Medicaid Finalizes Managed Care Rules, Including Qualified End To IMD Exclusion

On April 25, 2016, the federal Centers for Medicare & Medicaid Services (CMS) released the final rules for Medicaid managed care plans. The new rule includes plans to end the exclusion of any payment for care provided to adults between age 21 and 64 in an institution of mental disease (IMD). The rule means that the capitated rate paid to Medicaid managed care plans can be used to reimburse for mental health or addiction treatment services provided for up to 15 days in a given month to adults in a residential treatment setting with 17 or more beds. Historically, Medicaid . . .