MN HF3445

Eliminates requirement for state medical review agent to determine and document medical necessity for psychiatric residential treatment facility services before admission, replacing this with commissioner oversight and utilization reviews.

Requires commissioner to establish a statewide per diem rate per provider for youth psychiatric residential treatment facility services for individuals 21 years of age or younger, with rates set prospectively based on uniform cost reports.

Permits both facilities and licensed professionals to submit billing for professional services arranged by and provided at the facility, with services subject to prior authorization.

Requires commissioner to coordinate a statewide list of children and youth meeting medical necessity criteria for psychiatric residential treatment facility level of care who are awaiting admission, but prohibits using this list to direct admissions to specific facilities.

Maintains eligibility criteria including mental health diagnosis, severe aggression or risk to self or others, functional impairment, exhaustion of community-based services, physician-directed treatment, and referral by a qualified mental health professional.