHSA AND MCO/MMP COORDINATION AND SERVICE DELIVERY CONTACTS
61
March/April 2017
Aetna Better Health VA ARTS Program
Quality health plans & benefitsHealthier livingFinancial well-beingIntelligent solutions
Care Coordination and Contracting Contacts
Contact Contact Information
Compliance Officer: Doug Johnson (804) [email protected]
Chief Medical Officer: Dr. Ira Bloomfield (804) [email protected]
Medical Director/Psychiatrist: Dr. Mark Kilgus *Begins 03/20/17,Contact Information TBD
Director of Health Services: Ryan Hylton (804) [email protected]
Manager of Care Management: Melissa Parent (959) [email protected]
63
Service Auth and Payment/Claims Processing Contacts
Contact Contact Information
Chief Operating Officer: Joanne Landry*Begins 04/01/17(504) [email protected]
Director of Health Services: Ryan Hylton (804) [email protected]
Manager of Clinical Health Services: Stephanie Hargan
(959) [email protected]
64
Web Links for Provider Portals or Other Relevant Information
65
Provider Website: • https://www.aetnabetterhealth.com
/virginia/providers/
Provider Portal:• https://www.aetnabetterhealth.com
/virginia/providers/portal
Questions?
66
Addiction and Recovery Treatment Services (ARTS)
Care Coordination and Contracting
• Member Care Coordination• Customer Services center toll free number for members and providers• Virginia Behavioral Health Specialty group• Health Plan dedicated ARTS coordinator.• Our current newsletter informing members of ARTS can be found at:
https://mss.anthem.com/Documents/VAVA_CAID_ARTSProgramFlier.pdf
• Provider Network Contracting• Facility contracting, call 1-804-354-2634• Professional providers contracting, call 804-354-4126• General questions, Provider Services at 1-800-901-0020• For more information, see FAQs document at:
• https://mediproviders.anthem.com/Documents/VAVA_CAID_ARTSProgramFAQ.pdf
Auth and Claims Processing
• Service Authorization • Providers may use our online tools or toll free numbers for prior auths (Precert.)
Online PLUTO tool at: https://mediproviders.anthem.com/va/pages/pluto.aspx• Provider manual details found at:
https://mediproviders.anthem.com/va/pages/manuals-directories-training.aspx
• Claims Processing• For ASAM 3.3, 3.5, and 3.7, submitted claims will require appropriate modifiers.
Level of Care Rev Code HCPCS Modifier Type of service (General overview of ASAM levels)
3.3 1002 H0010 TG Clinically managed, population-specific, high-intensity residential services for those with cognitive impairments
3.5 1002 H0010 HA Clinically managed, population-specific, high-intensity residential services — 24-hour care –Adolescents
3.5 1002 H0010 HB Clinically managed, population-specific, high-intensity residential services — 24-hour care -Adults
3.7 1002 H2036 HA Medically monitored intensive inpatient services — 24-hour nursing care with physician availability - Adolescents
3.7 1002 H2036 HB Medically monitored intensive inpatient services — 24-hour nursing care with physician availability - Adults
Q/A
• ARTS Program FAQs• FAQs document created for internal and external use
• Customer Service Center trained and able to access Q&A doc• Q&A document uploaded to public VA health plan webpage for
external access
• Sample content of Q&A doc:• What is the ARTS program? • What are the services offered under the ARTS program?• What are the authorization requirements for these services?• Professional and Facility contracting contacts• What are the reimbursement levels for the various services?• Link to web doc at:
https://mediproviders.anthem.com/Documents/VAVA_CAID_ARTSProgramFAQ.pdf
Provider Portals
• Website for Providers• Providers have a private web portal once contracted with unique tools such
as Availity and prior authorization submission.• We also maintain a public members web portal for Virginia at:
• https://mediproviders.anthem.com/va
• Website for Members• Members have a private web portal once enrolled with Anthem with
unique tools such as benefits window and plan information. • We also maintain a public members web portal for Virginia at:
• https://mss.anthem.com/va
HumanaAddiction and Recovery Treatment Services (ARTS)
72
Clinical approach
73
• We believe effective clinical programs always begin with the individual. We believe in recovery; consumers should live and thrive in the community, with family and friends, engaging in gainful activity.
