WASHINGTON, DC - In an effort to reduce health care costs and expand access for mental health services to Medicaid patients, U.S. Senators Jack Reed and Sheldon Whitehouse and U.S. Representatives Jim Langevin and David Cicilline today announced that Rhode Island will be eligible to receive new federal funding as part of a national pilot program to provide services to Medicaid-eligible adults experiencing psychiatric emergencies.  This new program was created by a provision in the health reform law, the Affordable Care Act.

The Centers for Medicare & Medicaid Services (CMS) will allocate $75 million over three years to 11 states and the District of Columbia for the program.  For every dollar that Rhode Island spends on psychiatric care for Medicaid-eligible adults, the state will receive approximately 0.52 cents from the federal government.

“I am pleased that Rhode Island has been selected to participate in this pilot program to better serve individuals and families suffering from mental illnesses.  The Affordable Care Act continues to improve the care that patients receive and quality of our health care system. This initiative is one more example of how the new law will help expand Medicaid services and lower Medicaid costs to the state,” said Reed.

“Patients in need of emergency psychiatric care deserve access to high-quality treatment in the setting that is best suited to meet their needs,” said Whitehouse.  “With this demonstration project from the Affordable Care Act, Rhode Island once again is leading the way in streamlining the delivery of health care in the Medicaid program.”

“For too long, funding and coverage for mental illnesses has not been on par with support for physical illnesses,” said Langevin. “This program gives Rhode Island a lead role in improving mental health treatment and is an example of the much-needed effort by the Affordable Care Act to ensure patients with mental illnesses receive the high quality care they deserve.”

“I am happy to join my colleagues in announcing that Rhode Island will be eligible to receive new federal funding through this important pilot program under the Affordable Care Act, which has already eliminated lifetime limits on health insurance plans for 374,000 Rhode Islanders and saved 14,822 Medicare recipients in our state more than $8 million off the costs of their prescription drugs,” said Cicilline.  “I will continue to work with Senators Reed and Whitehouse, along with Congressman Langevin, to ensure that every Rhode Islander has access to quality, affordable health care.”

Under current federal law, institutions for mental disease (IMD) do not receive reimbursement for treating Medicaid beneficiaries aged 21 to 64.  According to CMS, Medicaid beneficiaries in need of emergency psychiatric treatment may seek services in general hospital emergency departments where treatment may not be appropriately matched to patients’ needs and is more costly, or in psychiatric hospitals where reimbursement is not provided.

This pilot program will also assess the effect of expanded Medicaid coverage for reducing the burden on general acute care hospital emergency departments.