N.M. Medicaid waiver limits retroactive coverage, includes IMD provision

Dec 18, 2018 - 02:42 PM
cms-new-mexico-waiver

The Centers for Medicare & Medicaid Services Friday approved a Section 1115 waiver extending a New Mexico Medicaid demonstration for five years, and authorizing the state to receive federal funding to treat enrollees with opioid and other substance use disorders who are short-term residents in Institutions for Mental Disease. The waiver also authorizes the state to increase Medicaid copayments for inappropriate use of hospital emergency departments or choosing certain high-cost drugs; gradually increase Medicaid premiums; terminate coverage after three months for failure to pay premiums; and eliminate retroactive coverage for new enrollees. Among other changes, the waiver authorizes pilot programs for home visitation and for individuals with serious mental illness; one additional year of funding for the state’s uncompensated care pool and three years of funding for the state’s Hospital Quality Improvement Incentive Pool. CMS last month 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.

Related News Articles

Headline
HHS clarifies when state Medicaid agencies can use patient SUD records to verify exemption from community engagement requirements
The Department of Health and Human Services Office for Civil Rights released new guidance on statutory and regulatory requirements under 42 CFR Part 2, which…
Headline
CMS launches outcomes-driven quality measurement initiative for states 
The Centers for Medicare & Medicaid Services Sept. 25 announced the launch of a new initiative measuring quality in Medicaid and the Children’s Health…
Headline
AHA recommends changes to CMS’ Medicaid provider tax proposed rule
The AHA commented Sept. 21 on the Centers for Medicare & Medicaid Services’ proposed rule to implement the changes to Medicaid provider tax policies that…
Headline
AHA requests CMS reconsider provisions within Medicaid community engagement rule
The AHA July 31 provided comments to the Centers for Medicare & Medicaid Services on its interim final rule on Medicaid community engagement requirements.…
Headline
CMS issues proposed provider tax rule
The Centers for Medicare & Medicaid Services today released a proposed rule that would update Medicaid provider tax policies included in the July 2025…
Headline
AHA comments to CMS on proposed rule covering Medicaid supplemental payments
The AHA provided comments July 21 to the Centers for Medicare & Medicaid Services on its proposed rule to modify policies governing Medicaid…