Today, the Centers
for Medicare & Medicaid Services (CMS) is issuing a technical
clarification Question and Answer (Q and A) document focused on a type of
residential setting recently defined in statute called a Qualified
Residential Treatment Program (QRTP) for foster care children. These
programs provide a trauma-informed model of care to address the needs of
children with serious emotional or behavioral disorders or
disturbances. This document clarifies that QRTPs may be included in
the section 1115 demonstrations described in the State Medicaid Director
Letter on “Opportunities to Design Innovative Service Delivery Systems for
Adults with Serious Mental Illness or Children with Serious Emotional
Disturbance”, issued in November of 2018.
The Q&A document
identifies the statutory basis and definition of a QRTP, explains the
Medicaid Institution for Mental Diseases (IMD) payment exclusion, discusses
the intersection of a QRTP and the IMD exclusion, and explains how states
may include QRTPs in a section 1115 SMI/SED demonstration to ensure
Medicaid coverage for services provided to Medicaid enrolled children
residing in QRTPs.
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