Child Health Plus

The following updates have been made to your CDPHP Child Health Plus plan:

Effective April 1, 2023, the Child Health Plus program added a new benefit, Residential Rehabilitation Services for Youth (RRSY).

Residential Rehabilitation Services for Youth (RRSY)

Residential Rehabilitation Services for Youth (RRSY). We will pay for Residential Rehabilitation Services for Youth (RRSY) provided by a program licensed, certified or otherwise authorized by the Office of Addiction Services and Supports. Services must be clinically indicated and specified in the individualized treatment/recovery plan and/or progress notes.

Effective January 1, 2023, the Child Health Plus program added the following new benefits:

Assertive Community Treatment Services

Assertive Community Treatment Services (ACT), Young Adult ACT, and Youth ACT will now be covered. Services must be referred by a physician or other licensed provider of the healing arts, within their scope of practice under State law, for maximum reduction of physical or intellectual disability and restoration of a beneficiary to their best possible functional level.

Additional Medical Supplies

Coverage for medical supplies has been expanded to include medical supplies which have been ordered by a provider in the treatment of a specific medical condition and which are usually consumable, nonreusable, disposable, and for a specific purpose and generally have no salvageable value.

Expanded Orthodontic Services

Orthodontic services for a severe physically handicapping malocclusion will now be covered. Prior approval for orthodontia coverage is required. Services include orthodontic care for severe physically handicapping malocclusions as a once in a lifetime benefit that will be reimbursed for an eligible member for a maximum of three years of active orthodontic care, plus one year of retention care. Retreatment for relapsed cases is not a covered service. Treatment must be approved and active therapy begun (appliances placed and activated) prior to the member’s 19^th birthday.

Expanded Emergency Transportation

Coverage has been expanded to include the following emergency services:

• Ambulance services for catastrophic, life-threatening illnesses or conditions when:

• Rapid transport is necessary to minimize risk of death or deterioration of the patient’s condition

• Ground transport is not appropriate for the patient or

• Life-support equipment and advanced medical care is necessary during transport




• Transportation Between Facilities

• Air and ground transportation between facilities when such services are considered emergency transports. This includes transport from an Emergency Room to a Psychiatric Center; transport from an Emergency Room to a Trauma/Cardiac Care/Burn Center; transportation from an Emergency Room to an Emergency Room and transportation from an Emergency Room to Another Facility. Prior authorization is not required.

Children and Family Treatment and Support Services

Children and Family Treatment and Support Services (CFTSS) will now be covered. Services may be delivered in the community where the child/youth lives, attends school and/or engages in services. Services include: services provided by Other Licensed Professionals (OLP), crisis intervention, Community Psychiatric Supports and Treatment (CPST), psychosocial rehabilitation services, family peer support services, and youth peer support.

Core Limited Health-Related Services

Core Limited Health-Related Services at a Voluntary Foster Care Agency (VFCA) /29-I Health Facility will now be covered. Health and behavioral health care services must meet reasonable and acceptable standards of health practice as determined by the State in consultation with recognized health organizations. Services include the following five Core Limited Health-Related Services: skill building services; nursing services; treatment planning and discharge planning; clinical consultation/supervision services, and VFCA Child Health Plus liaison/administrator.