Effective Oct. 1, healthcare services delivered by in-state psychiatric residential treatment facilities will be reimbursable for eligible Medicaid beneficiaries

Effective October 1, 2018, Teton Peaks, a division of the Eastern Idaho Regional Medical Center, will begin providing Medicaid reimbursable services as a certified in-state Psychiatric Residential Treatment Facility (PRTF).

These services are intended to help Idaho and PRTF’s improve healthcare delivery systems for Medicaid beneficiaries by allowing in-state access to care, strengthening continuity of care, and improving population health. Here is the legal notice: 

LEGAL NOTICE

Pursuant to 42 CFR §447.205 and the requirements of Section 1905(a) of the Social Security Act, the Department of Health and Welfare is giving public notice of an impending change in the Idaho State Medicaid Plan.

Idaho Medicaid intends to submit a State Plan Amendment (SPA) to create an in-state reimbursement methodology for Psychiatric Residential Treatment Facilities (PRTFs). The reimbursement for in-state PRTFs will be fifty percent (50%) of the all-inclusive usual and customary per diem charges.

Psychiatric Residential Treatment Facilities (PRTFs) are considered a covered benefit when required to satisfy an Idaho Medicaid participant’s Early and periodic Screening, Diagnostic and Treatment (EPSDT) medically necessary need. This change, is intended to support Idaho improve healthcare delivery systems for Medicaid beneficiaries by allowing in-state access to care, strengthening continuity of care, and improving population health.

The effective date is October 1, 2018.  There is no expected increase or decrease in annual aggregate expenditures.

No public hearings have been scheduled at this time.

For technical questions or to review the changes, call Angela Simpson at (208) 364-1817, or e-mail the request to Angela.Simpson@dhw.idaho.gov.

Written comments may also be sent to and reviewed by the public at the following address:

ANGELA SIMPSON

Bureau of Financial Operations

Division of Medicaid

Department of Health and Welfare

3232 Elder Street

Boise, Idaho 83720-0036

Phone (208) 364-1817; Fax (208) 334-2465

 

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