Medicaid Emergency Psychiatric Demonstration - Transition Watch!

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Hoping our friends at the two Transition RTC Centers (Pathways & Transitions) are watching this and weighing in on how it unfolds.

The Centers for Medicare & Medicaid Services (CMS) today announced that 11 States and the District of Columbia will participate in the Medicaid Emergency Psychiatric Demonstration, established under the Affordable Care Act to test whether Medicaid beneficiaries who are experiencing a psychiatric emergency get more immediate, appropriate care when institutions for mental diseases (IMDs) receive Medicaid reimbursement.

The CMS Innovation Center will provide up to $75 million in federal Medicaid matching funds over three years to 11 States—Alabama, California, Connecticut, Illinois, Maine, Maryland, Missouri, North Carolina, Rhode Island, Washington, and West Virginia— and the District of Columbia, to enable private psychiatric hospitals, also known as “institutions for mental disease” (IMDs), to receive Medicaid reimbursement for emergency care provided to Medicaid enrollees aged 21 to 64 who have an acute need for treatment. Historically, IMDs are not reimbursed under Medicaid for these services without an admission to an acute care hospital first.

The Medicaid Emergency Psychiatric Demonstration will test whether Medicaid reimbursement to treat psychiatric emergencies, described as suicidal or homicidal thoughts or gestures, in IMD settings will enable States to increase the quality of care for people experiencing mental illness at lower cost, and will also test whether such expanded coverage reduces the burden on general acute care hospital emergency departments.

To obtain more information on the Medicaid Emergency Psychiatric Demonstration, including the press release, visit: innovations.cms.gov/initiatives/Medicaid-Emergency-Psychiatric-Demo.

 

Comments

  1. Transitions RTC's avatar
    Transitions RTC
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    Response from Maryann Davis:
    Because young adults are often less connected to care for a wide variety of reasons, they may utilize ER’s as a source of treatment, rather than seeking it through a community mental health system, or a community based therapist. This Medicaid expansion could therefore help these young adults get access to ongoing care. Especially for individuals undergoing first episode psychosis, this may also be the key to rapid connection to both psycho-pharmacology and psychotherapy that can improve their trajectory of illness.
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