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Audit of Certified Community Behavioral Health Clinics Medicaid Reimbursement and Compliance With Demonstration Requirements

Announced on  | Last Modified on  | Project Number: OAS-25-06-109
Status
Active
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

Certified Community Behavioral Health Clinics (CCBHCs) provide whole-person, team-based care addressing both behavioral and physical health needs. They are required to offer a broad range of services, including crisis mental health care, case management, and integrated physical health screening. Section 223 of the Protecting Access to Medicare Act of 2014 authorized the creation of a demonstration program for CCBHCs. States participating in the CCBHC demonstration receive Federal funds at the enhanced Federal medical assistance percentage (FMAP) for qualifying expenditures and are required to implement standardized certification and payment structures for CCBHCs. We will determine whether select States participating in the CCBHC demonstration program claimed expenditures that were eligible for the enhanced FMAP and whether select CCBHCs provided the services required to receive Medicaid payments.

TIMELINE

  • November 17, 2025
    Announced
  • Today
    Office of Audit Services In-Progress
  • Est FY2027
    Estimated Fiscal Year for Project Completion
Work Plan Type
Office of Audit Services
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Financial Stewardship Mental Health Non-institutional care
Target Groups
-
Financial Groups
Medicaid