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DHS defends new independent-assessment process for behavioral-health Medicaid services as lawmakers press for fixes
Summary
DHS officials told the committee that independent functional assessments for behavioral-health Medicaid beneficiaries began in 2017 and that challenges have arisen from referral workflows, reassessment timing and contractor performance; DHS said it is refining processes and working with Optum and other vendors.
Department of Human Services staff briefed the committee on the process and performance of independent functional assessments for Medicaid behavioral-health services and described steps to remedy workflow and timeliness problems.
Paula Stone of Arkansas Medicaid said independent assessments—used to determine eligibility for home- and community-based behavioral-health services—have been in place since August 2017. She described a multi-party process in which behavioral-health providers refer clients to EQ Health for prior-authorization workflows, and…
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