Coordination of Care

(A) Coordination of Medical Care. A mental health center must coordinate behavioral health disorder treatment with medical care for MassHealth members. If a member has not received a physical exam within 12 months of the date of intake, the mental health center must advise the member that one is needed. If the member does not have an existing relationship with a physician, the mental health center must assist the member in contacting the MassHealth agency’s customer service center to receive help in selecting a physician. If the member declines a physical examination, the member’s record must document their preference and any stated reason for that preference. (B) Coordination of Behavioral Health Care. Centers designated as BHUC providers must have a qualified service organization agreement with at least one opioid treatment program provider furnishing services in accordance with 105 CMR 164.000: Licensure of Substance Use Disorder Treatment Programs and 130 CMR 418.000: Substance Use Disorder Treatment Services. Designated BHUC providers must have relationships with organizations and partners in the community that provide behavioral health services, inclusive of, but not limited to, community behavioral health centers, skilled nursing facilities, primary care providers, opioid treatment programs, emergency departments, schools, and hospitals.