HB5333 - Mental Health Assessment Reform Act

• Department of Healthcare and Family Services must identify minimum information required to document medical necessity for Medicaid community mental health services within 3 months, making requirements publicly available to all providers.

• Individuals become immediately eligible for community mental health services upon documentation of specified medical necessity criteria, and providers must be reimbursed for delivered services without delay or denial.

• Integrated assessment and treatment planning process limited to no more than annually for covered community mental health services, with a 90-day open period to gather necessary information and no further documentation required if services terminate within 90 days.

• Department must establish workgroup within 3 months to address practical challenges including motivational interviewing integration, trauma-informed practices, racial/cultural bias examination, and confidentiality protections, with report to General Assembly within 6 months.

• Department must develop billing code or reimbursement mechanism by July 1, 2022 for full time spent on assessment and treatment planning, including documentation and administrative tasks, with retroactive payment if implementation delayed.