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Bulletin ID: No. 11 - 30-Business-Day Authorization Request Rule


Wednesday, September 27, 2006

I.  Policy Decision:  Temporary Suspension of the 30-Business-Day Authorization Request Rule

After careful deliberation the Department of Mental Health has determined that it will temporarily suspend the 30-Business-Day Authorization Request Rule.  This rule requires a provider to submit an authorization request in the eCURA system 30 business days after the first contact with a consumer or; in the case of ongoing services, the authorization request must be submitted within 30 days of the expired authorization. The temporary suspension of the 30-Business-Day Authorization Request Rule will start immediately and end on December 31, 2006 and covers all FY2006 authorization requests.

Please note that this temporary suspension of the 30-Business-Day Authorization Request Rule does not change the providers’ requirement to complete the IRP / IPC and ISSP (the treatment plan) within 30 days as outlined in the Mental Health Rehabilitation Standards, Section 3408: IRP / IPC Development and Implementation, paragraph 3408.2 and DMH Provider Manual, Section 9.0 Service Authorization, Paragraph 9.3 IRP / IPC Development.  In addition, this temporary suspension of the 30-Business-Day Authorization Request does not alleviate providers’ responsibility to obtain prior authorizations for ACT, CBI, IDT, and Rehabilitation Day services and reauthorization for counseling services beyond 160 units. 

As part of its utilization review function, the Department of Mental Health plans to contract with an external utilization review firm and will ask said firm to among other things audit providers’ compliance with aforementioned standard to assure compliance, especially during this relaxation period.