CMS expands state access to Medicaid waivers for IMD services

The Centers for Medicare & Medicaid Services today announced new opportunities for states to design innovative service delivery systems for adults with serious mental illness and children with serious emotional disturbance, including Section 1115 waivers for short-term residential treatment services in an Institution for Mental Disease. While CMS has approved 17 state waivers to pay for IMD treatment for substance use disorders, including opioid use disorders, the new guidance will allow states to pursue waivers to pay for community and residential treatment services for the full continuum of mental health and SUDs.

“More treatment options for serious mental illness are needed, and that includes more inpatient and residential options,” said Health and Human Services Secretary Alex Azar. “As with the SUD waivers, we will strongly emphasize that inpatient treatment is just one part of what needs to be a complete continuum of care, and participating states will be expected to take action to improve community-based mental health care.”

CMS outlined the new waiver opportunities in a letter to state Medicaid directors, which also describes existing opportunities to support innovative service delivery systems for adults with serious mental illness and children with serious emotional disturbance.

“America’s hospitals and health systems commend Secretary Azar’s announcement regarding CMS guidance that will offer additional flexibility for state Medicaid agencies and providers to work together to better care for people with serious mental health conditions,” said AHA Executive Vice President Tom Nickels. “In 2016, approximately 10 million adults in the United States had a serious mental illness, but only 65 percent received mental health services in that year. … This guidance will lessen barriers to care for those in need of these services and increase access to quality behavioral health care.”