Regulation detail

22-A3408

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22-A3408 ENROLLMENT INTO AND AUTHORIZATION OF MHRS

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%)
Plain-English summary

This regulation governs the enrollment and service authorization process for Mental Health Rehabilitation Services (MHRS) in the District of Columbia. MHRS providers must conduct a face-to-face intake appointment with the consumer within seven calendar days of enrollment, obtain consent to treatment, and document any failed contact attempts in the clinical record. The Department may review a consumer's Plan of Care or other clinical materials to determine medical necessity as part of the service authorization process.

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Regulation text
3408 ENROLLMENT INTO AND AUTHORIZATION OF MHRS

3408.1 Enrollment is the process by which the Department ascertains a consumer’s eligibility for MHRS, and, if eligible for services, adds a consumer to the MHRS system of care and assigns them to an MHRS provider. 

3408.2 No later than seven (7) calendar days after enrollment, the MHRS provider shall conduct an intake appointment with the consumer. This is a face-to-face encounter that initiates the process for securing consent to treatment. 

3408.3 If the MHRS provider is unable to contact the consumer, the provider shall document all steps taken in the consumer’s clinical record.

3408.4 As part of the service authorization process, the Department may review the consumer’s Plan of Care or other clinical material if additional clinical information is required in order to evaluate a consumer’s needs and whether MHRS are medically necessary.

SOURCE: Final Rulemaking published at 48 DCR 10297 (November 9, 2001); as amended by Final Rulemaking published at 51 DCR 9308 (October 1, 2004); as amended by Final Rulemaking published at 52 DCR 5682 (June 17, 2005); as amended by Notice of Emergency and Proposed Rulemaking published at 58 DCR 1482 (February 18, 2011)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 3476 (April 22, 2011); as amended by Notice of Final Rulemaking published at 58 DCR 8366, 8367 (September 30, 2011); as amended by Final Rulemaking published at 67 DCR 10674 (September 4, 2020).

District of Columbia Municipal Regulations

 Mental Health
22-A DCMR § 3408