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Washington Administrative Code (Last Updated: November 23, 2016) |
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Title 182. Health Care Authority |
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Chapter 182-538B. Behavioral health wraparound services. |
Section 182-538B-040. Behavioral health wraparound services.
Latest version.
- (1) This chapter governs nonmedicaid funded behavioral health services provided under the medicaid agency's behavioral health services wraparound contract.(2) Washington apple health fully integrated managed care (FIMC) behavioral health wraparound services are available only through a managed care organization (MCO) contracted to provide FIMC services or behavioral health services only (BHSO).(3) The MCO provides contracted nonmedicaid funded behavioral health wraparound services to medicaid enrollees in an FIMC regional service area:(a) Within available resources;(b) Based on medical necessity; and(c) In order of priority to populations as identified by state and federal authorities.(4) When nonmedicaid funding is exhausted, behavioral health wraparound services are no longer paid for and cannot be authorized regardless of medical necessity.