13-005 Code Vt. R. 13-150-005-X - MENTAL HEALTH FACILITIES QUALIFIED FOR HEALTH INSURANCE

Section I AUTHORITY

This rule is adopted and promulgated by the Secretary of the Agency of Human Services of the State of Vermont pursuant to the general authority granted in 3 V.S.A., Chapters 25 and 53 and 8 V.S.A., § 4089.

Section II PURPOSE

The purpose of this regulation is to identify those mental health facilities that are qualified to render services as provided by the optional health insurance policy benefits required to be offered under 8 V.S.A., § 4089 (Mental Illness). Accordingly, the following facilities or service providers shall be qualified as mental health facilities for the purposes enumerated:

IN THE CASE OF BENEFITS TO BE PAID FOR CONFINEMENT OR SERVICES RENDERED AS AN IN-PATIENT:

1. A general licensed hospital;

2. A public or licensed mental health hospital; including a community mental health center which is recognized as such by the State of Vermont Department of Mental Health;

3. A substance abuse treatment facility which is recognized as such by the Alcohol and Drug Abuse Division of the Department of Social and Rehabilitation Services of the State of Vermont; or a comparable agency in any other state; but only for the treatment of substance abusers; and

4. A licensed mental health professional, including anyone licensed by another state to practice psychiatry or psychology, if the service is rendered in that state.

IN THE CASE OF BENEFITS TO BE PAID FOR OUT-PATIENT SERVICES:

1. A general licensed hospital;

2. A public or licensed mental health hospital, including a community mental health center which is recognized as such by the state of Vermont Department of Mental Health;

3. A substance abuse treatment facility which is recognized as such by the Alcohol and Drug Abuse Division of the Department of Social and Rehabilitation Services of the State of Vermont, or a comparable agency in any other state, but only for the treatment of substance abusers;

4. A licensed mental health professional, including anyone licensed by another state to practice psychiatry or psychology, if the service is rendered in that state, and

5. An out-patient substance abuse treatment counsellor or practitioner who is licensed, certified or otherwise approved as such by the Alcohol and Drug Abuse Division of the Department of Social and Rehabilitation Services of the Agency of Human Services of the State of Vermont, or a comparable agency of another state, if the service is rendered in that state; but only for the treatment of substance abusers.

Section III ADAD LISTING

The Alcohol and Drug Abuse Division of the Department of Social and Rehabilitation Services shall maintain a listing of the substance abuse treatment facilities and out-patient substance abuse treatment counsellors and practitioners approved for the purposes of this regulation. These listings shall be made available to the public at the main offices of the Division during normal business hours.

Section IV MENTAL HEALTH LISTING

The Department of Mental Health shall maintain a listing of community mental health centers which it recognizes for the purposes of this regulation. This listing shall be made available to the public at the main offices of the Department during normal business hours.

Section V SEVERABILITY

If any portion of this regulation, or the application thereof to any person or situation, is held to be invalid by a court of lawful jurisdiction, the remainder of this regulation shall not be affected thereby.

Section VI EFFECTIVE DATE

This regulation shall apply to all services which are rendered and eligible for coverage under Section 4089 on or after July 1, 1983.

Notes

13-005 Code Vt. R. 13-150-005-X

Effective Date: May 9, 1983 (SOS Rule Log # 83-48)

Statutory Authority: 8 V.S.A. § 4089