• We drive value for members and support recovery by increasing information flows, building care systems and measuring outcomes across behavioral health, medical, social and medication domains.
• Superior analytics, informed by local knowledge and reality, drive better decision-making and meaningful improvement in health status.
Service ASAM LOCSUD IOP 2.1
SUD Partial Hospitalization 2.5
SUD Group Home/Halfway House 3.1
Clinically Managed Population with Cognitive Impairments – High Intensity –RTS
3.3
Clinically Managed All Population – High Intensity – RTS
3.5(RTS)
Clinically Managed All Population – High Intensity – Inpatient Psychiatric Unit
3.5(Inpatient Psych Unit)
Medically Monitored Intensive Inpatient3.7
(RTS)
Medically Monitored Intensive Inpatient3.7
(Inpatient Psych Unit)
Medically Monitored Intensive Inpatient3.7
(Freestanding Psych)
Medically Managed Inpatient (acute detox)4.0
(Acute Care Hospital)
Utilization management
• For substance use, Beacon uses American Society of Addiction Medicine Levels of Care (ASAM LOCs) as its criteria for covered substance use benefits.
• Beacon uses its LOC criteria as guidelines, not absolute standards, and considers them in conjunction with other indications of a member’s needs, strengths and treatment history in determining the best placement for a member. Beacon’s LOC criteria are applied to determine appropriate care for all members. In general, members will be certified only if they meet the specific medical necessity criteria for a particular LOC. However, the individual’s needs and characteristics of the local service delivery system are taken into consideration.
74
75
SERVICES THAT REQUIRE PRIOR AUTHORIZATION
Outpatient Services Nontraditional Community BH Services Substance Abuse (SA) Treatment Services Psychological Testing± Day Treatment* SA Intensive Outpatient Program*
Neuropsychological Testing± Partial Hospitalization* SA Residential*
ECT (both inpatient and outpatient) Mental Health Skill-buildingSA Day Treatment*
Intensive Outpatient Treatment*Psychosocial Rehab Opioid Treatment**
Intensive Community Treatment (ICT) SA Case ManagementInpatient Services
Inpatient Hospitalization*
Observation (After 72 hours)*Crisis Stabilization (After 72 hours)*
Detox**Requires telephonic authorization
** Prior authorization needed only for non-approved OBOT and OTP programs±Can have an eServices authorization or a fax request
All other authorizations will use a fax request
Authorization is never required for emergency services or traditional outpatient services, including crisis intervention.Please call 1-855-765-9704 or fax 1-855-765-9705 for authorization requests.
Behavioral health and substance abuse services that are included as part of a member’s careplan are authorized as part of the care plan development process. The authorizationrequirements listed below will be used for services that are not included in the care plan at thetime of service:
Prior authorization for substance use disorders
Contact Information
Humana Member Services Hotline and CCC Customer Service – 1-855-280-4002Beacon Provider Hotline: 1-855-765-9704 Provider Fax: 1-855-765-9705
Beacon TTY (for hearing impaired): 1-855-371-3939IVR: 1-888-210-2018
__________________________________________________________________Beacon Network Contact Information
Telephone: 1-855-765-9704 Scott Parker
Beacon Program DirectorTelephone: 1-804-793-0463
John Strube Timothy PaceBeacon Network Manager Manager, Provider Partnerships
1-804-793-0464 1-804-793-0476 [email protected] [email protected]
Administrative/Claims Appeals:
Beacon Health Strategies LLC,Attn: Claims Department
10200 Sunset DriveMiami, FL 33173
Grievances and Clinical Appeals:
Humana Inc. Attn: Grievance and Appeals
P.O. Box 14546 Lexington, KY 40512-4546
Helpful links:Provider Tool Box: www.beaconhealthoptions.com/providersProvider Portal:https://provider.beaconhs.com
Questions?
