Administration of Mental Health Services by Medicaid Agencies

in providing Medicaid mental health services,with funding from Medicaid. In other States,the mental health agency contracted withindependent managed care organizationsrather than acting as a plan and deliveringservices on its own, again using funding fromMedicaid.Twenty-three of the 26 States using a BHOor ASO reported that they do not deliver servicesto all Medicaid mental health beneficiariesin the same way, excluding at least someMedicaid mental health services or populationsfrom the BHO or ASO or from broaderMedicaid managed care programs. Theseexcluded services or populations are coveredin the regular Medicaid fee-for-serviceprogram.Of the 25 States that reported not using aBHO or ASO to deliver mental health services,11 carve out or exclude at least somemental health services or populations frombroader Medicaid managed care programs.Only 10 States do not use either a BHO oran ASO for mental health services, nor dothey carve out any mental health services orpopulations from general Medicaid managedcare programs, thus covering these servicesand populations in the same way as all otherMedicaid services and populations.C. Data Collection and ReportingAs noted earlier, every State Medicaid program,as a condition of receiving Federalmatching funds, must collect enrollment andclaims data in a Medicaid ManagementInformation System (MMIS) in standardizedformats specified by CMS, and it must reportspecified data to CMS electronically throughthe Medicaid Statistical Information System(MSIS). 18 Individual States may also requirethe Medicaid program to report certainfinancial or programmatic data to the Statelegislature or the general public.1. Reports on Medicaid Mental HealthServicesEighty percent of the States (40) reportedthat their Medicaid agencies produce formalreports containing discrete data on mentalhealth utilization or expenditures (Table 5).Of the remaining States, eight reported thatthe mental health agency produces thesereports, two reported that neither the Medicaidagency nor any other State agency producesreports that break out the utilization orcost of mental health services within the StateMedicaid program, and one did not reportthe information.These reports most commonly contain thenumber of beneficiaries utilizing mentalhealth services (in 32 States), followed by utilization(30 States), utilization by service andcost by service (29 States), and cost per beneficiary(26 States). In 22 States, the Medicaidagency produces these reports monthly; in 6States, annually; in 5 States, quarterly; and in1 State, semiannually. There are four States inwhich the Medicaid agency produces reportson mental health services only on an “asneeded” basis.In eight States, all reports produced byMedicaid about mental health services arepublicly available, while in seven States,reports are only available internally. Most(22 States) have a mix of publicly availableand internal-only reports. Of the 29 States inwhich some or all of the mental health servicesreports are available only internally, thereare 26 in which the Medicaid agency sharesthe report with other State agencies.18Social Security Act, Section 1903(r)(1).26 Administration of Mental Health Services by Medicaid Agencies