At ABCS RCM, we often monitor the news for relevant changes in healthcare policy so that we can forward this information to our customers. Last week offered some relevant changes to the federal Medicaid program. The Medicaid program just recently announced that the recipients who participate in managed-care plans (MyCare), are now eligible for a maximum of 15 days of inpatient behavioral health treatments. This policy change reverses a 52-year old rule that specifically stated that Medicaid coverage does not include mental health treatments. This policy change is for Medicaid recipients who are 21 to 64 years old and considered low-income and disabled. In the state of Ohio, there are roughly 3 million people who fit this category.
Back in 1965, when Medicaid was first enacted, one reason for the exclusion of mental health was out of the fear that mental health asylums would hold people captive in order to collect payments from Medicaid. The community mental health model was seen as an alternative to mental health wards, but many would argue that it was never fully funded. In recent decades, the model of treatment, stabilize and release has produced critics. Recently, some health professionals have expressed a growing need for long-term, humane, inpatient, mental health facilities.
Ohio’s Department of Mental Health and Addiction Services director stated that Medicaid patients can now receive treatment more quickly and closer to home rather than having to go long distances for inpatient care. Qualifying patients will be able to use some private facilities, as well as state and public hospitals. There is a treatment challenge since Ohio state hospitals are currently operating at a 95% occupancy rate. The hope is that this new Medicaid funding policy for mental health treatment will reduce the burden being placed on state hospitals.
Sadly, the new updates in Medicaid will not change the long waiting lists for individuals seeking addiction treatment.
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Medicaid, Mental Health, Behavioral Health
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