Part 6 - INPATIENT PSYCHIATRIC AND SUBSTANCE USE DISORDER SERVICES

  1. § 317:30-5-94 - Definitions
  2. § 317:30-5-95 - General provisions and eligible providers
  3. § 317:30-5-95.1 - Medical necessity criteria and coverage for adults aged twenty-one (21) to sixty-four (64)
  4. § 317:30-5-95.2 - Coverage for children [REVOKED]
  5. § 317:30-5-95.3 - Medicare eligible individuals [REVOKED]
  6. § 317:30-5-95.4 - Individual plan of care for adults aged twenty-one (21) to sixty-four (64)
  7. § 317:30-5-95.5 - Physician review of prescribed medications for adults age 21 to 64
  8. § 317:30-5-95.6 - Medical, psychiatric, and social evaluations for adults aged twenty-one (21) to sixty-four (64)
  9. § 317:30-5-95.7 - Active treatment for adults age 21 to 64
  10. § 317:30-5-95.8 - Nursing services for adults age 21 to 64
  11. § 317:30-5-95.9 - Therapeutic services for adults aged 21 to 64
  12. § 317:30-5-95.10 - Discharge plan for adults aged twenty-one (21) to sixty-four (64)
  13. § 317:30-5-95.11 - Inpatient acute psychiatric services for persons sixty-five (65) years of age or older
  14. § 317:30-5-95.12 - Utilization control requirements for inpatient acute psychiatric services for persons sixty-five (65) years of age or older
  15. § 317:30-5-95.13 - Certification and recertification of need for inpatient care for inpatient acute psychiatric services for persons sixty-five (65) years of age or older
  16. § 317:30-5-95.14 - Individual plan of care for persons sixty-five (65) years of age or older receiving inpatient acute psychiatric services
  17. § 317:30-5-95.15 - Physician review of prescribed medications for persons over 65 years of age receiving inpatient acute psychiatric services
  18. § 317:30-5-95.16 - Medical psychiatric and social evaluations for persons sixty-five (65) years of age or older receiving inpatient acute psychiatric services
  19. § 317:30-5-95.17 - Active treatment for persons over 65 years of age receiving inpatient acute psychiatric services
  20. § 317:30-5-95.18 - Nursing services for persons over 65 years of age receiving inpatient acute psychiatric services
  21. § 317:30-5-95.19 - Therapeutic services for persons sixty-five (65) years of age or older receiving inpatient acute psychiatric services
  22. § 317:30-5-95.20 - Discharge plan for persons sixty-five (65) years of age or older receiving inpatient acute psychiatric services
  23. § 317:30-5-95.21 - Continued stay review for persons sixty-five (65) years of age or older receiving inpatient acute psychiatric services
  24. § 317:30-5-95.22 - Coverage for children
  25. § 317:30-5-95.23 - Individuals age 21
  26. § 317:30-5-95.24 - Prior authorization of inpatient psychiatric services for individuals under twenty-one (21)
  27. § 317:30-5-95.25 - Medical necessity criteria for acute psychiatric admissions for children
  28. § 317:30-5-95.26 - Medical necessity criteria for continued stay - acute psychiatric admission for children
  29. § 317:30-5-95.27 - Medical necessity criteria for admission - inpatient chemical dependency detoxification for children
  30. § 317:30-5-95.28 - Medical necessity criteria for continued stay - inpatient chemical dependency detoxification program for children
  31. § 317:30-5-95.29 - Medical necessity criteria Acute II and PRTF admissions for children
  32. § 317:30-5-95.30 - Medical necessity criteria for Acute II and PRTF continued stay for children
  33. § 317:30-5-95.31 - Prior authorization and extension procedures for children
  34. § 317:30-5-95.32 - Quality of care requirements for children
  35. § 317:30-5-95.33 - Individual plan of care for children
  36. § 317:30-5-95.34 - Active treatment for children
  37. § 317:30-5-95.35 - Certificate of need requirements for children in psychiatric hospitals and PRTFs
  38. § 317:30-5-95.36 - Treatment team for inpatient children's services
  39. § 317:30-5-95.37 - Medical, psychiatric, and social evaluations for inpatient services for children
  40. § 317:30-5-95.38 - Nursing services for children
  41. § 317:30-5-95.39 - Restraint, seclusion, and serious occurrence reporting requirements for members under the age of twenty-one (21)
  42. § 317:30-5-95.40 - Other required standards
  43. § 317:30-5-95.41 - Documentation of records for children receiving inpatient services
  44. § 317:30-5-95.42 - Service quality review (SQR) of psychiatric facilities and residential substance use disorder (SUD) facilities
  45. § 317:30-5-95.43 - Residential substance use disorder treatment
  46. § 317:30-5-95.44 - Residential substance use disorder (SUD) - Eligible providers and requirements
  47. § 317:30-5-95.45 - Residential substance use disorder (SUD) - Coverage by category
  48. § 317:30-5-95.46 - Residential substance use disorder (SUD) - Covered services and medical necessity criteria
  49. § 317:30-5-95.47 - Residential substance use disorder (SUD) - Individualized service plan requirements
  50. § 317:30-5-95.48 - Staff training
  51. § 317:30-5-95.49 - Medication policies and records
  52. § 317:30-5-95.50 - Residential substance use disorder (SUD) - Reimbursement
  53. § 317:30-5-95.51 - Residential substance use disorder (SUD) - reporting of suspected child abuse/neglect
  54. § 317:30-5-95.52 - Documentation of records for adults receiving inpatient services
  55. § 317:30-5-96 - Reimbursement for inpatient services [REVOKED]
  56. § 317:30-5-96.1 - Cost reports [REVOKED]
  57. § 317:30-5-96.2 - Payments definitions
  58. § 317:30-5-96.3 - Methods of payment
  59. § 317:30-5-96.4 - Outlier intensity adjustment
  60. § 317:30-5-96.5 - Disproportionate share hospitals (DSH)
  61. § 317:30-5-96.6 - Payment for Medicare/Medicaid dual eligible individuals
  62. § 317:30-5-96.7 - Cost reports
  63. § 317:30-5-96.8 - Psychiatric Residential Treatment Facility payments to subcontractors
  64. § 317:30-5-97 - Reporting abuse and/or neglect
  65. § 317:30-5-98 - Claim Form [REVOKED]

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