Idaho Department of Health and Welfare submits state plan amendment for Medicaid

Posted at 7:42 PM, Oct 03, 2019
and last updated 2019-10-03 21:42:33-04

BOISE — Idaho Department of Health and Welfare submitted a state plan amendment Monday that would allow coverage for adult psychiatric hospitalizations at institutions for mental diseases (IMDs).

“Today they would get service through the division of behavioral health using a different source of funding, so they’d go to the same places, but they’d go to same places, the different would be they’d get it as part of their Medicaid benefit," said administrator for division of Medicaid Matt Wimmer.

Last fall, the SUPPORT Act passed and signed by president trump allows for coverage of people with substance use disorder needs through Medicaid agencies, but it does not cover for mental illness alone. The department says this amendment would potentially help cover both.

“If you had a substance use disorder and another mental health issue, then we could cover inpatient psychiatric hospital services," said Wimmer.

In addition to the amendment, they're also pursuing an 1115 IMD waiver, which would cover individuals to seek treatment at free-standing psychiatric hospitals, rather than full-service hospitals.

“There’s some hospitals, general acute hospitals like St. Alphonsus, that do some [psychiatric] services but they’re not solely dedicated to that," said Wimmer, "places like Intermountain Hospital, or Cottonwood Hospital are solely dedicated to psychiatric services, and that’s what it lets us cover."

The department says this amendment is just a way to provide the full level of behavioral health care necessary to the populations they serve.

"If all they need is some counseling, then great, we have them covered there, but if they need those more intensive levels of service, we can help them there as well," said Wimmer.

The department says they expect the comment period for the 1115 IMD waiver to occur in the next 2-3 weeks this October. The department also says in their press release, "Since the requirements for 1115 waivers have become extensive and highly prescriptive, approval for funding is not expected until well after Jan. 1."