MH/SUD Services (EHB) (Cont’d) Requirement WAC to Contract must provide benefits for neurodevelopmental therapies. Cover (Washington 2017 Base benchmark Plan subject to RCW 48.44.450(1)) Therapy O.S.T. v. Must provide benefits for mental health diagnoses (Diagnoses Regence; WAC listed in the DSM) without any “blanket limitations” (e.g., age six and under) O.S.T. v. Regence BlueShield, No. 88940-6 (WN October 9, 2014). Requirement to Services covered must include physical, speech, and RCW Cover occupational therapies. WAC 284-43-5642(10)(a)(i). 48.44.450(2); Therapy (Cont’d) Benefits shall be payable only where the services have been RCW (Cont’d) delivered pursuant to the referral and periodic review of a holder 48.44.450(2)
MH/SUD Services (EHB) (Cont’d) Therapy Therapy (Cont’d) Requirement to Cover Requirement to Cover (Cont’d) WAC Contract must provide benefits for neurodevelopmental therapies. (Washington 2017 Base benchmark Plan subject to RCW 48.44.450(1)) O.S.T. v. Regence; WAC Must provide benefits for mental health diagnoses (Diagnoses listed in the DSM) without any “blanket limitations” (e.g., age six and under) O.S.T. v. Regence BlueShield, No. 88940-6 (WN October 9, 2014). RCW 48.44.450(2); Services covered must include physical, speech, and occupational therapies. WAC 284-43-5642(10)(a)(i). RCW 48.44.450(2) Benefits shall be payable only where the services have been delivered pursuant to the referral and periodic review of a holder
cl-forms-19-hcsc-sg-analyst-checklist.docx