Set 1 - Section 223 Demonstration Programs

May 20th 2015

Q1: Where should interested parties submit questions and/or requests for technical assistance (TA) about the prospective payment system (PPS) for demonstration services provided by certified community behavioral health clinics (CCBHC)?

A1: Questions and requests for TA should be submitted to: CCBHC-

Q2: Can states that are planning grant recipients also claim Medicaid administrative expenditures associated with preparing to participate in this demonstration?

A2: Yes. States may claim administrative expenditures, eligible for 50 percent federal financial participation (FFP), to the extent the planning grants do not cover all such costs. All claimed expenditures must meet the federal requirement that normally apply to Medicaid administrative claiming.

Q3: Do states need Medicaid state plan authority to implement PPS for payment of demonstration services provided by CCBHCs?

A3: No. States may rely on demonstration authority to pay the CCBHC PPS for services covered under the demonstration. This authority does not extend to non demonstration services that a certified clinic also may provide.

Q4: Is the Quality Bonus Payment (QBP) optional under the CC PPS-1 methodology?

A4: Yes. Under PPS-1 a state may elect to implement QBP payment to certified clinics.