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["The Missouri Substance Use Disorder and Serious Mental Illness 1115(a) Demonstration Waiver: Provider Data Information Report"]
["Objective","The CMS 1115 Serious Mental Illness (SMI) Program demonstration aims to improve the availability of crisis stabilization services and increase access to community-based supports for beneficiaries with SMI. It also strives to improve care coordination, particularly ensuring continuity of care in the community after episodes of acute care in hospitals and residential treatment facilities. CMS requires the State to conduct an annual Provider Availability Assessment, which identifies the number of mental health services and providers across the State by county.  Visit the MO HealthNet Division (MHD) 1115 Substance Use Disorder (SUD) and SMI website for more information about the demonstration. "]
["Due Date","The annual report must be submitted by January 30th each year throughout the duration of the waiver (e.g., January 30, 2026, January 30, 2027, January 30, 2028, January 30, 2029). "]
["Goal","The goal is to obtain the number/count of Medicaid-enrolled providers in Missouri counties who are accepting new Medicaid participants. "]
["Data Requests","1) Psychiatrists or Other Practitioners Who Are Authorized to Prescribe: \nPer CMS instructions, the State would like to request the number/count of Medicaid-enrolled psychiatrists or other practitioners who are authorized to prescribe and are accepting new Medicaid patients in each Missouri county. \n\na) Accepting new Medicaid patients means any provider enrolled in Medicaid who holds billing privileges and will treat new Medicaid-enrolled patients. \n\nb) All MD and DO psychiatrist provider types should be included. \n\nc) The state of Missouri does not have regulations limiting authorized practitioners’ ability to prescribe medication. For this measure, the following provider types should also be included as other practitioners authorized to prescribe: all MDs, DOs, physician assistants, assistant physicians, nurse midwives, advanced practice registered nurses (APRNs), and nurse practitioners. \n"]
[null,"2) Other Practitioners Certified and Licensed to Independently Treat Mental Illness:\nPer CMS instructions, the State would like to request the number/count of Medicaid-enrolled other types of practitioners certified and licensed to independently treat mental illness, accepting new Medicaid patients in each Missouri county.\n\na) Per CMS instructions, other types of practitioners certified or licensed to independently treat mental illness include non-psychiatrist mental health providers who are certified or licensed to independently treat mental illness as defined by state licensure laws. \n\nb) All licensed psychologists, clinical social workers, professional counselors, and marital and family therapists should be included. \n           i) Exclude all provisionally licensed practitioners, as they require supervision by a licensed practitioner \n               and cannot independently treat mental illness.  \n"]
[null,"3) Number of Providers Offering Intensive Outpatient or Partial Hospitalization: \nPer CMS instructions, the State would like to request number/count of providers offering intensive outpatient services in each geographic designation. Intensive outpatient services are designed to meet the needs of individuals who may be at risk for crisis or require a higher level of care, or who are in transition from a higher level of care. \n \na) Intensive outpatient services may include partial hospitalization programs, day treatment, intensive outpatient programs, assertive community treatment, and other services and settings more intensive than regular outpatient and less intensive than inpatient or residential care. \n\nb) All providers who offer IOP and/or PHP services should be included. \n"]
[null,"4) Intensive Outpatient or Partial Hospitalization Providers:\nPer CMS instructions, the State would like to request the number/count of Medicaid-enrolled intensive outpatient (IOP) and partial hospitalization providers (PHP) accepting new Medicaid patients in each Missouri county. \n\na) Per CMS instructions, IOP or PHP means a distinct and organized intensive ambulatory treatment program that offers less than 24-hour daily care other than in an individual's home or in an inpatient or residential setting.\n\nb) All providers who offer IOP and/or PHP services should be included. "]
["Reporting Requirements","For all three data requests, please ensure the following are met: \nPer CMS instructions, the report should use a consistent month each year to populate the availability assessment. The state has selected August as the timeframe to collect information for the report (e.g., August 2025, August 2026, August 2027, and August 2028). Please ensure that the reported data reflects the August timeframe of the given year, if available, or by the end of December of that year. \n\n• \tUse the worksheet tabs below to enter the requested data.\n\n• \tInclude the provider's reported address, state, zip code, and county.\n\n• \tInclude the provider NPI/provider numbers.  \n\n• \tRemove duplicate provider NPIs/provider numbers from the number/counts for each county. \n\n* Important note: MCOs should report on provider locations in each county/geographical area in which they practice. For example, if a provider has a location in County A and County B, they should be counted for both counties in the Availability Assessment. ",null,null,null,null,null,null,null,null,null,null,null,null,null," "]
["Resources","•\tContract section:  2.23.25 SUD/SMI Provider Data Information Report, in Amendment 13. "]
[null,"•\tThe Missouri Substance Use Disorder and Serious Mental Illness 1115(a) Demonstration Waiver: Provider Data Information Report will be posted on the Reporting Templates & Vendor Documents website by October 2025. The managed care organizations can access the document annually on the Health Plan Reporting Schedule and Template website. "]

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["1) Psychiatrists or Other Practitioners Who Are Authorized to Prescribe:"]
["NPI/Provider License Number","Address","City","State","County ","Practitioners Accepting New Medicaid Participants (Y/N)"]

{"sheet":"Other BH Practitioners ","index":2,"n_rows":2,"n_cols":6,"rows_kept":2,"cut":false,"hidden":false,"merged":[[0,0,0,5]]}
["2) Other Practitioners Certified and Licensed to Independently Treat Mental Illness:"]
["NPI/Provider License Number","Address","City","State","County","Practitioners Accepting New Medicaid Participants (Y/N)"]

{"sheet":"IOP_PHP_Practitioners","index":3,"n_rows":2,"n_cols":6,"rows_kept":2,"cut":false,"hidden":false,"merged":[[0,0,0,5]]}
["3) Number/Count of Providers Offering Intensive Outpatient or Partial Hospitalization Providers:"]
["NPI/Provider License Number  ","Address","City","State","County ","Practitioners Accepting New Medicaid Participants (Y/N)"]

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["4) Intensive Outpatient or Partial Hospitalization Providers Accepting New Medicaid Participants:"]
["NPI/Provider License Number  ","Address","City","State","County","Practitioners Accepting New Medicaid Participants (Y/N)"]