Coordination of Medical Care

A community behavioral health center must coordinate behavioral health disorder treatment with medical care for MassHealth members. If a member has not received a physical exam within twelve months of the date of intake, the community behavioral health center will advise the member that one is needed. If the member does not have an existing relationship with a physician, the community behavioral health center will assist the member in contacting the MassHealth agency’s customer service toll-free line to receive help in selecting a physician. If the member declines a physical examination, the member’s record will document the member’s preference and any stated reason for that preference. The center will have agreements with other providers where necessary to ensure member access to medically necessary medical and behavioral health services not provided by the center.