Sweep Report — Ariadne

Sweep run:

Substantive changes — review required 6 jurisdictions

ND North Dakota HIGH PRIORITY

AMENDED NDAC 75-09.1-11 ↗ DETOX OUTPATIENT SUD_IOP SUD_PHP SUD_RESIDENTIAL

• **New section added (75-09.1-11-15):** A brand-new section on "Medical Expenses Reimbursement" has been added to the chapter. Facilities that serve individuals whose Medicaid coverage is suspended while residing in an Institution for Mental Diseases (IMD) should review this section closely, as it creates a new reimbursement pathway for direct medical costs incurred during that suspension period. • **Two new definitions added:** "Institution for mental diseases" (IMD) is now formally defined as a hospital, nursing facility, or other institution with more than 16 beds primarily engaged in mental disease diagnosis, treatment, or care. "Medical expenses" is defined as approved, direct costs a program incurs managing a medical condition for an individual whose Medicaid is suspended during an IMD stay. Facilities need to understand these definitions to determine whether they qualify for the new medical expense reimbursement. • **"Voucher" definition narrowed/clarified:** The previous version excluded "human service centers and the state hospital" from voucher eligibility. The current version replaces "human service centers" with "state-operated behavioral health clinics." Practically, this means the exclusion now explicitly targets all state-operated behavioral health clinics by that name — facilities should confirm their operational classification has not changed in a way that affects their voucher eligibility. • **Effective date updated:** The history line now reflects an additional amendment effective **July 1, 2026**, signaling these changes are forward-looking and facilities should prepare policies and billing procedures in advance of that date.

RENAMED NDAC 75-09.1-01 ↗ DETOX OTP OUTPATIENT SUD_IOP SUD_PHP SUD_RESIDENTIAL

The two versions of NDAC 75-09.1-01-01 through 75-09.1-01-05 provided are substantively identical — the only observable difference is minor formatting/spacing in the chapter citation list (e.g., "75 -09.1-05" vs. "75-09.1-05"), with no changes to definitions, licensing procedures, timelines, requirements, or any compliance-relevant content.

RENAMED NDAC 75-09.1-03 ↗ SUD_RESIDENTIAL

After a careful side-by-side comparison, the current and previous versions of NDAC 75-09.1-03 are substantively identical — the only differences are minor punctuation and hyphenation formatting (e.g., "twenty-four-hour" styling) with no changes to requirements, definitions, timelines, staffing ratios, admission criteria, or any other compliance-relevant content.

RENAMED NDAC 75-09.1-10 ↗ OTP

The two versions provided are substantively identical in all visible content — the only detectable difference is a minor truncation in Section 75-09.1-10-02(1)(a) where the previous version reads "Section 75-09.1-01-20. Di" and the current version reads "Section 75-09.1-01-20. Dis," which appears to be an artifact of how the documents were cut off rather than an actual regulatory change. No definitions, requirements, timelines, thresholds, or operational standards were altered in the portions provided.

RENAMED NDAC 75-05-03 ↗ CMHC CRISIS_STABILIZATION MH_RESIDENTIAL OUTPATIENT

The two versions provided are substantively identical in all compliance-relevant content; the only observable difference is minor punctuation formatting (e.g., "face -to-face" corrected to "face-to-face" and "semi -independent" corrected to "semi-independent"), with no changes to requirements, timelines, definitions, staff ratios, or documentation obligations.

RENAMED NDAC 75-09.1-02 ↗ SUD_RESIDENTIAL

After a side-by-side comparison, the previous and current versions of NDAC 75-09.1-02 are substantively identical in all sections (Definitions, Provider Criteria, Program Criteria, and Admission Criteria); the only detectable difference is minor punctuation formatting in section 75-09.1-02-04(c), where a hyphen in "twenty-four-hour" was adjusted, with no change to any requirement, threshold, definition, timeline, or operational standard.

RENAMED NDAC 75-09.1-03 ↗ SUD_RESIDENTIAL

After a careful side-by-side comparison, the current and previous versions of NDAC 75-09.1-03 are substantively identical — the only differences are minor punctuation and hyphenation formatting (e.g., "twenty-four-hour" hyphenation consistency), with no changes to definitions, provider criteria, program criteria, admission criteria, staffing requirements, timelines, thresholds, or any other compliance-relevant content.

