§ 15-840. Coverage for medically necessary residential crisis services

   (a) "Residential crisis services" defined. -- In this section, "residential crisis services" means intensive mental health and support services that are:

   (1) provided to a child or an adult with a mental illness who is experiencing or is at risk of a psychiatric crisis that would impair the individual's ability to function in the community;

   (2) designed to prevent a psychiatric inpatient admission, provide an alternative to psychiatric inpatient admission, or shorten the length of inpatient stay;

   (3) provided out of the individual's residence on a short-term basis in a community-based residential setting; and

   (4) provided by entities that are licensed by the Department of Health and Mental Hygiene to provide residential crisis services.

(b) Application. -- This section applies to:

   (1) insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies or contracts that are issued or delivered in the State; and

   (2) health maintenance organizations that provide hospital, medical, or surgical benefits to individuals or groups under contracts that are issued or delivered in the State.

(c) Coverage. --

   (1) An entity subject to this section shall provide coverage for medically necessary residential crisis services.

   (2) The services required under this section may be delivered under a managed care system.

HISTORY: 2002, ch. 394; 2006, ch. 331.