- As
part of the 1115 HealthChoice waiver process, specialty mental health services, those
services provided by a mental health professional or a mental health service agency which
are not performed as part of a primary practitioner's office visit, were carved out into a
separate managed fee-for-service system. This
system, the Specialty Mental Health System (SMHS), is administered by the Mental Hygiene
Administration (MHA), local Core Service Agencies (CSA's), and an administrative services
organization, which is currently APS Healthcare (APS).
APS Healthcare (APS)
authorizes services and pays claims for the
SMHS. Any claims for non-emergency specialty mental health services for both HealthChoice
and non -HealthChoice recipients must be authorized and paid by
APS Healthcare (APS).
-
- For
some organizations and practitioners, all claims must be paid by
APS Healthcare (APS). These include special acute psychiatric
facilities, both inpatient and outpatient services, special chronic psychiatric
facilities, both inpatient and outpatient services, residential treatment center,
psychologists, certified nurse psychiatric specialists, community mental health centers,
psychiatric rehabilitation programs, mental health case management agencies, and mental
health mobile treatment agencies. For other
organizations and practitioners, only specific services rendered to recipients with
defined diagnoses will be paid by
APS Healthcare (APS). These
providers include acute hospital and acute rehab inpatient and outpatient psychiatric
services, chronic and chronic rehab inpatient and outpatient services, special acute and
special chronic inpatient and outpatient psychiatric services, psychiatrists, behavioral
pediatricians, social workers, licensed professional counselors, local health departments,
and FQHC's and MQHC's.
-
- Practitioners
who want to participate individually or as groups as specialty mental health providers
must be appropriately licensed and must be able to provide services under their licensure. Organizations that want to participate as
specialty mental health providers must be licensed or approved by the Office of Licensing
and Certification. All providers,
individuals, groups, or organizations, must be enrolled by both the Maryland Medical
Assistance Program and by Maryland Health Partners. For
further information contact the Mental Hygiene Administration at
http://www.dhmh.state.md.us/mha/ .
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