CMS 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 Medicaid Emergency Psychiatric Demonstration will test whether Medicaid reimbursement to treat psychiatric emergencies 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.
Historically, federal law has prohibited Medicaid from paying for IMD services provided to Medicaid enrollees between the ages of 21 and 64. As a result, when these particular Medicaid beneficiaries need emergency psychiatric treatment, they may seek services in general hospital emergency departments where services may not be matched to their needs or in psychiatric hospitals where the care is appropriate but reimbursement is not provided. This has been detrimental to Medicaid beneficiaries, hospitals, and State Medicaid programs.
The Demonstration will be administered by the Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care.
Additional information can be found here
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