CMS announces Medicaid Emergency Psychiatric Demonstration
The Center for Medicare and Medicaid Services (CMS) has announced that it will provide up to $75 million to 11 states and the District of Columbia to test whether Medicaid can support higher quality care at a lower total cost by reimbursing private psychiatric hospitals for some services for which reimbursement has historically not been available. The Medicaid Emergency Psychiatric Demonstration, established as part of the Affordable Care Act, will make Medicaid funds available for emergency inpatient psychiatric care for Medicaid enrollees aged 21 to 64.
Currently, under a restriction referred to as Medicaid's IMD (institutions for mental disease) exclusion, Medicaid does not reimburse psychiatric institutions. As a result, Medicaid enrollees with acute psychiatric needs, such as patients expressing suicidal or homicidal thoughts, are generally diverted to general hospital EDs, which often lack the resources or expertise to adequately care for these patients. This pattern has been detrimental to Medicaid beneficiaries, hospitals, and state Medicaid programs, acknowledged CMS, in a press release announcing the new demonstration project.
In August of 2011, all state Medicaid Program Directors were invited to submit proposals to participate in the demonstration. These proposals were required to specify how the states would track patients, monitor stabilization, and ensure proper discharge planning. According to CMS, the states selected to participate were chosen through a competitive process in which an independent panel reviewed, scored, and ranked each proposal.
States selected to participate in the three-year demonstration project include Alabama, California, Connecticut, Illinois, Maine, Maryland, Missouri, North Carolina, Rhode Island, Washington, West Virginia, and Washington, DC.
The Center for Medicare and Medicaid Services (CMS) has announced that it will provide up to $75 million to 11 states and the District of Columbia to test whether Medicaid can support higher quality care at a lower total cost by reimbursing private psychiatric hospitals for some services for which reimbursement has historically not been available.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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