Ch. 14 1997 LAWS OF MARYLAND

(v) The Department shall work with managed care organizations and
school-based clinics to develop collaboration standards, guidelines, and a process to
assure that the services provided are covered and medically appropriate and that the
process provides for timely notification among the parties.

(vi) Each managed care organization shall maintain records of all
health care services:

1. Provided to its enrollees by school-based clinics; and

2. For which the managed care organization has been billed.

(20) The Department shall establish standards for the timely delivery of
services to enrollees.

(21) (i) The Department shall establish a delivery system for specialty
mental health services for enrollees of managed care organizations.

(ii) The Mental Hygiene Administration shall:

1. Design and monitor the delivery system;

2. Establish performance standards for providers in the delivery

system; and

3. Establish procedures to ensure appropriate and timely
referrals from managed care organizations to the delivery system that include:

A. Specification of the diagnoses and conditions eligible for
referral to the delivery system;

B. Training and clinical guidance in appropriate use of the
delivery system for managed care organization primary care providers;

C. Preauthorization by the utilization review agent of the

delivery system; and

D. Penalties for a pattern of improper referrals.

(iii) The Department shall collaborate with managed care
organizations to develop standards and guidelines for the provision of specialty mental
health services.

(iv) The delivery system shall:

1. Provide all specialty mental health services needed by

enrollees;

2. For enrollees who are dually-diagnosed, coordinate the
provision of substance abuse services provided by the managed care organizations of the
enrollees;

3. Consist of a network of qualified mental health professionals
from all core disciplines;

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