Section 65, Behavioral Health Services for Dual Eligible Members

July 26, 2013

On June 28, 2013, a listserv notified providers that as of August 1, 2013, dual eligible members will no longer be able to receive Section 65, Behavioral Health Services from Licensed Clinical Professional Counselors (LCPCs) or Licensed Marriage and Family Therapists (LMFTs) because they must receive services from a Licensed Clinical Social Worker (LCSW). However, if a dual eligible member lives further than 30 minutes from an LCSW or has other extenuating circumstances, they may qualify for an exception to continue services with their LCPC/LMFT.

In order to maintain continuity of care, if a dual eligible member has requested an exception in order to continue receiving services from an LCPC/LMFT, please do not discharge the member from your care on or after July 31, 2013 until a determination is made to approve or deny the exemption request. Please do not discharge dual eligible members without an appropriate transition plan. Claims will continue to be accepted by MaineCare and subject to all other requirements as outlined in the MaineCare Benefits Manual Chapter 65.