North Carolina Medicaid Clarifies That Behavioral Health MCOs Responsible For Detoxification Charges

On October 31, 2014, the North Carolina Department of Health and Human Services (DHHS) issued a bulletin to hospitals and behavioral health managed care organizations (MCOs) clarifying that behavioral health MCOs are responsible for paying for medical detoxification charges. This clarification was issued because some detoxification claims were being denied by the MCOs. In the bulletin, DHHS confirmed that hospital charges for medically-supervised detoxification are included in the MCO per member per month capitated rate. The capitation rate includes all claims on a psychiatric Diagnosis-Related Group (DRG), which encompasses “medical detoxification.” The MCOs are also responsible for follow . . .