March 11, 2009

CMS Corrective Action Letter to Utah Department of Health Regarding IMD Status of Residential Treatment Facilities

The Region VIII Centers for Medicare and Medicaid Services (CMS) letter to the Utah Department of Health outlined nine concerns about the state's claims for federal financial participation for services provided unter the rehabilitation service provision of Medicaid. CMS asked the state to review all residential treatment facilities with more than 16 beds to determine their status as an institution of mental disease (IMD). CMS also asked the state to unbundle per diem reimbursements for residential treatment. The state found that determining IMD status was complicated and requested further clarification on various scenarios created by provider organizations that were not distinctly addressed by the IMD guidelines in the State Medicaid Manual.