Managed Care
An organized system for delivering comprehensive mental health services that allows the managed care entity to determine what services will be provided to an individual in return for a prearranged financial payment. Generally, managed care controls health care costs and discourages unnecessary hospitalization and overuse of specialists, and the health plan operates under contract to a payer.
Medicaid
Medicaid is a health insurance assistance program funded by Federal, State, and local monies. It is run by State guidelines and assists low-income persons by paying for most medical expenses.
Medicaid client
Mental health clients to whom some services were reimbursable through Medicaid.
Medical group practice
A number of physicians working in a systematic association with the joint use of equipment and technical personnel and with centralized administration and financial organization.
Medical review criteria
Screening criteria used by third-party payers and review organizations as the underlying basis for reviewing the quality and appropriateness of care provided to selected cases.
Medically necessary
Health insurers often specify that, in order to be covered, a treatment or drug must be medically necessary for the consumer. Anything that falls outside of the realm of medical necessity is usually not covered. The plan will use prior authorization and utilization management procedures to determine whether or not the term “medically necessary” is applicable.
Medicare
Medicare is a Federal insurance program serving the disabled and persons over the age of 65. Most costs are paid via trust funds that beneficiaries have paid into throughout the courses of their lives; small deductibles and some co-payments are required.
Medication Therapy
Prescription, administration, assessment of drug effectiveness, and monitoring of potential side effects of psycho-tropic medications.
MediGap
MediGap plans are supplements to Medicare insurance. MediGap plans vary from State to State; standardized MediGap plans also may be known as Medicare Select plans.
Member
Used synonymously with the terms enrollee and insured. A member is any individual or dependent who is enrolled in and covered by a managed health care plan.
Mental health
How a person thinks, feels, and acts when faced with life’s situations. Mental health is how people look at themselves, their lives, and the other people in their lives; evaluate their challenges and problems; and explore choices. This includes handling stress, relating to other people, and making decisions.
Mental Health Parity (Act)
Mental health parity refers to providing the same insurance coverage for mental health treatment as that offered for medical and surgical treatments. The Mental Health Parity Act was passed in 1996 and established parity in lifetime benefit limits and annual limits.
Mental health problems
Mental health problems are real. They affect one’s thoughts, body, feelings, and behavior. Mental health problems are not just a passing phase. They can be severe, seriously interfere with a person’s life, and even cause a person to become disabled. Mental health problems include depression, bipolar disorder (manic-depressive illness), attention-deficit/ hyperactivity disorder, anxiety disorders, eating disorders, schizophrenia, and conduct disorder.
Mental disorders
Another term used for mental health problems.
Mental illnesses
This term is usually used to refer to severe mental health problems in adults.
MHA Administration
Activities related to the planning, organization, management, funding, and oversight of direct services.
MHA Data collection/reporting
These are activities to obtain, analyze, and report data for planning, management or evaluation purposes.
MHA Other Activities
Other specific non-direct service activities of State MHAs that further the provision of mental health services in the State.
MHA Planning Council Activities
All activities that comply with the mandate of State MHAs to form and operate a planning council to support the development of a strategic plan for mental health services and assess ongoing operations.
MHA Technical Assistance
Provision or sponsorship of training, education, or technical support in the planning, operation or management of public mental health programs in the State.
MI and MR/DD services
Services designed to address the needs of people with both psychiatric illness and mental retardation or developmental disabilities.
Mobile Treatment Team
Provides assertive outreach, crisis intervention, and independent-living assistance with linkage to necessary support services in the client’s/patient’s own environment. This includes PACT, CTTP, or other continuous treatment team programs.
More Than One Race
A category of racial grouping for a person who reports multiple racial origins.
