In response to an increasing need for access to inpatient behavioral health care and changes in Idaho law during the 2019 legislative session, the Idaho Department of Health and Welfare (DHW) released a section 1115 IMD Waiver titled Behavioral Health Transformation Waiver on Friday for public comment. 

Public comments

will be accepted through Dec. 24.

If approved by CMS, this waiver would allow Medicaid to cover inpatient psychiatric hospitalization at all facilities as part of the overall behavioral health system of care. Today, individuals who are admitted to a freestanding psychiatric hospital with more than 16 beds cannot have these services covered by Medicaid, even if they are Medicaid eligible. These services are only payable when rendered in a full-service hospital.

The waiver focuses more than just coverage for treatment in a psychiatric hospital and lays out the full continuum of care for individuals suffering from mental illness and substance use disorders. This waiver is also focused on the transformation of the behavioral health system in Idaho by expanding access to outpatient behavioral health services throughout the state, particularly in rural and frontier areas. Idahoans will be able to access a wider array of services and will benefit from improved coordination of care, particularly when transitioning between levels of care.  

Confronting the opioid epidemic, a priority for both the Governor’s Office and the Idaho Legislature, is a major component of this waiver. More, and more varied, resources will be made available under this waiver for assisting and treating those with substance and opioid use disorders, in particular by expanding the currently available levels of care. 

“The department’s vision is that Idahoans who live with mental illness and addiction can access the behavioral health care services they need when they need them,” said DHW Director Dave Jeppesen. “If it’s approved, this waiver will help make that vision a reality.”

DHW’s comprehensive public notice, tribal notice and the waiver application are available at https://medicaidexpansion.idaho.gov/.  

Load comments