The Department of Medical Assistance Services (DMAS) has contracted with HMS to perform audits of Community Mental Health / Rehabilitative services and other Behavioral Health services. Specifically, HMS is auditing the following participating provider services: Outpatient Psychotherapy and Substance Abuse services, Intensive In-Home services, Therapeutic Day Treatment and Mental Health Support services. Additional provider services may be audited as deemed necessary by DMAS.
HMS and DMAS are working closely together during this auditing contract to ensure that Virginia Medicaid recipients receive the appropriate behavioral and community mental health services in the appropriate setting. HMS also ensures that services received by Virginia Medicaid recipients are performed in accordance with federal and state guidelines in addition to guidelines set forth in the Medicaid Manual.
HMS will publish newsletters designed to offer education on the review process, communicate review trends and common errors. The newsletters will also function as a means to project information to the providers that serve Virginia Medicaid clients. Webinars may be scheduled periodically to communicate common errors identified during the review process.
Newsletters and other provider education materials are available in portable document form (pdf). In order to view, you will need the Adobe Acrobat Reader. It is available for download at no charge from Adobe Systems Incorporated.
Click below to download or view:
Questions or inquiries regarding the Virginia Behavioral Health Provider Audits can be sent to Project Manager, Kelly Dickson, at VABH@hms.com.
