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.