In a meeting on March 18, 2021 the Department of Drug and Alcohol Programs (DDAP) met with the behavioral health managed care organizations (MCOs) and HealthChoices primary contractors to discuss its expectations of providers’ initial alignment with DDAP’s mandates that are part of the ASAM transition. The deadline for providers to align their services with ASAM services at each level of care is July 1. In part, the purpose of the meeting was to stress to the MCOs and primary contractors that ASAM alignment is a continuous process, not a date to be met, and alignment is not an all-or-nothing proposition. Rather, DDAP is seeking substantial compliance with the criteria and does not expect payers to be punitive in their audits of providers’ alignment with ASAM.
This document defines “Initial Alignment” at each level of care. Per the document, at Levels 2.5 and 3.7, “DDAP will document initial alignment for licensed facilities.” RCPA sought clarification on this point.
According to DDAP, at those levels of care, during a provider’s first audit after July 1, DDAP will be looking for “substantial” alignment. What constitutes “substantial” alignment, what happens if DDAP determines substantial alignment has not occurred, and how other audits by other regulators and payers will be conducted relative to the determination of “substantial” alignment are still being determined.
In addition, RCPA continues to work with DDAP, the Department of Human Services/Office of Mental Health and Substance Abuse Services, MCOs, the legislature, and the governor’s office, among other key stakeholders, to illustrate the challenges this transition is placing on providers, the potential consequences, and workable solutions for providers. RCPA will make an in-depth presentation of its efforts to date and plans going forward at the Tuesday, April 6 Drug and Alcohol Committee meeting.
Please contact Jason Snyder with any questions or concerns.