ROBERT L. EHRLICH, JR., Governor                           H.B. 943

(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;

4. Include linkages with other public service systems; and

5. Comply with quality assurance, enrollee input, data
collection, and other requirements specified by the Department in regulation.

(v) [The Department may contract with a managed care
organization for delivery of specialty mental health services if the managed care
organization meets the performance standards adopted by the Department in
regulations.

(vi)] The provisions of § 15-1005 of the Insurance Article apply to the
delivery system for specialty mental health services established under this paragraph
and administered by an administrative services organization.

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