CMS issues IMD payment guidance for Medicaid/CHIP managed care

The Centers for Medicare & Medicaid Services today issued answers to frequently asked questions about payments to Medicaid and Children’s Health Insurance Program managed care organizations and prepaid inpatient health plans for patients in an institution for mental disease. Under a final rule last year modernizing Medicaid and CHIP managed care regulations, states may make capitated payments to managed care plans for enrollees aged 21 to 64 who have a short-term stay of no more than 15 days in an IMD, as long as the facility is an inpatient psychiatric hospital, substance use disorder inpatient care or sub-acute facility providing psychiatric or SUD crisis residential services.