Sec. 10.67.02.03. Health Service Needs Information

A. The Department, MCO, or agents of the Department or MCO shall attempt to complete the health service needs information at the time of enrollment.

B. The Department shall transmit any information obtained from health service needs information to the enrollee’s MCO within 5 business days.

C. Upon its receipt and review of the health service needs information, an MCO shall take appropriate action to ensure that a new enrollee, who needs special or immediate health care services, as identified by the health service needs information, receives them in a timely manner.

D. If the Department does not transmit health services needs information for an enrollee to the MCO within 10 days of enrollment, the MCO shall make at least two attempts to conduct an initial screening of the enrollee’s needs, within 90 days of the effective date of enrollment. At least one of these attempts shall be during non-working hours.

E. The Department shall inform an enrollee identified in connection with the health service needs information as having a behavioral health problem that the individual may self-refer to the behavioral health ASO for services as described in COMAR 10.09.59 and 10.09.80.