AMENDED NDAC 75-09.1-11 ↗ DETOX OUTPATIENT SUD_IOP SUD_PHP SUD_RESIDENTIAL

• **Two new definitions added:** "Institution for mental diseases" (IMD) is now formally defined as a hospital, nursing facility, or other institution with more than 16 beds primarily serving people with mental diseases. "Medical expenses" is also newly defined as approved direct costs a program incurs managing a medical condition for an individual whose Medicaid coverage is suspended while in an IMD. Facilities need to understand these terms as they now carry regulatory weight. • **New Section 75-09.1-11-15 added — Medical Expenses Reimbursement:** A brand-new section was created specifically to address reimbursement for medical expenses incurred during IMD stays. Facilities that serve individuals in IMD settings should review this section carefully, as it creates a new reimbursement pathway and likely comes with associated documentation and billing requirements. • **"Voucher" definition updated:** The exclusion language changed from "human service centers" to "state-operated behavioral health clinics." This is a terminology update reflecting an organizational or naming change within the state system — the practical effect is the same (those state-operated entities remain excluded), but facilities should use the new terminology in any documentation or communications referencing excluded entities. • **Practical impact:** Facilities that serve Medicaid-enrolled individuals in residential or inpatient settings with more than 16 beds should immediately assess whether they qualify as an IMD under the new definition, and whether the new medical expenses reimbursement section (75-09.1-11-15) creates billing opportunities or obligations they need to operationalize.

OR Oregon HIGH PRIORITY

AMENDED OAR 309-072 ↗ CMHC CRISIS_STABILIZATION

• **Tax compliance certification now required:** Providers *and* any owner with a minimum 20% ownership interest must now certify in writing, under penalty of perjury, that they are not in violation of Oregon tax laws (ORS 305.380). Additionally, those owners must submit an Oregon Tax Compliance Certificate from the Oregon Department of Revenue. This is a new administrative requirement that must be completed as part of the certification process — facilities should identify all qualifying owners and gather the necessary documentation before applying or renewing. • **Two new definitions added:** "Built Environment" (facilities, vehicles, and physical locations where work is performed) and "Lone Worker" (staff who deliver MCIS or Stabilization Services without a nearby colleague or direct supervision) are now formally defined. These definitions signal that new operational requirements tied to these concepts are likely in effect or forthcoming elsewhere in the rule set — facilities should review whether any staff regularly work alone in the field. • **These are temporary amendments:** All changes are in effect only from July 14, 2026 through January 9, 2027. Facilities should plan for potential further rulemaking before that expiration date and should not treat these provisions as permanent without monitoring for a subsequent permanent rule filing. • **No changes to training timelines or supervision requirements** in OAR 309-072-0120 are visible in the amended text — those sections appear substantively unchanged in the current version.

CT Connecticut

RENAMED RCSA 17-226d ↗ DETOX OTP OUTPATIENT SUD_IOP SUD_PHP SUD_RESIDENTIAL

The two versions are substantively identical in all definitions and content; the only differences are minor formatting and typographical corrections (e.g., spacing in agency name headers, punctuation normalization, and the addition of the effective date notation "Effective September 20, 1984" at the end of Section 17-226d-1), with no changes to any defined terms, thresholds, requirements, or compliance obligations.

RENAMED RCSA 17a-451(c) ↗ CMHC MH_IOP MH_PHP MH_RESIDENTIAL OUTPATIENT PRTF PSYCH_FACILITY

The two versions are substantively identical in content; the only differences are minor formatting and typographical corrections (e.g., spacing and font rendering artifacts such as "D epartment" vs. "Department"), with no changes to definitions, requirements, data categories, responsible officials, or any other compliance-relevant provisions.

RENAMED RCSA 17-205a ↗ PSYCH_FACILITY

The two versions are substantively identical in all compliance-relevant content — the only observable differences are minor formatting variations (inconsistent spacing in agency/title headers, e.g., "Department of Mental Health" vs. "D epartm ent of M ental H ealth"), which appear to be OCR or typesetting artifacts rather than intentional regulatory changes. No definitions, requirements, timelines, forms, payment conditions, or operational provisions were altered.

RENAMED RCSA 17-215 ↗

The current and previous versions are identical in substance — the only differences are minor formatting artifacts (spacing in words like "Connecticut" and "Department of Mental Health"), with no changes to content, requirements, or legal effect.

RENAMED RCSA 17-226d ↗ DETOX OTP OUTPATIENT SUD_IOP SUD_PHP SUD_RESIDENTIAL

The two versions are substantively identical in all definitions and regulatory content; the only differences are minor formatting and typographical corrections (e.g., spacing in agency name header, punctuation normalization, and the addition of the effective date notation "Effective September 20, 1984" at the end of Section 17-226d-1), with no changes to any defined terms, thresholds, requirements, or compliance obligations.

