Recovery in the Community: Program and Reimbursement Strategies for Mental Health Rehabilitative Approaches Under Medicaid (Volume 2)

Publication Date: June 2003

Publisher: Technical Assistance Collaborative, Inc.; Judge David L. Bazelon Center for Mental Health Law

Author(s): John O'Brien; Patrick Lanahan; Evette Jackson

Research Area: Health

Keywords: Provider networks; Rehabilitation services; Medicare reimbursement

Type: Report

Coverage: United States


This report describes how states have developed and implemented community mental health services under the Medicaid Rehabilitation Option. It is the second of two reports produced by the Bazelon Center for Mental Health Law on use of the option for individuals with serious mental illnesses. The first, Recovery in the Community, Funding Mental Health Rehabilitative Approaches Under Medicaid, provided information about the federal Medicaid rules governing the Rehabilitation Option, along with research on recovery and rehabilitation and an analysis of how states have covered community-based psychiatric rehabilitation and case management services for adults under Medicaid.

This report discusses the strategies states use to: (1) identify the practitioners who can provide Medicaid rehabilitation services; (2) reimburse providers for these services; and (3) organize agencies and practitioners into provider networks that will promote recovery and rehabilitation for adults with serious mental illnesses. It is based on a review of federal and state rules, regulations and policies that pertain specifically to the Medicaid Rehabilitation Option for community mental health services. Approximately 40 state Medicaid plan amendments and policy manuals were reviewed for this analysis.