The Minnesota House Bill HF958 proposes establishing Medical Assistance (Medicaid) coverage for psychiatric collaborative care model (CoCM) services. The bill sets out definitions, provider requirements, reimbursement guidelines, and evaluation methods to ensure effective behavioral health integration within primary care.

Key Provisions of HF958:

1. Defines Key Roles:

   • Behavioral Health Care Manager: Clinical staff with mental health expertise who supports treatment under a medical provider.
   • Psychiatric Consultant: A licensed psychiatrist, physician, advanced practice nurse, or physician assistant specializing in behavioral health.
   • Treating Medical Provider: A primary care provider responsible for overseeing a patient's psychiatric collaborative care.

2. Covered Services:

   • The bill authorizes Medical Assistance coverage for psychiatric collaborative care model services.
   • These services involve collaborative treatment between a primary care provider, care manager, and psychiatric consultant.
   • Includes initial assessment, treatment planning, patient monitoring using registries, care coordination, medication management, and relapse prevention planning.

3. Provider Requirements:

   • Must be an enrolled provider in Minnesota Health Care Programs.
   • Use electronic health records and patient registries for tracking and managing care.
   • Obtain patient consent before initiating services.
   • Conduct regular evaluation and follow-up interventions using evidence-based techniques.

4. Sites Eligible for Billing:

   • Federally Qualified Health Centers (FQHCs) and Rural Health Centers are expressly listed as eligible service providers.

5. Reimbursement:

   • Payment will be set at the current Medicare reimbursement rate for psychiatric collaborative care services.

6. Evaluation and Oversight:

   • The Minnesota Commissioner of Human Services will collect data on service outcomes and review reimbursement rates to ensure sustainability.
   • The collected findings may inform future service modifications, provider standards, or funding allocations.

Purpose and Impact:

This bill aims to integrate mental health care into primary care settings, improving access to behavioral health treatment while leveraging a collaborative, team-based approach. It aligns with evidence-based models that have been shown to enhance patient outcomes and reduce the burden on the broader healthcare system.

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