CMS approves Idaho Medicaid Behavioral Health Transformation 1115 waiver allowing reimbursement for services for adults in IMDs and residential settings

Niki Forbing-Orr

The Idaho Department of Health and Welfare (DHW) has received approval from the Centers for Medicare and Medicaid Services (CMS) for a Medicaid 1115 waiver to allow reimbursement of services for adults age 21 through 64 treated in large psychiatric hospitals, also known as institutions for mental diseases (IMDs).

“This is very exciting news,” said Idaho Medicaid Administrator Matt Wimmer. “Medicaid will now be able to pay for services for people with behavioral health needs, even when those needs are so acute as to require hospitalization. It is a great step forward for Idaho’s behavioral health system of care.”

The waiver, accompanied by a corresponding implementation plan, is an agreement with the federal government that allows Idaho to tap into federal funding for approved Medicaid benefits. This waiver benefits both the Medicaid expansion population as well as the existing Medicaid population, and is effective April 17.

The waiver also describes how inpatient services fit into the overall system of behavioral health care for Idaho Medicaid and provides a road map for developing Idaho’s behavioral health care system over the next five years.