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California & The Mental Health Carve-Out

Last week, OPEN MINDS Market Intelligence Analyst Athena Mandros gave a great overview of all the many changes happening in California’s Medicaid program (Medi-Cal) and discussed why it’s important for other states to keep an eye on California’s system (see California As A Bellwether). Amid all of these changes, one of the most important policies that California’s behavioral health community is keeping an eye on, is the mental health carve-out. At the end of June, the Centers for Medicare and Medicaid Services (CMS) approved California’s 1915(b) Specialty Mental Health Services (SMHS) waiver for an additional five years. This preserves California’s county-based mental health system until at least 2020. In spite of the approval, CMS did voice some concerns about program integrity and access – this resulted in increased reporting and transparency requirements (see California’s Mental Health Carve-Out Preserved For Five Years, But With New Performance Transparency Requirements).