(1) Each contract between the state department and a managed care organization providing mental health services to a recipient under the medical assistance program shall comply with all federal requirements, including but not limited to:
Ensuring that a recipient with complex or multiple needs who requires mental healthservices shall have access to mental health professionals with appropriate training and credentials and shall provide the recipient with such services in collaboration with the recipient's other providers;
Informing each recipient of his or her right to and the process for appeal upon notification of denial, termination, or reduction of a requested service; and
Administering initial stabilization treatment for a recipient and transferring the recipient for appropriate continued services.
(1.5) Each contract between the state department and a managed care organization providing mental health services to a recipient under the medical assistance program shall allow for the use of telemedicine pursuant to the provisions of section 25.5-5-320.
(2) For mental health managed care recipients, the state department shall have a patient representative program for recipient grievances that complies with all federal requirements and that shall:
Be posted in a conspicuous place at each location at which mental health services areprovided;
Allow for a patient representative to serve as a liaison between the recipient and theprovider;
Describe the qualifications for a patient representative;
Outline the responsibilities of a patient representative;
Describe the authority of a patient representative; and
Establish a method by which each recipient is informed of the patient representativeprogram and how a patient representative may be contacted.
Source: L. 2006: Entire article added with relocations, p. 1844, § 7, effective July 1. L. 2008: (1.5) added, p. 111, § 1, effective August 5.
Editor's note: This section is similar to former § 26-4-409.5 as it existed prior to 2006.