Feds update Medicaid rules, encourage behavioral health EHR adoption

A little more creativity, and maybe this time we’ll find a way to pay for health IT in behavioral health.

As reported in Modern Healthcare last week, the Center for Medicare and Medicaid Services (CMS) has proposed new rules to govern Medicaid managed care plans. One of these rules would enable managed care companies contracting with state Medicaid programs to include activities related to health IT and Meaningful Use (MU) in the definition of core services that contribute to the overall medical loss ratio.

“A medical loss ratio, or MLR, requires health plans to spend a minimum portion of the rates they receive on medical services as opposed to administrative costs and profits. The proposed Medicaid rule recommends that states impose an MLR of 85 percent in their managed-care plans.”

If the proposed rule is approved, it will enable managed care companies not covered by MU to pass the costs of electronic health records (EHRs) and other health IT on to the federal government as reimbursable core services.

The federal MU program directly reimburses hospitals and providers for the costs associated with purchasing and implementing an EHR, provided they demonstrate use in a way that meets federal requirements.

In recent years legislation has been proposed a few different times that would expand direct federal financial support for EHRs in behavioral health. To date, none of those introduced bills have made it out of Congressional committee.

Click to read the original Modern Healthcare story.

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