卡拉伊姆行為健康計劃常見問題
以下是從技術支援和資訊網路研討會收集的常見問題清單，並提交至 BHCalAIM@dhcs.ca.gov 電子郵件中的提交內容。 DHCS 將每季更新此列表。
精神健康服務和同時發生的疾病沒有錯門
如果根據「無誤門」政策，會員可以保留先前的 NSMHS Medi-Cal 提供商，同時從 MHP 接收 SMHS 的 SMHS，是否需要遵守供應商審查和簽訂按照 BHIN 18-059 的持續保健（CoC）要求？
不。 「無障礙就醫」政策允許會員同時接受非專科心理健康服務 (NSMHS)（透過按服務收費或管理式醫療計劃 [MCP] 提供者）和專科心理健康服務 (SMHS)（透過心理Health Plan [MHP] 提供者），前提是所有服務在臨床上都是合適的，治療在服務提供系統之間得到協調，並且服務不重複。 Continuity of Care (Continuity of Care)規則不適用於「無錯門」項目，也無需遵守BHIN 18-059中概述的提供者審查和合約流程。 Continuity of Care (Continuity of Care)允許與 MHP 存在先前關係的會員向 MHP 提出申請，繼續接受 SMHS 服務，最長可達 12 個月。本服務可由網路外的Medi-Cal服務提供者或已終止網路的醫療服務提供者繼續提供 SMHS 服務（例如，MHP 的員工或簽約的組織提供者、提供者團體或個人執業者）。
會員使用 SMHS 政策的無誤門和條件如何影響 AB 1299 假設轉讓（PT）要求？
參考中心 十八至 027 巴欣 21-073 巴 欣 22-0 11
「無誤門」政策（BHIN 22-011）和會員訪問 SMHS 政策的準則（BHIN 21-073）不會取代現有 PT 要求。 各縣應繼續遵守 ACL 18- 027 中概述的 PT 政策指引。
SMHS 提供者在向會員提供 SMHS 時，是否可以解決向會員提供的 SMHS 內同時發生的物質使用問題？
參考文獻中心 22-011
Yes. For example, during a therapy session, a Specialty Mental Health Services (SMHS) provider may discuss and treat a member’s co-occurring substance use; however, the session must primarily address the member’s mental health (e.g. symptoms, condition, diagnosis, and/or risk factors), which can include co-occurring substance use disorder. A claim for SMHS, submitted by a SMHS provider, will not be denied for including documentation, including a diagnosis, about a member’s co-occurring substance use concern. Note: A provider must only provide services within their scope of practice, and about subject matter that is within their scope of competence.
DMC/DMC-ODS 提供者在向會員提供 SUD 服務時，可否在提供給會員的服務中解決同時發生的精神健康問題？
參考文獻中心 22-011
Yes. For example, during a counseling session, a Drug Medi-Cal (DMC)/Drug Medi-Cal Organized Delivery System (DMC-ODS) provider may discuss a co-occurring mental health concern; however, the session must primarily address the member’s substance use (e.g. symptoms, condition, diagnosis, and/or risk factors), which can include co-occurring mental health conditions. A claim for DMC/DMC-ODS services, submitted by a DMC/DMC-ODS provider, will not be denied for including documentation, including a diagnosis, about a member’s co-occurring mental health concern. Note: A provider must only provide services within their scope of practice, and about subject matter that is within their scope of competence.