Regulation .04 Covered Services.
Regulation .04 Covered Services.LinkCopy Citation
A.
Effective July 1, 2023, the Department shall reimburse for community violence prevention services as described in §B of this regulation when these services:
(1)
Are medically necessary; and
(2)
Rendered to a participant who:
(a)
Has been exposed to community violence or has a personal history of injury resulting from community violence;
(b)
Is at an elevated risk of violent injury or retaliation resulting from another act of community violence, as determined by a certified or licensed health care provider or social services provider; and
(c)
Has been referred by a certified or licensed health care provider to a certified violence prevention professional to receive community violence prevention services.
B.
Community violence prevention services shall include one or more of the following interventions:
(1)
Mentorship;
(2)
Conflict mediation;
(3)
Crisis intervention;
(4)
Referrals to certified or licensed health care professionals or social services providers;
(5)
Patient education; and
(6)
Screening services.
C.
The Program shall cover a maximum of 100 30-minute units of services in a rolling 12-month period.