CMS Issues Clarification on Provision of Services for Community Mental Health Centers

PUBLISHED: Jul 31, 2017
Relevant to: Community Mental Health Centers

The US Centers for Medicare and Medicaid Services (CMS) has issued a clarification on the provision of services for Community Mental Health Centers (CMHCs).

The Conditions of Participation (CoP) for CMHCs, were published in October 29, 2013 and became effective on October 29, 2014. The Condition at §485.918(b)(1)(iii) Provision of Services requires that the CMHC provide day treatment, partial hospitalization services other than in an individual’s home or in an inpatient or residential setting, or psychosocial rehabilitation services. The use of the word, “or” in the regulatory text of the Standard suggests that the CMHC must provide at least one of the services listed in order to be in compliance with the Standard. There is no requirement included within the regulatory text that the one service must be partial hospitalization. Therefore, a CMHC could be found in compliance with Standard §485.918(b)(1)(iii) without providing partial hospitalization services.

However, §489.2(c)(2) Provider Agreements and Supplier Approval states that CMHCs may only enter into provider agreements under Medicare to furnish partial hospitalization services. Therefore, if a survey finds that a CMHC does not provide or intend to provide partial hospitalization services even though §485.918(b)(1)(iii) was found to be met during the survey, the State Survey Agency (SA) would document this finding in the CMS-2567 “Statement of Deficiencies and Plan of Correction” under Tag 000 “Initial Comments.”

If the CMHC does not choose to either add partial hospitalization services or to voluntarily terminate their Medicare provider agreement, CMS may exercise its authority to terminate the agreement with the CMHC pursuant to §489.53.

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