Legal Action Center submitted two comment letters, endorsed by 89 other health and justice advocacy organizations, urging CMS to withdraw two Medicaid proposals that would limit behavioral healthcare access.
The letters challenge a proposed rule that would cap certain Medicaid provider payments and an interim final rule implementing Medicaid community engagement requirements. The organization said the proposals would create new barriers to Medicaid coverage and behavioral healthcare at a time when the U.S. continues to face overdose, suicide and incarceration challenges.
Here are three things to know:
1. LAC said the proposals would disproportionately affect vulnerable populations. The organization said individuals with substance use disorders, mental health conditions and histories of criminal legal system involvement would face greater barriers to obtaining and maintaining Medicaid coverage. It also argued Medicaid is the nation’s largest payer of substance use disorder and mental healthcare and provides a critical safety net for people returning from incarceration.
2. The group challenged proposed Medicaid payment caps. LAC said CMS lacks the authority to cap Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments beyond what Congress authorized. The organization also argued benchmarking Medicaid behavioral health payments to Medicare is flawed because Medicare does not cover the full continuum of mental health and substance use disorder services and under-reimburses many behavioral health providers.
3. LAC also opposed CMS’ work requirement rule. The organization said the interim final rule narrows the “medically frail” exemption beyond what Congress enacted and creates documentation and verification requirements that would be burdensome for enrollees, providers and states. LAC said the rule fails to account for people with behavioral health conditions who are not currently receiving treatment because of provider shortages, stigma or other barriers to care.
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