Sec. 17b-263. (Formerly Sec. 17-274b). Utilization of outpatient mental health services. Contract for services. Rates. - Connecticut Statutes

      Sec. 17b-263. (Formerly Sec. 17-274b). Utilization of outpatient mental health services. Contract for services. Rates. (a) The Commissioner of Social Services shall extend the provisions of section 17-134d-11 of the regulations of Connecticut state agencies to monitor and control Medicaid recipient utilization of outpatient mental health services. The commissioner shall contract, through a competitive bidding process, for recipient surveillance and review services. Such contract shall authorize the imposition of utilization controls, including but not limited to, prior authorization requirements based on medical appropriateness and cost effectiveness.

      (b) The rate paid for hospital outpatient mental health therapy services, except for partial hospitalization and other comprehensive services as defined by the commissioner, shall be that established in subsection (d) of section 17b-239 for an outpatient clinic visit. Payment for partial hospitalization services shall be considered payment in full for all outpatient mental health services.

      (June Sp. Sess. P.A. 91-8, S. 10, 63; P.A. 93-262, S. 1, 87.)

      History: P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-274b transferred to Sec. 17b-263 in 1995.

      Cited as "17b-260 et seq. (providing for supplemental medical assistance)". 233 C. 557.