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Appendix VI: Access to Mental Health
and Substance Abuse Services1
The following services are available from HIV SNP network
providers2:
Inpatient hospital-based and outpatient detoxification
Inpatient voluntary and involuntary hospital admissions for mental health
services and alternative levels of care from psychiatric hospitals
Outpatient in-home, office or community-based mental health services delivered
by New York State Office of Mental Health (NYS OMH) providers or other providers
of mental health services
Inpatient treatment and rehabilitation for alcohol and substance abuse
The following services are available outside of the HIV
SNP provider network. These services are carved out. HIV SNP case managers
should help coordinate carved-out mental health and substance abuse services
for enrollees. HIV SNP enrollees will need to use their regular Medicaid card
to access care.
Outpatient clinic services (under the supervision of a physician) for alcohol
or substance abuse, except outpatient detoxification.
Methadone maintenance treatment
Medically supervised substance abuse services
Alcoholism outpatient rehabilitation services
Residential drug abuse and alcoholism treatment programs
Psychiatric rehabilitation, day treatment, and partial hospitalization services
NYS OMH community residences and family treatment programs
Intensive case management for individuals who are seriously and persistently
mentally ill (SPMI).
New York State Office of Mental Retardation and Developmental Disabilities
(NYS OMRDD) services.
1. For the HIV negative children of HIV SNP enrollees who
receive Supplemental Security Income (SSI), all mental health and substance
abuse services, except for detoxification services, will be accessed on a
fee-for-service basis using the regular Medicaid card.
2. Please be aware that for HIV positive SSI Medicaid
beneficiaries enrolled in mainstream health plans, all of the in-network
services listed below, except for detoxification services, can be accessed
on a fee-for-service basis from out-of-network providers. If an HIV positive
SSI Medicaid beneficiary chooses to enroll in an HIV SNP, these same services
will only be available from providers participating in the HIV SNP.
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