HB 5333

Abstract

Creates the Mental Health Assessment Reform Act. Provides that the purpose of the Act is to remove barriers to care in the Medicaid mental health assessment and treatment planning process. Provides that, within 3 months after the effective date of the Act, the Department of Healthcare and Family Services shall clearly identify the minimum information necessary to establish and document medical necessity in an individual's medical record for each community mental health general rehabilitation option service through the use of the Department's standardized assessment and treatment planning tool required in the integrated assessment and treatment planning process. Requires minimum medical necessity documentation requirements to be publicly available to all community mental health centers and behavioral health clinics. Provides that an individual is immediately eligible to receive any community mental health service upon documentation of the specified medical necessity criteria in his or her medical record, and the provider shall be reimbursed for such delivered services. Provides that the integrated assessment and treatment planning process shall be required no more frequently than annually for specified community mental health services. Contains provisions requiring the Department to establish a workgroup to resolve certain issues identified by the Department with the assessment tool and the integrated assessment and treatment planning process. Requires the Department to submit a report to the General Assembly that outlines the issues and recommendations discussed by the workgroup. Contains provisions concerning the Department's development of a billing code, modifier, or other mechanism to reimburse providers for the full time spent on the integrated assessment and treatment planning process; assessment tool training; and other matters. Requires the Department to seek federal approval, if required to implement the Act. Permits the Department, with input from the Department's workgroup, to adopt emergency rules in accordance with the Illinois Administrative Procedure Act. Effective immediately.