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The Department of Community Health (DCH) administers Medicaid reimbursement and associated policy for mental health treatment and services through partnership with The Department of Behavioral Health and Developmental Disabilities (DBHDD). As Georgia’s Behavioral Health Authority, DBHDD provides services through a network of community providers.
On January 1, 2016, adults age 21 and older enrolled in Georgia Medicaid became eligible for coverage of one preventive health visit per calendar year. The preventive health visit includes a medical history, physical exam, health counseling, health screenings (such as Pap tests and mammograms) and Medicaid-covered adult immunizations (such as flu shots). Most Medicaid enrollees pay nothing for the preventive health visit and services.
In March of 2016 the Centers for Medicare and Medicaid Services (CMS) finalized a rule to strengthen access to mental health and substance use disorder services for people with Medicaid, Children’s Health Insurance Program (CHIP), or Alternative Benefit Plan (ABP) coverage, similar to the requirements that were already in place for private health insurance plans. In summary, the rule requires that Medicaid, CHIP, and ABP Managed Care Plans not impose more restrictive benefit limitations on mental health and substance use disorder (MH/SUD) benefits than on medical and surgical (M/S) benefits.