Section 17-134d-144 - Limitations(a)Target Group Limitations(1) Payment for case management services is limited to case management services provided to eligible persons with chronic mental illness as defined in the Department of Mental Health target population definition, as amended from time to time.(b)Provider Limitations(1) For eligible persons with mental illness, the Department of Mental Health shall be the sole entity enrolled with the Department to provide case management services to eligible persons and to enter into a provider agreement with the Department for the provision of such services.(2) For eligible persons with mental illness, qualified case managers are limited to case managers designated to render services to said persons by the Department of Mental Health. Such providers are limited to programs operated by the Department of Mental Health or its performing providers.(c)Payment Limitations(1) Payment for case management services will be made only when the receipt of said services occurs at the option of the eligible person or their representative.(2) Payment for case management services may not duplicate payments made under the Connecticut Medical Assistance Program for other services which are covered under the program. Specifically, separate payment for case management services is not available when the same case management service is provided as an integral and inseparable part of another Connecticut Medical Assistance Program covered service or included as part of a Medicaid funded service, including but not limited to the following: outpatient clinic services; partial hospital services; emergency crisis intervention services; inpatient services; substance abuse treatment services; psychiatric/psychological evaluation; individual therapy; group therapy; or; family therapy.(3) Payment for case management services by the Department will not be made unless one or more of the case management activities pursuant to Section 17-134d-143 above are rendered in a calendar month.Conn. Agencies Regs. § 17-134d-144
Effective February 23, 1993