Cenpatico To No Longer Require OTRs for BH Outpatient Services in January 2014

In January 2014, the implementation of the Affordable Care Act will expand on the Mental Health Parity & Addiction Equity Act (MHPAEA), also referred to as the Federal Parity Law of 2008. This expansion, as it relates to Medicaid Managed Care plans, aims to provide equal protection for covered members to ensure that the coverage for mental health and substance use conditions will be comparable to and no more restrictive than coverage for general medical and surgical care. As a result of these changes, Cenpatico will no longer require participating providers to submit Outpatient Treatment Requests, (OTR), for behavioral health outpatient, (BHOP), services. Certain services such as inpatient, partial hospitalization, intensive outpatient, ECT, and psychological testing will still require authorization.

A more detailed communication will be sent to participating providers once the final rules from the Centers for Medicare and Medicaid Services, CMS, are known.