CMS to Mandate Marketplace Plans Cover Mental Health Facilities, SUD Treatment Centers

CMS

The U.S. Centers for Medicare & Medicaid Services (CMS) has announced a new proposal that would require health plans offered through the federal and state-based marketplaces to cover mental health facilities and substance use disorder treatment centers.

The new proposal would make these two types of facilities essential community providers (ECPs). It would also extend the current overall 35% provider participation threshold to federally qualified health centers (FQHCs) and family planning providers (FPPs), Behavioral Health Business reports.

ECPs mainly serve vulnerable populations. The federal government presently defines six types of providers as ECPs: FQHCs and look-alike facilities; FPPs; Ryan White HIV/AIDS Program Providers; Indian Health Providers; hospitals; and a handful of condition-specific facilities. Read more.

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