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Policy for the enrollment of Child Welfare Behavioral Health

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					  Policy for Medicaid Managed Care Enrollment of Department of
 Juvenile Justice Behavioral Health Overlay Services Beneficiaries


Managed Care Disenrollment Policy

MediPass:
   If a beneficiary is enrolled in MediPass is receiving Department of Juvenile
      Justice Behavioral Health Overlay (DJJ BHOS) services, the beneficiary needs to
      be exempted/disenrolled from MediPass coverage.
   A Managed Care Enrollment Request Form needs to be faxed to the Medicaid
      Area Program Office where the DJJ BHOS facility is located.
       Area Office staff WILL exempt/disenroll any child placed in a DJJ BHOS facility
          from MediPass coverage.

Prepaid Mental Health Plan:
    If a beneficiary is enrolled in a Prepaid Mental Health Plan (PMHP) and is
      receiving Department of Juvenile Justice Behavioral Health Overlay (DJJ BHOS)
      services, the beneficiary needs to be exempted/disenrolled from PMHP coverage.
    A Managed Care Enrollment Request Form needs to be faxed to the Medicaid
      Area Program Office where the DJJ BHOS facility is located.
       Area Office staff WILL exempt/disenroll any child placed in a DJJ BHOS facility
         from PMHP coverage.

Health Maintenance Organization:
    If a beneficiary is enrolled in a Health Maintenance Organization (HMO) and is
      receiving Department of Juvenile Justice Behavioral Health Overlay (DJJ BHOS)
      services, the beneficiary needs to be exempted/disenrolled from HMO coverage.
    A Managed Care Enrollment Request Form needs to be faxed to the Medicaid
      Area Program Office where the DJJ BHOS facility is located.
       Area Office staff WILL exempt/disenroll any child placed in a DJJ BHOS facility
         from HMO coverage.

Managed Care Reenrollment Policy

MediPass, Prepaid Mental Health Plan, & Health Maintenance Organization:
   Upon a beneficiary’s DJJ BHOS placement discharge, the DJJ BHOS facility is
      required to fax a Managed Care Enrollment Request Form to the Medicaid Area
      Program Office where the DJJ BHOS facility is located.
       Area Office staff WILL initiate managed care coverage reinstatement on
         children discharged from a DJJ BHOS facility.