                                 CODE OF VIRGINIA

CREDENTIALING OF PRIVATE MENTAL HEALTH AGENCIES (§ 38.2-3407.10:2)

A. As used in this section, &#8220;carrier,&#8221; &#8220;covered person,&#8221;
and &#8220;health benefit plan,&#8221; have the same meaning ascribed thereto in
&#xA7; 38.2-3407.10:1.
			&#8220;Mental health professional&#8221; means a person who by education and
experience is professionally qualified to provide counseling interventions
designed to facilitate an individual&#8217;s achievement of human development
goals and remediate mental, emotional, or behavioral disorders and associated
distresses that interfere with mental health and development.
			&#8220;Network&#8221; means a group of participating mental health
professionals who provide mental health services under the carrier&#8217;s
health benefit plan that requires or creates incentives for a covered person to
use the participating mental health professionals.
			&#8220;Private mental health agency&#8221; means a practice group of mental
health professionals at least one of whom is licensed under Chapter 24 (&#xA7;
54.1-2400 et seq.) of Title 54.1.

B. A carrier that credentials the mental health professionals in its network may
establish reasonable protocols and procedures for credentialing private mental
health agencies. Upon approval by a carrier of a credentialing application made
by a private mental health agency, any mental health professional employed or
engaged by such agency shall be deemed credentialed pursuant to the approved
credentialing application of the private mental health agency. If a carrier opts
to credential a private mental health agency, at a minimum the protocols and
procedures established by the carrier shall:

   1. Apply only if the private mental health agency&#8217;s credentialing
   application is approved by the carrier; and

   2. Require a private mental health agency to maintain minimum audit report
   requirements, as determined by the Department of Behavioral Health and
   Developmental Services.

C. The Commission shall have no jurisdiction to adjudicate individual
controversies arising out of this section.

HISTORY: 2019, c. 689.