All Plan Letter 22-005 No Wrong Door for Mental Health Services Policy
| Date: | October 18, 2023 |
| To: | Health Plan of San Joaquin (HPSJ) Practitioners and Facilities |
| Type: | Informational/ Educational |
| Subject: | All Plan Letter 22-005 No Wrong Door for Mental Health Services Policy |
| Business: | Medi-Cal Managed Care |
This is being sent as a reminder on how you can apply the information to your practice or facility operations, where appropriate.
The Department of Health Care Services (DHCS) issued All Plan Letter 22-005 (APL-22- 005): https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2 022/APL22-005.pdf, “No Wrong Door for Mental Health Services Policy” on March 30, 2022. This summary is provided as an excerpt of APL 22-005. Please see the APL itself for complete guidance.
This policy was created to ensure that members receive timely mental health services without delay regardless of the delivery system where they seek care and that members are able to maintain treatment relationships with trusted providers without interruption.
Key Information
Guidance provided around the managed care plan coverage of clinically appropriate non-specialty mental health services (NSMHS) when:
- Members are able to access services without prior authorization and regardless of entry point
- Members of any age with potential mental health disorders not yet diagnosed
- Services are covered whether or not the NSMHS were included in an individual treatment plan
- The member has a co-occurring mental health condition and Substance Use Disorder (SUD); or
- NSMHS and Specialty Mental Health Services (SMHS) are provided concurrently, if those services are coordinated and not duplicated
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/.