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SAMHSA News - Volume XI, Number 3, Summer 2003

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Publications Available on Financing of Mental Health Services

Covers of Medical Necessity, The Provision of Mental Health Services in Managed Care Organizations, and Medicaid Financing of State and County Psychiatric HospitalsSAMHSA recently published three reports that examine public and private sector financing of mental health services.

  • The Provision of Mental Health Services in Managed Care Organizations reports on a nationally representative survey of managed care organizations that examined how mental health services were provided in 1999 and how the provision varied by product type and contracting arrangement. The publication describes the prevalence and characteristics of different methods that managed care organizations use to provide behavioral health care.
  • Medical Necessity in Private Health Plans: Implications for Behavioral Health Care addresses how the term "medical necessity" is defined in decisions on private health insurance coverage. It includes a review of the literature, an extensive review of legal cases that challenge insurer decisions, materials prepared by the insurance industry, consultations with experts in the field, a review of investigations conducted by state departments of insurance and attorneys general, and interviews with health care executives regarding the decision-making process.
  • Medicaid Financing of State and County Psychiatric Hospitals addresses the lack of comprehensive information on the nature and scope of Medicaid support for individuals in psychiatric institutions. The study identifies potential sources of Medicaid funds paid on behalf of public psychiatric hospitals, and provides an estimate of the amount of such funds in 2001. The Medicaid funding experiences of public psychiatric hospitals in five states-Arkansas, California, Iowa, Maryland, and New Jersey-were examined in depth for this study.

For copies of the publications, contact SAMHSA's National Mental Health Information Center, P.O. Box 42490, Washington, DC 20015. Telephone: 1 (800) 789-2647 or 1 (866) 889-2647 (TTY). Or, visit End of Article

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Inside This Issue

Disaster Preparedness: Mental Health & Substance Abuse
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    SAMHSA News

    SAMHSA News - Volume XI, Number 3, Summer 2003