The vendor is required to provide Medicaid consultation and billing services surrounding state residential substance use and behavioral health disorder services housed in a correctional setting.
- Provide, perform, and/or furnish the following for both of agency facilities:
1. Agency, as a behavioral health entity (BHE), is licensed to provide the following services:
• Behavioral health: both mental health (MH) and substance use disorder (SUD) treatment services
• Outpatient mental health (MH)
• Outpatient substance use disorder (SUD) ASAM level 1.0
• Intensive outpatient program mental health (IOP MH)
• Intensive outpatient program substance use (IOP SUD) ASAM level 2.1
• Clinically managed residential services (MH, level 3.1-type)
• Clinically managed residential services (SUD) ASAM level 3.1
• Clinically managed residential services (SUD) ASAM level 3.3
• Clinically managed residential services (MH, level 3.5-type)
• Clinically managed residential services (SUD) ASAM level 3.5
• Recovery supports
• Population-specific endorsements
• Services for criminal justice-involved individuals (CJS)
• CJS SUD education and treatment ASAM level 0.5 and ASAM level 1.0
• CJS SUD enhanced outpatient program (EOP)
• CJS SUD intensive outpatient program (IOP) ASAM level 2.1
• Essential safety net provider status 2. The contractor must provide online access to billing information and/or provide monthly billing data reports by the 5th business day of the month, for services provided the previous month; the required billing information includes, but is not limited to, the following:
• Payer (RAE)
• Client’s name
• Client’s program: (STIRT (strategic individualized remediation treatment), IRT (intensive residential treatment) and RDDT (residential drug diagnosis treatment) programs).
• Client’s dates of service
• Date claims submitted
• Claims amount billed
• Date claims are paid by regional accountable entities (RAE)
• Amount paid by RAE
• Balance of claims uncollected “write-off”
• Amounts of denied claims.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: April 24, 2025