77
INTotalAddiction and Recovery Treatment Services (ARTS)
78
INTotal Health ARTS Contacts
Type of Inquiry Contact Phone Email/WebsiteGeneral Questions Regarding ARTS
Karen FrieszDirector, Behavioral Health
703.245.4028 [email protected]
Contracting Questions Mary FountainDirector, Network Management
703.462.7424 [email protected]
Credentialing Questions Jake CarsonManager, Credentialing
703.462.7390 [email protected]
Care Coordination Karen FrieszDirector, Behavioral Health
703.245.4028 [email protected]
INTotal Health ARTS Resources
Type of Inquiry Resource Phone Website/URLEligibility Provider Services 855.323.5588 Provider.Intotalhealth.org
Pre-Authorizations Provider Services 855.323.5588 Provider.Intotalhealth.org
Billing Questions Provider Relations 800.231.8076 Provider.Intotalhealth.org
Claims Status Inquiries Provider Services 855.323.5588 Provider.Intotalhealth.org
Pharmacy Questions(Caremark)
Provider Services 855.323.5588, Opt. 3 Provider.Intotalhealth.org
Transportation(Logisticare)
Provider Services 855.323.5588, Opt. 6 Provider.Intotalhealth.org
Provider Portal(Navinet)
Eligibility, Claims Status, Claims Submission
navinet.navimedix.com
Language Line Interpreter Services 1.855.323.5588, Opt . 2, Select 3
Helpful Documents & FormsResource Website/URL
INTotal Health ARTS Program Overview provider.intotalhealth.org/content/arts
Online Provider Orientation provider.intotalhealth.org/uploads/files/ProviderOrientation2017.pdf
INTotal Health Provider Manual provider.intotalhealth.org/uploads/files/2016_Provider_Manual.pdf
ARTS Authorization Formprovider.intotalhealth.org/content/provider_resources_documents –
See FORMS
ARTS Pharmacy Authorization Form provider.intotalhealth.org/content/pharmacy_resources
Pharmacy Questions provider.intotalhealth.org/content/pharmacy_services
Formulary provider.intotalhealth.org/content/formulary
Pre-Authorization Look Up Tool provider.intotalhealth.org/content/preauthorization_lookup
Claims SubmissionMail paper claims to:
INTotal HealthAttn: ClaimsP.O. Box 830614Birmingham, AL 35283-0614
Submit claims electronically using these payer IDs:Change Healthcare (formerly Emdeon): 35115 1.800.792.5256, Opt 1Emdeon One (formerly Capario): 35115 1.800.792.5256, Opt 1Gateway (Trizetto): INT01 1.800.969.3666Availity: 35115 1.800.282.4548
The primary diagnosis code for all ARTS claims must specify a substance use disorder. If billing on a UB, you must include the appropriate revenue and HCPCS code. When submitting claims for lab services, please include CLIA number in Box 23 or EDI 2300 Ref Loop. For additional ARTS billing information, please visit our website at
http://provider.intotalhealth.org/content/arts.
Electronic Remittance Advice (ERA) via Payspan• Please contact Payspan Provider Services at 1-877-331-7154, option 1.Electronic Funds Transfer (EFT)• If you would like to enroll, please visit our website for enrollment forms and information.
Questions?
Magellan (BHSA)
Addiction and Recovery Treatment Services (ARTS)
84
Magellan of Virginia
• Service authorization questions:• Please call 800.424.4046 and speak with a care manager
• Service authorization requests for ASAM levels of care can be submitted on the Magellan Provider website
• Care coordination for a member:• Please call 800.424.4046 and speak with an ARTS Care Manager
ARTS85
Magellan of Virginia
• Contracting questions or to join the provider network:• Please call 800.424.4536 and speak with a provider specialist
• Visit the Magellan of Virginia ARTS website
• Payment or claims processing question:• Please call 800.424.4046 and speak with an Customer Service
Associate
• Many billing and claims questions can be answered by using the Magellan Provider website
ARTS86
Magellan of Virginia
• Useful Links:
• Magellan of Virginia: http://magellanofvirginia.com/
• Magellan Provider Homepage: https://www.magellanprovider.com/
• Magellan of Virginia ARTS information for providers: http://magellanofvirginia.com/for-providers-va/arts-information-training-communication.aspx
• Contact us: http://magellanofvirginia.com/utility-va/contact-us.aspx
ARTS87
Magellan of Virginia
Questions?
