Regulation detail

22-A3303

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22-A3303 ELIGIBILITY

Jurisdiction: DC Agency: DC Department of Behavioral Health (DBH) — Title 22-A; and DC Department of Health Care Finance (DHCF) — Title 29 Medicaid behavioral-health chapters
CMHC (60%) OUTPATIENT (40%)
Plain-English summary

This section establishes eligibility criteria for Community Support Agencies (CSAs), Assertive Community Treatment (ACT) Programs, and Community-Based Intervention (CBI) Programs to receive Community Transition Voucher (CTV) payments when enrolling consumers transferring from the DC Central Supportive Agency during a transition period. Only the consumer's designated clinical home entity is authorized to bill for CTV payments through the eCura system. A concurrent claim for a Mental Health Rehabilitation Services (MHRS) service must accompany each CTV payment claim.

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Regulation text
3303 ELIGIBILITY

3303.1 A CSA, ACT Program, or CBI Program that enrolls a consumer transferring from the DCCSA during the transition period as evidenced by a CSA Transfer Event in eCura shall be eligible for the CTV by submitting a claim through the Department’s eCura system as described below in Section 3304. 

3303.2 Only the consumer’s clinical home will be eligible to receive CTV payments. If a consumer enrolls in a CSA but his or her clinical home is an ACT Program or CBI not affiliated with the CSA, the ACT Program or CBI Program, as appropriate, is the clinical home of the consumer and is the authorized entity to bill for the CTV. 

3303.3 For each CTV payment set forth below in Section 3304, the CSA must have a concurrent claim for an MHRS service provided to the consumer. 

 SOURCE: Final Rulemaking published at 56 DCR 4399 (May 1, 2009).