Alliance is responsible for conducting routine monitoring of agencies and solo practitioners providing outpatient mental health services to individuals. Through the monitoring process, we have learned that many LIPs are not aware of current requirements for practitioners serving individuals with Medicaid. It is Alliance’s hope that the following information will serve as a regulatory tool kit, including standardized information and resources, to assist you in complying with and keeping up-to-date with regulations.
You, as the provider of services to Medicaid beneficiaries, are ultimately responsible for adhering to all federal and state laws and regulations, administrative rules, state policies and contractual obligations. While there are multiple sources of requirements, it is the provider’s responsibility to follow the most stringent requirements, including the code of ethics of your professional licensure.
This page provides links to external resources and sample forms and other information. All forms need to be adapted to reflect the nuances of your practice. We gave provided prompts in red to indicate where you will add your unique provider information and processes. For example, one of the requirements is to notify individuals in writing of their rights as well as your practice’s rules that individuals are expected to follow and possible penalties for violating the rules. This notification of rules and possible penalties is for your protection as well. What will happen if someone frequently misses appointments without adequate notification? Will you give them a warning? How many missed appointments do you allow before they are discharged from your services? Are guns allowed on your premise? If not, what will happen if someone brings a fire arm onto the premises? You need to develop your rules for your practice, give a written copy of those rules to the individual or legally-responsible person (LRP), and have a mechanism by which you can validate that they have received it. This is often in the form of a signature and date on an acknowledgment of receipt of the information.