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- September 28, 2023
Foster Youth Access to Medi-Cal Specialty Mental Health Services in the California Counties with the Largest Foster Care Populations
Carly Myers, Alexis Robles-Fradet, Abigail Coursolle, and T. Nancy Lam Issue Brief, Manual/Report, Fact Sheet, GuideRead moreChildren and youth involved in child welfare have complex mental health needs, due in part to their compounding experiences with trauma and often inadequate access to appropriate services. In California, the State’s Medicaid program (Medi-Cal) provides a critical safety net for foster children and youth. Under Medi-Cal, County Mental…
- September 25, 2023
NHeLP Letter to CCIIO on Legal Authorities and Regulatory Changes for Essential Health Benefits
Read moreIn this letter to the HHS Center for Consumer Information and Insurance Oversight (CCIIO), NHeLP urges changes in regulations governing Essential Health Benefits (EHB). As NHeLP points out, nothing in the Affordable Care Act precludes HHS from adding adult oral health as part of the department's statutory responsibility to…
- August 1, 2023
Institutions for Mental Diseases (IMD) Exclusion and Substance Use Disorders: Lay of the Land
Read moreThe Medicaid Act prohibits the use of federal funding for services provided in Institutions for Mental Diseases (IMDs). In response to the overdose epidemic, two competing pathways have been implemented that allow states to circumvent the IMD exclusion: the SUPPORT Act's state plan amendment (SPA) option and the use…
- July 14, 2023
Comments on Proposed Medicaid Managed Care Access Rule
Read moreCMS proposed a major administrative rule that would increase transparency in managed care; improve monitoring and assure adequacy of payments in managed care; increase accountability, transparency, and participant input into external quality review; and help states to make information about quality measures widely available. NHeLP filed comments in support…
- July 13, 2023
Comments on Proposed Medicaid Access Rule
Jennifer Lav, Wayne Turner, David Machledt, Abigail Coursolle, Dania Douglas, Charly Gilfoil, Jasmine Young, and Madeline Morcelle CommentsRead moreCMS proposed changes and additions to regulations enforcing the "equal access" provision of Medicaid. These changes would strengthen opportunities for enrollees' input and oversight of state Medciaid programs, would help promote access to Medicaid services, would improve quality of care, and promoting transparency and adequate payment for fee-for-service Medicaid.…
- May 17, 2023
Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary Rights
Read moreMedi-Cal covers Specialty Mental Health Services (SMHS) for beneficiaries who need them. In California, County Mental Health Plans (MHPs) are responsible for providing SMHS to Medi-Cal beneficiaries of all ages. This issue brief analyzes the legal requirements that require MHPs to ensure Medi-Cal beneficiaries’ access to SMHS and maintain…