Section 12-15-1.3-25 - Certified community behavioral health clinics; implementation; certification; requirements; reimbursement for eligible services; demonstration program; rules(a) As used in this section, "certified community behavioral health clinic" refers to a community behavioral health clinic that has been certified according to criteria established under Section 223 of the federal Protecting Access to Medicare Act of 2014 (42 U.S.C. 1396a note).(b) The office may follow the following procedures for implementing certified community behavioral health clinics that satisfy all federal requirements necessary for certified community behavioral health clinics certified under this section to be eligible for reimbursement from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) or the federal Centers for Medicare and Medicaid Services (CMS). The office may consult with the certified community behavioral health clinics while establishing and implementing changes to the certification process and requirements to do the following: (1) Establish Indiana specific certified community behavioral health clinic goals.(2) Conduct community needs assessments.(3) Develop certified community behavioral health clinic criteria and processes.(4) Establish certified community behavioral health clinic prospective payment methodology.(5) Develop data collection and reporting capacities.(c) After completing the processes described in subsection (b)(1) through (b)(5), and not later than December 31, 2027 (if selected for a demonstration program referenced in subsection (f)), or not later than December 31, 2025 (if not selected for a demonstration program referenced in subsection (f)), the office may apply for:(1) an amendment to the state Medicaid plan; or(2) a waiver or an amendment to an existing waiver; to require reimbursement by the office of the secretary for eligible certified community behavioral health clinic services provided by a behavioral health professional, including a behavioral health professional authorized to provide Medicaid services and employed by a certified community behavioral health clinic.
(d) Reimbursement described in subsection (c) may include reimbursement for at least:(1) an initial assessment;(4) medication management;(7) other services required by the division as provided in the state plan amendment, waiver, or demonstration program; in a certified community behavioral health clinic for an eligible Medicaid recipient.
(e) The office of the secretary may adopt rules under IC 4-22-2 necessary to implement this section.(f) The office may apply for, and if selected, participate in, the expansion of a community mental health services demonstration program under Section 223 of the federal Protecting Access to Medicare Act of 2014 (42 U.S.C. 1396a note), as amended by the Bipartisan Safer Communities Act (P.L. 117-159).Added by P.L. 162-2023,SEC. 7, eff. 7/1/2023.