The New Jersey Division of Medical Assistance and Health Services has issued new requirements for requesting prior authorization of mental health partial care services for new admissions and those beneficiaries previously authorized to provide mental health.
The announcement in the DMAHS February newsletter states that providers have been “submitting prior authorization requests for services that have not been properly documented in the treatment plan.”
Among the requirements, effective April 1:
- All initial prior authorization requests for newly admitted mental health partial care clients shall be submitted on the FD-07 Prior Authorization Request Form indicating that the request is for a new admission.
- Authorizations are limited to six weeks to allow completion of the comprehensive assessment.
- Upon completion of the comprehensive assessment, a prior authorization request, including a copy of the signed Individual Recovery Plan (IRP) shall be sent to the Medical Assistance Customer Center (MACC) for prior authorization.
The prior authorization request will be denied if an IRP is received without the required signatures or without the prior documentation indicating why the client did not sign.
Questions on these and other particulars contained in the newsletter should be directed to the Office of Customer Service, at 609-631-4641.