ARTS88
OptimaAddiction and Recovery Treatment Services (ARTS)
89
Optima Eligibility Verification
• Always ask for the Member’s ID card
• Verification may be obtained by:• Optima website: optimahealth.com• Optima Interactive Voice Response:
(757) 552-7474 or (800) 229-8822• Optima Provider Relations:
(757) 552-7474 or (800) 229-8822 Option #4
Optima Claims Filing Preferred method of claim filing is electronic
We accept the following electronic vendors:* PayerPath - UB/CMS* Optima - UB/CMS* Vendors that connect through Payerpath
• All paper Behavioral Health claims must be sent to:Optima ClaimsP.O. Box 1440Troy, Michigan, 48007-1440
• All paper Medical claims must be sent to:Optima ClaimsP.O. Box 5028Troy, Michigan, 48007-5028
• Timely Filing is 365 days from date of service.
ERA/EFT
Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) are encouraged.
• Need help with setup and implementation of 835 (EFT/ERA transactions)?– Contact Optima’s Disbursement Supervisor at (757) 252-8055
• Do you have questions related to 837 (electronic claims submission)?– Email Optima’s EDI Team at [email protected] or
call 757-687-6422.
Forms are also located at www.optimahealth.com
• View Needed Forms & Documents • View Eligibility• View Claim Status• View Remits• View Authorization Status• Submit On-line Reconsiderations
Provider Connection(www.optimahealth.com)
Important Optima Contacts
Network Management (Contract/Credential) [email protected] Services 800-229-8822 or 757-552-7474Member Services 800-881-2166 or 757-552-8975Clinical Care Services Dedicated ARTS Line* 844-372-8948 or 757-687-6170Clinical Care Services/Pre-Authorization 800-648-8420 or 757-552-7540After Hours/Triage 800-394-2237 or 757-552-7250
*Live April 1st
QUESTIONS?
Virginia Premier Health Plan, Inc.
Addiction Recovery Treatment Services(ARTS)
Provider Resources
96
Virginia Premier Health Plan, Inc.
Member Services
97
Member Service Representatives can assist members with information about the Addiction Recovery Treatment Services (ARTS) that is available to them. As well, a Member Service Representative can connect members with a Care Manager as requested and/or if necessary. Member Services Phone Numbers are:Virginia Premier (Medicaid): 1-800-727-7536 Option 1Virginia Premier Complete Care (Duals): 1-855-338-6467 Options 1 and 1Please visit our website at https://www.vapremier.com/ for more ARTS related information.
Current Behavioral Health Coverage Limits Additional ARTS Coverage Limits Effective 4/1/2017 Additional ARTS Coverage Limits effective 7/1/2017
Virginia Premier covers inpatient and outpatient behavioral health care. Covered services include:
• Inpatient psychiatric hospitalization in a psychiatric unit of a general acute care hospital.
• Inpatient psychiatric hospitalization in a freestanding psychiatric hospital to members up to 21 years of age and members over 64 years of age.
• Outpatient (individual, family, and group) behavioral health and substance abuse treatment
• Electroconvulsive therapy
Virginia Premier covers inpatient and outpatient behavioral health care. Added covered services include:• Inpatient psychiatric hospitalization in a
freestanding psychiatric hospital for all ages.
• Mental Health rehabilitative services (crisis stabilization, intensive outpatient, day treatment and substance abuse case management services)
• Residential treatment facility services• Opioid Treatment services (includes
individual, group counseling, family therapy and medication administration)
Peer Support Specialists:
Peer support specialists consist of qualified peer support providers to assists members with the self-management and recovery from a mental health disorder and/or a substance use disorder.
Virginia Premier Health Plan, Inc.
Contracting/Provider ServicesContracting Specialist can assist providers with information regarding joining the Virginia Premier Network and validating ASAM Levels of Care.Contracting Phone Numbers are:Virginia Premier (Medicaid): 1-800-727-7536 Option 6Virginia Premier Complete Care (Duals): 1-855-338-6467 Options 3 and 1
For providers and/or facilities wishing to make modifications to their ASAM Level(s) of Care, please be sure to notify DMAS and Virginia Premier.