RENAMED RCSA 17-226l ↗ CMHC MH_IOP MH_PHP MH_RESIDENTIAL OUTPATIENT PSYCH_FACILITY

The two versions are substantively identical in all requirements, timelines, thresholds, and definitions; the only differences are minor formatting and typographic variations (e.g., inconsistent spacing, font styling in headings), with no changes to any compliance obligations.

RENAMED RCSA 17a-451(c) ↗ CMHC MH_IOP MH_PHP MH_RESIDENTIAL OUTPATIENT PRTF PSYCH_FACILITY

The two versions are substantively identical in content and requirements; the only differences are minor formatting and typographical variations (e.g., spacing in headings such as "D epartment" vs. "Department"), with no changes to definitions, data system descriptions, compliance obligations, or operational requirements for behavioral health facilities.

RENAMED RCSA 17a-451(t) ↗ CMHC DETOX OTP OUTPATIENT SUD_RESIDENTIAL

The two versions provided are substantively identical in all compliance-relevant content — the only observable difference is minor formatting and typographical cleanup (e.g., spacing in "Grievance review procedure" in the table of contents and minor font/spacing variations throughout), with no changes to definitions, timelines, thresholds, applicability criteria, or procedural requirements.

RENAMED RCSA 17a-543(i) ↗ PSYCH_FACILITY

The two versions are substantively identical in all requirements, procedures, and language; the only differences are minor formatting variations (inconsistent spacing in agency/title headers) that appear to be artifacts of document conversion, with no changes to compliance obligations, timelines, definitions, or operational requirements.

IA Iowa

AMENDED Iowa Admin. Code ch. 641-155 ↗ CRISIS_STABILIZATION DETOX OTP OUTPATIENT SUD_IOP SUD_PHP SUD_RESIDENTIAL

• The only substantive change visible in this section is an update to the publication date stamp on the cover page: the previous version was dated **IAC 8/20/25** and the current version is dated **IAC 6/10/26**, indicating this is a newer codified version of the chapter. • The definition text across both versions appears substantively identical in all definitions shown — no definitions were added, removed, or materially reworded in the portion provided. • **Practical note for compliance staff:** Because only the definitions section (155.1) was provided for comparison, you should review the remainder of Chapter 155 in the 6/10/26 version for any substantive changes in later rules (e.g., staffing, documentation, licensing procedures) that may not be visible here. Do not assume the full chapter is unchanged based solely on this excerpt.

MA Massachusetts

AMENDED 104 CMR 27.00 ↗ CMHC DETOX MH_RESIDENTIAL PRTF PSYCH_FACILITY

• The two versions provided appear substantively identical in the sections that are fully visible — however, the text in both versions is cut off at the same point (mid-sentence in 27.03(5)(a)), so a complete comparison of all changes cannot be made from the excerpts provided. • No changes are detectable in the definitions (27.02) or the visible portions of the licensing provisions (27.03(1)–(4)) — all language, thresholds, and stakeholder consultation requirements remain the same between versions. • **Compliance staff should obtain the complete current and previous versions** to identify any changes in sections 27.03(5) through 27.18, as those sections — covering specialty populations, admission procedures, restraint/seclusion, human rights, discharge, treatment, records, interpreter services, and substance use disorder standards — are not visible in either excerpt and may contain substantive amendments. • Until a full comparison can be completed, facilities should not assume operational standards are unchanged, particularly in high-risk areas such as restraint/seclusion (27.12), human rights (27.13–27.14), and discharge (27.09).

RENAMED 130 CMR 434.00 ↗ MH_PHP OUTPATIENT

The two versions are substantively identical; the only observable difference is minor typographical/formatting variation (e.g., a space inserted in "servi ces" and "parent ," in the current version), with no changes to definitions, requirements, thresholds, or any compliance-relevant content.

RENAMED 130 CMR 434.00 ↗ MH_PHP OUTPATIENT

The two versions are substantively identical; the only observable difference is minor typographical/formatting variation (a space inserted in "servi ces" in the Medication Visit definition of the current version), with no changes to definitions, requirements, thresholds, or compliance obligations.

WI Wisconsin

CHANGED DHS 61 ↗ CMHC DETOX IDD_COMMUNITY IDD_DAY_HAB MH_PHP OUTPATIENT PSYCH_FACILITY