CMS Lets States Cover Nonmedical Services for Medicaid Beneficiaries

Social determinants of health (SDoH) like housing instability and food insecurity dramatically impact patient health outcomes. To address these factors, the US Centers for Medicare and Medicaid Services (CMS) has issued a new guidance that allows states to offer benefits for nonmedical services, under the classification of “in lieu of services and settings.”

According to Susan Morse, “In lieu of services allows health plans to pay for nonmedical services instead of standard Medicaid benefits when it is medically appropriate and cost effective to do so, the report said. States can write provisions into their risk contracts that allow the Managed Care Organization, with the beneficiary’s consent, to furnish in lieu of services offerings, according to Georgetown University Health Policy Institute.”

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(Source: Healthcare Finance News, January 5^th, 2023)