Behavioral Health Enhanced Services

Effective July 1, 2021, the Department of Medical Assistance Services (DMAS) will offer a new service, Assertive Community Treatment (ACT), to replace the current program, Intensive Community Treatment (ICT). ACT will include similar services currently offered through ICT, but now expands services to weekends and holidays.

The Virginia Department of Behavioral Health and Developmental Services (DBHDS) and DMAS recently announced new licensure requirements. New service license(s) will become effective on July 1, 2021 if applications were submitted and approved by the stated deadline. Visit the DBHDS website for more information www.dbhds.virginia.gov/quality-management/Office-of-Licensing.

Service Modifications for ACT

Specialized service modification applications for small, medium and large ACT teams were due no later than May 15, 2021. Providers who do not have this conditional license issued by June 30, 2021 will not meet the DMAS requirements for reimbursement for ACT services effective July 1, 2021.

These conditional licenses are a requirement for Medicaid reimbursement, without which claims for ACT services will be denied. If you do not become an ACT provider, you may continue to provide other “non-ICT” CMHRS services, such as mental health case management, mental health skill building, or psychosocial rehabilitation services, if you were previously approved by Optima Health to provide these services.

MH-PHP Services

Per the DMAS policy manual a one-year grace period to become a Medicare enrolled provider (Hospital or Community Mental Health Center (CMHC)) will begin on July 1 for existing providers and for new providers from the date they become contracted with a plan. There is no grace period for staffing requirements.

MH-IOP Services

There will be a two (2) year grace period for accreditation from date on invoice. There is no grace period for staffing requirements.

Service Modifications for the ASAM Level of Care

Service modification applications for current providers of substance use disorders services for relicensing based on the ASAM Level of Care were due no later than May 15, 2021. Providers who do not have this conditional license issued by July 1, 2021 will not meet the DMAS requirements for reimbursement through the Addiction and Recovery Treatment Services (ARTS) benefit.

If you have questions or concerns, you may contact your behavioral health contract manager: Chris Hamilton, Janaki Smith or Randy Hoffman. If you are not sure who your contract manager is, please contact Randy at rchoffma@sentara.com or by phone at (540) 560-5219. You may also visit www.dmas.virginia.gov/for-providers/ for additional information.