Administration Releases Medicaid and CHIP Mental Health and SUD Action Plan, Parity Initiatives

In another round of mental health-related announcements, this week, the Centers for Medicare & Medicaid Services (CMS) released a Medicaid and CHIP Mental Health and Substance Use Disorder Action Plan alongside Administration announcements focused on mental health parity. 

The seventeen page Mental Health and Substance Use Disorder Action Plan provides an overview of Medicaid and CHIP coverage of behavioral health services and recent CMS activities including the informational bulletin issued last year on leveraging Medicaid and the Children’s Health Insurance Program to deliver behavioral health services for children and youth, proposed rules on access and managed care released this past spring, and recently updated guidance on claiming for school-based services in Medicaid. It then outlines CMS’s strategies and actions for improving treatment and support for Medicaid and CHIP enrollees with mental health and substance use disorder (SUD) conditions focusing on three priority areas:

  1. Increasing access to prevention and treatment by improving coverage of mental health and SUD screening and therapy and promoting parity, and supporting integration and coordination of mental health and SUD treatment with other health care
  2. Improving engagement in care by increasing treatment and support in home and community-based settings and supporting access to mental health and SUD services through non-traditional settings and services
  3. Enhancing quality of care by encouraging implementation of evidence-based practices, improving quality measurement, and analyzing and publicizing data on key topics

The Administration also announced a proposed rule focused on mental health parity along with a plan to issue a request for information on how to work with states to ensure compliance with parity protections for individuals enrolled in Medicaid managed care plans–especially important given that 82% of children (and 70% of all individuals covered by Medicaid) are enrolled in comprehensive managed care.

This week’s mental health announcements also come on the heels of a recent update from CMS that two more states–California and Kentucky–received approval to participate in the American Rescue Plan Act’s (APRA) community-based mobile crisis intervention services option to provide qualifying services for individuals with Medicaid and receive enhanced federal Medicaid support for the first three years. According to a KFF behavioral health survey of state Medicaid programs, 28 states reported they had taken up or had plans to take up the APRA mobile crisis intervention services option. States with approved State Plan Amendments include: Arizona, California, Kentucky, North Carolina, Oregon, and Wisconsin.

Anne Dwyer is an Associate Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.