Has ADHS developed any guidelines regarding service provision to Non-XIX consumers who are receiving Court-ordered treatment?
Court Ordered Evaluation and Treatment is addressed in the DBHS guidance document on Services for Non-TXIX members with SMI. Q: Provider Manual Section 3.5, Third Party Liability and Coordination of Benefits, states that RBHAs should pick up the cost of third party co-payments if the co-payment is greater than the ADHS/DBHS $3 co-payment. However, if someone has Medicare Part D, shouldn’t the Part D plan be billed first before using Title XIX or state funds? A: RBHAs will pick up a third party co-payment only for medications or services that are also covered in the service package for Non-Title XIX/XXI persons determined SMI. It is still the expectation that third party payors are billed prior to using Title XIX/XXI or state funds (please note for Title XIX/XXI eligible individuals with Medicare Part D coverage, Title XIX/XXI funds cannot be used to cover medication co-payments). ADHS/DBHS expects RBHAs to pick up the co-payment to address discrepancies between Non-Title XIX/XXI person
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