The process of opening a behavioral health program in Maryland can be very length due to the requirements set by the state. While some states have a fairly quick and easy process, Maryland has quite a few steps before a program can open and start seeing patients.
First, it’s important to note what behavioral health programs fall into this category. This decision tree provided by the Maryland Behavioral Health Administration can help you determine the accreditation and licensing requirements before beginning the process. The team at Revive BHS is also very familiar with what is needed and can guide you in the right direction.
If your program does require an accreditation-based license, below are the steps that you will need to follow:
- Accreditation:
The first step in opening a behavioral health program in Maryland begins with seeking accreditation from a relevant organization such as the Commission on Accreditation of Rehabilitation Facilities (CARF) or the Joint Commission. Accreditation ensures that your facility meets certain standards.
The accreditation process is slightly different depending on which accrediting board you are working with, but essentially you’ll be receiving what is known as a “preliminary accreditation” before you’ve even opened your doors. This will include reviewing your written policies and procedures, following the standards outlined by whichever accrediting board you’re working with, and then a survey with one of the accrediting boards surveyors. These surveyors will meet with your leadership, conduct a short site visit and review your policies and procedures which includes information such as Strategic Planning, Risk Management, Intake Process, etc. After the survey, the accrediting board will determine if they think your program is positioned to be able to meet their standards and will issue you a preliminary accreditation.
- Agreement to Cooperate:
After receiving your preliminary accreditation, the next step will be to get an Agreement to Cooperate from your Local Addiction Authority. Every jurisdiction, county and Baltimore city, has a LAA that issues ATCs to new programs. This is agreement states that your program is willing to cooperate with the local jurisdiction and follow their guidelines and processes. Each jurisdiction might require different information as it relates to the staff and organization, but an application will need to be filled out and submitted regardless.
- COMAR 10.63 State License
Once you have your signed Agreement to Cooperate back from your Local Addiction Authority, you can begin the process of submitting your COMAR 10.63 Application for your state license. This is a multi-page application that includes information about yourself, your program, key personnel and more. This application gets submitted to the Maryland Behavioral Health Administration. Additional documents that are typically needed are a Fire Inspection, Certificate of Occupancy, Copy of Good Standing with SDAT and your Accreditation Report. All of this information will be reviewed by the team at BHA and they will either sign off on your license or request additional information.
- Maryland Medicaid Enrollment
After you receive your official state license, you can now start seeing patients! Most programs will elect to wait until they are credentialed with insurance payers, unless they are following a self-pay model. We find many programs choose to get enrolled with Maryland Medicaid first as the process is faster than commercial insurance payers.
Maryland Medicaid runs through Optum and behavioral health credentialing is all done through Optum, as opposed through the Managed Care Organizations (MCOs). This makes the process very streamlined compared to other state Medicaid programs! First you will start with creating an account through ePrep which is where you’ll submit your application to become a provider. This is where you’ll need information such as your group/facility NPI number. Depending on the services your program is offering, you may need more than one NPI and more than one application.
Once the application is submitted, it will be reviewed and a site visit is usually also required before you’re officially an enrolled provider. You’ll also need to register with Incedo which is where authorizations are requested and how claims can be submitted and processed.
As you can see, there are many steps involved to opening a behavioral health program in Maryland. This post doesn’t even cover zoning, insurance, staffing, etc.! Typically, we see programs take between 6-9 months to get open from the start of the accreditation process, but sometimes it can take even longer. It’s important to plan properly and work with professionals who understanding this space. Revive BHS has worked with dozens of programs in Maryland and we would be happy to support your organization. Contact us today for a free consultation!