Md. Code Regs. 10.67.04.14

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.67.04.14 - Referral to Behavioral Health ASO

A. An MCO is responsible for providing medically necessary primary behavioral health services to their enrollees.

B. An enrollee may self-refer to the behavioral health ASO for services described in COMAR 10.67.59 or 10.67.80.

C. If an enrollee's primary care physician determines that primary behavioral health services are not sufficient to meet the enrollee's needs, the primary care physician shall refer the enrollee to the behavioral health ASO for services described in COMAR 10.67.59 or 10.67.80.

D. If an MCO determines that primary behavioral health services are not sufficient to meet the enrollee's needs, the MCO shall refer the enrollee to the behavioral health ASO for services described in COMAR 10.67.59 or 10.67.80.

E. An MCO shall cooperate with the behavioral health ASO in developing referral procedures and protocols.

Md. Code Regs. 10.67.04.14

Regulations .14 recodified from 10.09.65.14 effective 46:22 Md. R. 976, eff. 11/1/2019