Behavioral Health Maximizing Revenue Recommendations Table

Recommendation NumberRecommendation
3.0.4The Department should pursue implementation of Certified Community Behavioral Health Clinic (CCBHC) services in order to take advantage of enhanced federal Medicaid financing for vital delivery system reforms.
3.0.5 The Department should consider expanding Medicaid to cover adults under 65 with income up to 133% of the Federal Poverty Level (FPL), taking advantage of substantially enhanced federal funding to build additional infrastructure to meet the needs of underserved behavioral health populations.
3.0.6The Department should transform the State’s current Medicaid 1915 waivers, including implementation of 1915(i) and 1915(k) options to refinance and improve community behavioral health service delivery.
3.0.7The Department should consider the pursuit of a Medicaid 1115 waiver to broaden the array of behavioral health services financed by Medicaid.
3.0.9 The State should develop local sources of funding for behavioral health initiatives.
6.4.1 As Medicaid plays an increasing role in financing the Department’s behavioral health services, the Department should consider a thorough review of position descriptions and delineation of regulatory responsibilities to optimize Medicaid administrative reimbursement.
9.2.4The Department should amend its grant and contract requirements to more strongly incentivize behavioral health providers to leverage third party insurance.
9.5.7The Department should continue its progress in transitioning from grants to contract-based financing for behavioral health services that are amenable to fee-for-service billing.
10.2.2The Department should improve its efforts to identify veteran recipients who may be eligible for services through the VA Healthcare System.
10.2.3The Department should proceed with implementing Medicaid 1915(i) and 1915(k) options in order to open up new opportunities for Medicaid financing through CMS.
12.2.1As the behavioral health system becomes increasingly dependent on Medicaid financing, current utilization tracking must be adapted to incorporate utilization controls more appropriate to fee-for-service payments than grant-based reimbursement.