Mental Health Targeted Case Management

Medicaid

RULE NO.: RULE TITLE:

59G-4.199 Mental Health Targeted Case Management

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 31, No. 50, December 16, 2005, issue of the Florida Administrative Weekly.  This is the second Notice of Change.  The first Notice of Change was published in Volume 32, Number 10, March 10, 2006, issue of the Florida Administrative Weekly.  These additional changes were made in response to comments received at the public hearing and from the Department of Children and Families after the public hearing. 

In the rule text in paragraphs (2) and (3), all references to “October 2005” were changed to “July 2006.”  In paragraph (2), the last sentence was revised to read, “Both handbooks are available from the Medicaid fiscal agent’s website at http://floridamedicaid.acs-inc.com.  Click on Provider Support, and then on Handbooks.  Paper copies of the handbooks may be obtained by calling Provider Inquiry at 800-377-8216.”

The proposed rule is incorporating by reference the Florida Medicaid Mental Health Targeted Case Management Coverage and Limitations Handbook.  The effective date of the handbook was changed to July 2006, and the footer dates on all the handbook pages were changed to July 2006.  The following revisions were made to the handbook:

Introduction, page i, Background, last paragraph, we deleted the reference to Transportation Services, because it is no longer a combined coverage and limitations and reimbursement handbook.

Chapter 1, page 1-3, Enrollment Process, second bullet, we changed “Certification forms signed by the district or regional SAMH office” to “signed by the area Medicaid office.”

Chapter 1, page 1-4, District of Regional SAMH Office Responsibilities, we moved the first and forth bullet to a new section entitled, “Area Medicaid Office Responsibilities.”  The second bullet was revised to read, “May participate in the process the training targeted case managers.”  We deleted, “every three months.”  We added a third bullet to the new section that the area Medicaid office is also responsible for “participating in the process of training targeted case managers.” 

Chapter 1, page 1-5, Provider Agency Qualifications, we changed the first bullet to read, “Must be certified by its area Medicaid office for the specific target group(s) that the agency will serve.”  Under Provider Agency Certification, first paragraph, first sentence, we deleted, “in conjunction with DCF.”  In the second paragraph, we revised the references to the district or regional SAMH program office certifying the mental health targeted case management agency to the area Medicaid office.

Chapter 1, page 1-6, Administrative Provider Agency Certification Criteria for Mental Health Targeted Case Management, bullet 6, we deleted, “and DCF Mental Health Central Office, the district or regional SAMH office.”  In bullet 10., we changed “in-service training,” to “targeted case management training,” and deleted approved by “DCF.” 

Chapter 1, page 1-8, Supervisor Certification Criteria, second paragraph, first sentence, was revised to state that the training must be approved by AHCA. 

Chapter 1, page 1-9, Individual Children’s Mental Health Targeted Case Manager Certification, bullet 1, the third paragraph was deleted because it is no longer applicable.  Bullet 2, first sentence, was revised to state that the individual, “has completed or agrees to complete AHCA-approved mental health targeted case management training . . .”

Chapter 1, page 1-10, Individual Adult Mental Health Targeted Case Manager Certification, bullet 1, third paragraph, “can” was changed to “may.”  Bullet 2 was revised to state that the individual, “has completed or agrees to complete AHCA-approved mental health targeted case management training . . .”

Chapter 2, page 2-3, Certification Criteria for Children’s Mental Health Targeted Case Management, the last paragraph was numbered bullet 9 and corrected to read, “Has relocated from a DCF district or region where he was receiving mental health targeted case management services.  This must be documented in the recipient’s case record.

Chapter 2, page 2-5, Certification Criteria for Adult Mental Health Targeted Case Management, bullet 9 was corrected to read, “Has relocated from a DCF district or region where he was receiving mental health targeted case management services.  This must be documented in the recipient’s case record.”

Chapter 2, page 2-9, Institutions for Mental Diseases, we revised the first sentence to read, “Medicaid does not reimburse for mental health targeted case management services rendered to a resident of an institution for mental diseases (IMD), unless the resident is participating in the Statewide Inpatient Psychiatric Program Waiver.”

Chapter 2, page 2-10, third bullet, we replaced the acronyms with full titles.  In the sixth bullet, we made the last sentence a separate bulleted item.

Chapter 2, page 2-12, Transportation, second paragraph, we corrected the last sentence to read, “Medicaid contracts with a vendor, who arranges for non-emergency transportation services for Medicaid recipients.”

Chapter 2, page 2-12, Travel, the policy was rewritten to read, “Reimbursement for travel time is incorporated into the unit rate and may not be billed separately.”

Chapter 2, page 2-21, Documentation Reviews, the reference to the district or regional SAMH program office was deleted.  

Chapter 3, page 3-2, Exceptions to Service Limits, the second paragraph was deleted, because exceptions to the service limits are not available for adults age 21 and older. 

Appendix A, the Maximum Fee was changed to $12.00 per unit.

Appendices B, C, D, and L, the signature block was changed from the District or Regional SAMH Designated Representative to the Area Medicaid Office Designated Representative. 

Appendices B and C, bullet 10, was revised to read, “Has the ability to maintain and produce documentation that verifies that mental health targeted case managers have participated in case management training as required and approved by AHCA.”

Appendices E and F, third bullet, first sentence, and Appendices G and H, second bullet, “SAMH approved” mental health targeted case management training was replaced with “AHCA-approved” mental health targeted case management training.  

A copy of the revised Florida Medicaid Mental Health Targeted Case Management Coverage and Limitations Handbook, July 2006, is available from Michelle Comeaux, Bureau of Medicaid Services, at 921-8288.

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