Demonstration Program To Improve The Quality Of Care For Patients Suffering From A Psychiatric Emergency - Make Your Revenue Smarter

From the CMS Press Release:

Medicaid Emergency Psychiatric Demonstration Program

CMS announced a new Medicaid Emergency Psychiatric Demonstration designed to provide states with more flexibility and resources to care for Medicaid beneficiaries with mental illnesses.

This demonstration provides up to $75 million in funding to states over three years, as authorized by the Affordable Care Act, to help care for Medicaid patients (aged 21 through 64) with psychiatric emergencies, in private inpatient psychiatric facilities with 17 or more beds, also known as institutions for mental diseases (IMDs).  The demonstration defines psychiatric emergencies as expressions of suicidal or homicidal thoughts or gestures resulting in a determination that the patient is dangerous to himself or to others.

As a result, in order for states to receive federal reimbursement for medical assistance to care for psychiatric emergencies warranting hospitalization, Medicaid patients must receive services in non-IMD settings such as general hospital emergency rooms, which can often result in higher cost and less appropriate care settings.  This demonstration will permit federal reimbursement for treatment of psychiatric emergencies in IMD settings, providing Medicaid patients with improved access to psychiatric treatment and enabling states to ensure the provision of needed services at lower cost.

The Medicaid Emergency Psychiatric Demonstration is part of the CMS’s commitment to improving the quality of care available to Medicaid beneficiaries.   The demonstration is being administered by the Center for Medicare and Medicaid Innovation (the Innovation Center).  Created by the Affordable Care Act, the Innovation Center is committed to achieving the three aims of better health, better health care, and reduced costs through improvement for CMS beneficiaries by testing delivery system models.

CMS is now accepting applications to participate in this demonstration from interested State Medicaid Directors.  States will be selected competitively based on their application proposals.

Click here for more information, including the solicitation, application and fact sheet

Click here for the complete CMS press release

 

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