Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Fast Facts: Demonstration Claiming

09/10/2019

Fast Facts: Demonstration Claiming

  • Under the Demonstration, states do not need Medicaid state plan authority to claim for CCBHC services.

  • States may report only expenditures for demonstration services provided to Medicaid beneficiaries during the effective dates of a state's demonstration program.

  • States may report administrative expenditures that support the development and implementation of the demonstration. CMS added new lines to the budget and expenditure reporting forms (CMS-37 and CMS-64) to support states in reporting demonstration cost data at the various federal matching rates.

  • States cannot receive enhanced FMAP after the demonstration ends. However, to the extent applicable, newly eligible FMAPs and the IHS/Tribal FMAP continue to apply.

  • Only those states selected for the demonstration are eligible to enter budget and expenditure amounts for CCBHC services.

  • States may fund the non-federal share of payment using intergovernmental transfers or appropriations to the Medicaid agency, but NOT certified public expenditures, because states are not allowed to pay clinics at cost for demonstration services. No state has notified CMS that it will use provider assessments to help fund demonstration payment.

  • States have the option to incorporate the CCBHC demonstration into managed care while continuing to receive the enhanced match rate for the portion of the capitation rate attributable to CCBHC services.