Continuity of Care - Behavioral Health

HMSA promotes continuity of patient care by encouraging behavioral  healthcare providers to share appropriate confidential patient medical information with other providers.  HMSA is also committed to ensuring that members continue to receive quality healthcare when a provider terminates his or her HMSA participating provider agreement.

Sharing Medical Information

Behavioral healthcare providers are encouraged to provide copies of medical information when:

• The behavioral healthcare provider refers a member to another provider
• The member requests information be sent to another provider
• Another provider who is treating the member requests information

Sharing medical information with other medical professionals involved with the patient's care helps to ensure continuity of care and reduce duplication of services.  When transferring a patient's medical information, providers must maintain patient record confidentiality and comply with pertinent state and federal laws governing such transfers.

Providers may not share medical information when the member specifically asks that it not be shared. A signed release from the member must be obtained before medical information can be shared (see Authorization of Release of Records or Information.)

Care After Voluntary Termination of Contract

If a contracted behavioral healthcare provider terminates his or her contract with HMSA, the provider must notify his or her HMSA members not less than 30 days prior to the termination date.  The behavioral healthcare provider is obligated to offer patients who are receiving an active course of treatment continued care for up to 90 days or completion of the active course of treatment, whichever is shorter.  An active course of treatment is one in which discontinuity of care would cause a recurrence or worsening of the condition and interfere with anticipated outcomes.

A behavioral healthcare provider who voluntarily terminates his or her participating provider agreement must give HMSA 60 calendar days' written notice before the date of termination.  For more information, see Termination of a Participating Provider Agreement.

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