CMS Issues Final Rule on Mental Health and Substance Abuse ServicesImage Banner

CMS Issues Final Rule on Mental Health and Substance Abuse Services

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CMS Issues Final Rule on Mental Health and Substance Abuse Services

April 4, 2016

On March 30, the Centers for Medicare & Medicaid Services (CMS) finalized a rule (RIN 0938-AS24) to strengthen access to mental health and substance use services for people with Medicaid or Children’s Health Insurance Program (CHIP) coverage, aligning with protections already required of health plans in the commercial market. The Mental Health Parity and Addiction Equity Act of 2008 generally requires that health insurance plans treat mental health and substance use disorder benefits on equal footing as medical and surgical benefits. 

The protections set forth in this final rule seek to benefit over 23 million people enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and CHIP. Currently, states have flexibility to provide services through a managed care delivery mechanism using entities other than Medicaid managed care organizations, such as prepaid inpatient health plans or prepaid ambulatory health plans. 

The press release from CMS accompanying the rule is available here. More information on behavioral health services within Medicaid is available here