TITLE 53. SOCIAL SERVICES AND INSTITUTIONS

CHAPTER 21. MENTALLY ILL

Part 7. Mental Health Managed Care

Rulemaking Authority

53-21-703. Rulemaking authority. (1) The department shall adopt appropriate rules necessary for the administration of a program to provide mental health managed care services. The rules must establish eligibility criteria and may include but are not limited to financial standards and criteria for income and resources, treatment of resources, nonfinancial criteria, residency, application, termination, definition of terms, and confidentiality of applicant and recipient information.

(2) The department shall adopt rules establishing the amount, scope, and duration of services. The rules may also include but are not limited to ensuring that services are medically necessary and that the services are the most efficient and cost-effective available.

(3) The department may adopt rules establishing rates of reimbursement of services provided under this part, selection and qualification of providers, and standards for managed care.

(4) Rules adopted by the department must take into account, when appropriate, the availability of appropriated funds, the actual costs of services, the quality of services, the professional knowledge and skills necessary for the delivery of services, and the availability of services.

History: En. Sec. 8, Ch. 577, L. 1999.