Medicaid Recipients Under 21: Not Allowed to Self-Refer Selves to Mental Health Services
In the wake of the killings in Connecticut and with all the recent discussions nationally about mental health, I realized something yesterday that floored me:
In North Carolina, an 18-year-old Medicaid recipient is not allowed to self-refer him or herself to a therapist.
According to DMA Clinical Policy 8C, a Medicaid recipient, under the age of 21, who wants to seek mental health services by a therapist (Outpatient Behavioral Health services) is required to have an “individual, verbal or written referral, based on the beneficiary’s treatment needs by a Community Care of North Carolina/Carolina Access (CCNC/CA) primary care provider, the LME-MCO or a Medicaid-enrolled psychiatrist.”
Medicaid recipients over the age of 21 can self-refer him or herself to mental health services.
Adam Lanza, the boy who shot so many innocent children and teachers in Connecticut, was 20-years-old at the time of the horrible event.
Yet, if he lived in North Carolina, he could not have self-referred himself to receive therapy. He would have needed to see a doctor first.
I understand that Medicaid recipients under the age of 21 CAN see a therapist. But, by placing another hoop for them to jump through (seeing another doctor first), just makes it that much harder to receive therapy. If access to mental health services is that important, why make it more difficult for Medicaid recipients under 21?
Surely, a 20-year-old Medicaid recipient has the capability to determine whether he or she is in need of therapy.
Posted on January 30, 2013, in Medicaid, Medicaid Recipients, Medicaid Recipients Under 21, Mental Illness, NC DMA Clinical Coverage Policy 8C, North Carolina, Outpatient Behavioral Health, Primary Care Physicians, Psychiatrists, Psychologists and tagged Community mental health service, Connecticut, Direct memory access, Health policy, Medicaid, Mental health, North Carolina, United States. Bookmark the permalink. Leave a comment.
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