| DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 |
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SHO# 20-002
RE: Access to Mental Health and Substance Use Disorder Services for Children and Pregnant Women in the Children’s Health Insurance Program
March 2, 2020
Dear State Health Official:
The passage of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (P. L. 115-271), referred to as the SUPPORT Act, on October 24, 2018, among other things, strengthens behavioral health coverage for children and pregnant women eligible through the Children’s Health Insurance Program (CHIP). Section 5022 of the SUPPORT Act amends section 2103(c)(5) of the Social Security Act (the Act) to
make behavioral health coverage a required benefit for CHIP effective October 24, 2019.
Section 5022 of the SUPPORT Act specifically requires that child health and pregnancy related assistance “include coverage of mental health services (including behavioral health) necessary to prevent, diagnose, and treat a broad range of mental health symptoms and disorders, including substance use disorders.” The statute also stipulates that these services must be delivered in a culturally and linguistically appropriate manner. It applies to all CHIP eligible populations regardless of the type of coverage (e.g., benchmark coverage) elected by the state under a separate CHIP under section 2103 of the Act. We also note that the requirements in the SUPPORT Act are distinct from those in the Mental Health Parity and Addiction Equity Act (P.L. 110-343)(MHPAEA). Additional information is provided in the section below entitled, “Behavioral Health Related Regulations in CHIP.”
The purpose of this State Health Official (SHO) letter is to describe this new provision, and provide guidance to states with separate CHIPs on the actions necessary to implement the requirements of section 5022 of the SUPPORT Act. In general, states with a separate CHIP will need to submit a CHIP (Title XXI) state plan amendment (SPA) to demonstrate compliance with section 5022 of the SUPPORT Act in areas related to coverage of behavioral health screening, prevention and treatment services, strategies to facilitate use of appropriate screening and assessment tools and the requirement that these services be provided in a culturally and linguistically appropriate manner. This letter also provides states with the attached SPA template created for use during the SPA submission process.
