SB 410

Under current law, the Department of Health Services (DHS) administers the

Medical Assistance (MA) program, which is a joint federal and state program that

provides health and long-term care services to individuals who have limited

resources. The MA program reimburses certified providers for providing services to

MA recipients. Among the health benefits provided to MA recipients are mental

health services including, among others, mental health day treatment services and

alcohol and other drug abuse services; psychiatric services; mental health and

psychosocial rehabilitative services and case management services provided by a

community support program; psychosocial and case management services provided

by a community-based psychosocial service program; and mental health crisis

intervention services.

This bill makes changes to MA program mental health benefits and

reimbursement for certain mental health services. The bill requires DHS to allow

a child experiencing a severe emotional disturbance to access in-home therapy

without first showing a failure to succeed in outpatient therapy. DHS is required,

under the bill, to allow certain families to participate in in-home therapy even if one

of the children is enrolled in a day treatment program. The bill limits the elements

that DHS may require on the prior authorization form used to obtain outpatient

mental health services. The bill also specifies that mental health services provided

through telehealth by Wisconsin-licensed physicians are reimbursable by the MA

program even if that Wisconsin-licensed physician is located outside the state.

Telehealth is the use of electronic information and telecommunication technology to

provide long-distance health care and education.