This week CMS’ Center for Medicaid and CHIP Services (CMCS) released an
Information Bulletin
(IB) regarding coverage and service design opportunities for
individuals with mental illness and substance abuse disorders. CMS
developed the guidance because states had expressed interest in
effective strategies for dealing with this population, as evidenced by
recent state plans and various Medicaid managed care waivers. In the
bulletin CMS provides background on the major factors that were taken
into consideration when creating the guidance including the demographics
of the service population, their utilization of services, as well as
legislation and newly developed policies and programs that reform the
service delivery for the behavioral health population.
The
bulletin describes the overarching principles and goals for providing
coverage to individuals with mental and substance abuse disorders which
includes proper identification and treatment of disorders, a
person-centered approach, and high quality, cost-effective care. In
addition, the bulletin identifies existing and emerging resources for
states seeking to enhance their efforts to address the service need of
individuals with mental and substance use disorders. The resources seek
to support states in their efforts to improve benefit design through
collaboration with other federal partners, comply with the Mental Health
Parity and Addiction Equity Act, develop community integration
strategies and better coordinate behavioral health care with primary
care and other services.
Over
the next year, CMS will distribute a series of informational bulletins
that will provide further information regarding service coverage for
individuals with mental illness and/or substance use disorder. Details
regarding the sequence of the subsequent bulletins are included, the
first of which will address the prevention and early intervention of
mental health conditions for children, youth and adults.
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