CurrentCareSourcePolicy N/A

Court-mandated Health Services — Arkansas PASSE

Governs how CareSource administers court-mandated health services for members in the Arkansas PASSE program, including applicability of existing medical necessity, prior authorization, and care coordination requirements.

Policy Summary

PayerCareSource

PolicyCourt-mandated Health Services — Arkansas PASSE

Policy CodePolicy N/A

Change TypeClarified (non-material review)

Effective Date06/01/2025

Next Review DateN/A

Key ActionIf court-mandated services are not medically necessary, the member's care coordinator will assist to ensure access to appropriate treatment and coordinate necessary care.

SourceLink

POLICY UPDATE CHANGES

Annual reviews updated and committee approvals noted; effective date set to 06/01/2025.

06/01/2025Effective date

4+Document revisions

MHPAEAParity referenced

RequiredCare coordination

Court-Mandated Services Coverage Criteria

Court-mandated services coverage criteria

Court-mandated health services are governed by existing CareSource policy frameworks.

Services are subject to existing CareSource policies and procedures, including medical necessity determinations and prior authorization when required.

If court-mandated services are determined not to meet medical necessity criteria, the member's care coordinator provides assistance to ensure access to appropriate treatment and coordinate necessary care.

Coverage for behavioral health diagnoses and treatment will comply with the Mental Health Parity and Addiction Equity Act (MHPAEA) and will not be subject to less favorable limitations than medical conditions.

Court-mandated services may include withdrawal management, medication-assisted treatment, community-based services, behavioral health inpatient or outpatient treatment, and medical inpatient or outpatient treatment.

Policy Summary

PayerCareSource

PolicyCourt-mandated Health Services — Arkansas PASSE

Policy CodePolicy N/A

Change TypeClarified (non-material review)

Effective Date06/01/2025

Next Review DateN/A

Key ActionIf court-mandated services are not medically necessary, the member's care coordinator will assist to ensure access to appropriate treatment and coordinate necessary care.

SourceLink

On This Page

Prior Authorization, Medical Necessity, and Care Coordination Requirements

Prior Authorization

Prior Authorization and Medical Necessity

Court-mandated health services remain subject to all applicable CareSource policies and procedures, including medical necessity determinations and prior authorization requirements when applicable. Providers must follow normal prior authorization processes and submit necessary documentation for review.

Note

Care Coordinator Assistance for Non‑Medically Necessary Determinations

If a court-mandated service is determined NOT to meet medical necessity criteria, the member's CareSource care coordinator will assist the member and provider to identify and coordinate appropriate alternative treatment and support services to ensure continuity of care and access to needed supports.

Care coordinator will review alternative community resources and benefit options with the member and provider.
Care coordinator will facilitate referrals,appointments, or expedited reviews where appropriate.
Care coordinator will document outreach and coordination efforts in the member's care plan.

OpenPayer

Court-mandated Health Services — Arkansas PASSE

Court-Mandated Services Coverage Criteria

Prior Authorization, Medical Necessity, and Care Coordination Requirements

Key Terms

Document Revisions and Effective Date