State Profiles of Mental Health and Substance Abuse Services In Medicaid

Research conducted during an 18-month period over 2002-2003 determined that all States provided mental health services through Medicaid and the State Children's Health Insurance Program (SCHIP), and most also provided some substance abuse services. States combined the use of eligibility standards, service selection, and service limits to manage service delivery in these programs. The way such controls were used in concert reflected States' priorities as to which individuals should have received services, which services should have been provided, and how many services could have been provided. States had the choice of delivering services through some form of managed care or through traditional fee-for-service delivery systems. With funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), staff from Abt Associates Inc. and the National Academy for State Health Policy (NASHP) conducted an examination of State Medicaid and SCHIP programs. The purpose of this study was to identify State policies related to those who were covered under the programs, what services the programs provided, and how the services were delivered. This effort revealed four key findings, described below.

Key Finding Number 1: All States provided mental health services to their Medicaid and SCHIP program participants, and most provided some substance abuse services.

Key Finding Number 2: Limits on mental health and substance abuse services in Medicaid and SCHIP tended to follow common patterns and were based on a relatively mall number of criteria.

Key Finding Number 3: Most States used some form of managed care to deliver behavioral health services in Medicaid and SCHIP.

Key Finding Number 4: States used the flexibility offered in Medicaid and SCHIP to expand program coverage to cover more people than they were required to cover under Federal minimum requirements. (Excerpt from report).