Important Provider Web Links Include:• Virginia Premier Website: http://www.vapremier.com/• Join Our Network: https://www.vapremier.com/providers/join-our-network/• Provider Portal Link: https://www.vapremier.com/providers/medicaid/provider-portals/• Addiction and Recovery Treatment Services : https://www.vapremier.com/providers/addiction-and-
recovery-treatment-services/
98
Virginia Premier Health Plan, Inc.
Medical Management
99
Medallion 3.0To request service authorizations:
• Phone: 1-800-727-7536
• Admissions Fax: 1-877-739-1365
• Outpatient Fax: 1-800-827-7192
To request a Case Manager• 1-800-727-7536 Options 3 and 4
Complete CareTo request service authorizations:
• Phone: 1-855-251-3063
• Admissions Fax: 1-877-739-1365
• Outpatient Fax: 1-877-739-1364
To request a Case Manager• 1-855-338-6467 Option 3 (Care Manager)
To access Addiction and Recovery Treatment Services (ARTS) forms and other important information such as:
• Service Authorization Forms • Prior Authorization List• Provider Directory• Care Management Request FormVisit us at: https://www.vapremier.com/providers/addiction-and-recovery-treatment-services/
Virginia Premier Health Plan, Inc.
Claims Inquiry & PaymentThe Claims Department is committed to providing the highest level of service possible. Our mission is to pay claims correctly and quickly the first time. Providers that may have questions regarding claim status to include claim adjustments/reconsiderations, should call and speak with a Claims Customer Service Representative.Claims Customer Service Phone Numbers are:Virginia Premier (Medicaid): 1-800-727-7536 Option 4Virginia Premier Complete Care (Duals): 1-855-338-6467 Options 3 and 2
Please visit our website at https://www.vapremier.com/providers/ and select the applicable line of business. To ensure your claims are filed accurately and on time, click the Claims Link. Under the Claims Link you will also have access to the Provider Forms Library as well as the list of Virginia Premier claim filing addresses and Provider FAQs.
100
© 2013 Kaiser Foundation Health Plan, Inc.
Kaiser Permanente Care Coordination
Addiction and Recovery Treatment Services (ARTS)
101March 2016
© 2013 Kaiser Foundation Health Plan, Inc.
Authorizations and Claims
Claims and Billing Procedures
Utilization Management Operations Center (UMOC)Automated Auth Requests/KP HealthConnectAffiliateLink
www.providers.kaiserpermanente.org/mas
General Number (listen for prompts) 1-800-810-4766
Fax Numbers• Specialty Care Referrals• Concurrent Review
Fax: 1-800-660-2019Fax: 1-301-388-1631
102
103 | © 2011 Kaiser Foundation Health Plan, Inc.March 2016
Provider Contact NumbersProvider RelationsCPP: Provider Manual, Provider Directory, forms for provider data changes, enrollment in KP HealthConnect Online Affiliate
www.providers.kp.org/mas
Contract questions 1-877-806-7470Provider appeals (written form only) (fax) 1-855-414-2622
Claims/Member ServicesProvider claims inquiries 1-855-249-5025 Benefits and eligibility 1-855-249-5025 Automated eligibility & copay line 1-800-810-4766Member appeals and grievances 1-855-249-5025 Behavioral Access Unit (self-referred) 1-866-530-8778
104 | © 2011 Kaiser Foundation Health Plan, Inc.March 2016
Questions ?????
Questions?
If you have any questions regarding this presentation please contact Provider Relations at 1-877-806-7470 or email us at [email protected].
Resources
DMAS Addiction and Recovery Treatment Services (ARTS) Provider Manual
The ASAM Criteria; Treatment Criteria for Addictive, Substance –Related and Co-Occurring Conditions, 3rd edition, 2013
ASAM Guidelines and Consensus Documents: http://www.asam.org/quality-practice/guidelines-and-consensus-documents/the-asam-criteria