10A NCAC 27I .0404. PROCESS

(a)  A LME seeking approval to directly deliver services shall submit a request in writing containing all required information at least 60 days in advance of the date on which the LME wishes to begin service delivery or the expiration date of a previous approval if the LME wishes to continue service delivery.

(b)  The request shall be submitted to the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS), 3001 Mail Service Center, Raleigh, NC 27699-3001.

(c)  The Director of DMH/DD/SAS or designee shall review the submitted documentation and request additional information, if necessary.  If the service the LME wishes to deliver is a Medicaid payable service, DMH/DD/SAS shall also consult with the Division of Medical Assistance.

(d)  The Secretary shall make a decision regarding the request within 15 business days of receipt of the recommendation from the Director of DMH/DD/SAS or designee.

(e)  The Secretary's decision shall be based upon the following:

(1)           access;

(2)           availability of qualified public or private providers;

(3)           client choice; and

(4)           fair competition.

(f)  The Director of DMH/DD/SAS or his designee shall communicate the Secretary's decision to the LME in writing within 15 business days of the decision.

(g)  In the event that a LME requests to deliver services on a temporary basis as a result of an unanticipated closure of a private or public provider in the LME catchment area, the LME may request an expedited review of its service delivery request.

 

History Note:        Authority G.S. 122C-112.1(a)(26);

Eff. July 1, 2008.