CMS Overhauls Medicaid Managed Care Regulations; Proposes End To IMD Exclusion For 15-Day Stays

On May 26, 2015, the federal Centers for Medicare & Medicaid Services (CMS) released a proposed rule on Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations, which focuses on network standards and quality measures, medical loss ratio standards, and rate setting transparency. The rule also includes a provision to end the reimbursement exclusion of services provided to adults by an institution for mental disease (IMD) for 15 days or less. CMS defines an IMD as any inpatient or residential psychiatric treatment setting with more than 16 beds.

The provisions of the “Proposed Rule For Medicaid Managed Care . . .