Page 22

(f) Hospital stay for patients requiring more than ten days for detoxification may be allowed provided that there is a justification that patient requires more than ten days for inpatient care. [Eff 08/01/94 ] (Auth: HRS §346-14; 42 C.F.R. §§431.10, 405.1020) (Imp: 42 C.F.R. §§405.116, 405.1020)

§17-1737-21 Outpatient psychiatric care. (a) Outpatient psychiatric care shall be provided by authorized psychiatric providers.

(b) Prior authorization is required for outpatient psychiatric care for: (1) All eligible recipients in need of outpatient psychiatric care; (2) Non-Medicaid patients who become eligible for medical assistance and whose outpatient visits may be covered retroactively. The prior authorization form shall be submitted by the provider immediately upon learning that the patient became eligible for retroactive coverage; and (3) Medicaid patients with third party coverage or any other available resources except for Medicare.

(c) The appropriate department of human services form for prior medical authorization shall be used to request authorization for outpatient psychiatric care. The following procedure shall be taken: (1) The form shall be completed, signed, and dated by the psychiatrist or psychologist; (2) The form shall be received in the medical assistance program (Medicaid) office of the department within five working days from the time of the patient's first visit. The postmarked date shall be accepted provided it is within the five working days requirement from the time of patient's first visit; (3) Subsequent requests shall be submitted to the medical assistance program (Medicaid) office within five working days from the date of the last visit authorized. The postmarked date shall be accepted provided it is within the five working days requirement; and