CMS Chief Brooks-LaSure: Pressing State Medicaid Programs to Cover New Mental Health Innovations Is Crucial

Federal health care leader Chiquita Brooks-LaSure is encouraging digital health entrepreneurs to press state-level regulators to have Medicaid cover innovative behavioral health products and services.

Speaking on Wednesday, Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services (CMS), also said states need to take a broader view of how health care is delivered to capture the impact of innovation.

“[State Medicaid programs] have requirements from us to cover mental health services, but they have a lot of flexibility to cover new ways and new approaches,” Brooks-LaSure said. “It’s so crucial to really engage with the states to make sure they’re aware of new types of initiatives and really press for those things to be covered in Medicaid and CHIP programs.”


Brooks-LaSure made these remarks during a pre-recorded appearance at the 2022 Going Digital: Behavioral Health Tech conference.

Medicaid and the Children’s Health Insurance Program (CHIP), the Medicaid program for children, are jointly funded by the federal and state governments, but administered by states.

The opportunity to serve government health plans or their members directly is significant considering the reach of these programs.


As of February, the Medicare and CHIP programs provided health benefits for 87.4 million people, an increase of 24% since February 2020, according to the latest data from CMS.

CMS oversees the health benefits of about 146.7 million people through Medicaid, CHIP and Medicare, the federal health plan for seniors. Medicare covered about 64.3 million people as of February. These three programs cover about 44% of the American population.

In 2020, Medicare and Medicaid accounted for about $1.5 trillion of the total national health care expenditure, about 36% of the estimated $4.1 trillion spent.

Specific to behavioral health, public funds from state and federal programs including Medicare and Medicaid are estimated to account for about 64% of spending on mental health and substance use disorder treatment — $179.4 billion out of $280.5 billion, according to a report from the Substance Abuse and Mental Health Services Administration.

Brooks-LaSure pointed out that much of the innovation on the regulatory front comes through waiver programs. These waivers give state Medicaid programs permission to go beyond the specific limitation of the Medicaid program to test new approaches if they so choose.

“It has authority to do things differently in the Medicare and Medicaid program,” Brooks-LaSure said, of waiver and innovation programs at CMS.

She also reiterated CMS’ interest in engaging with health care stakeholders, a pillar of the agency’s strategic vision.

“We know you’re the ones actually delivering care,” Brooks-LaSure said. “We just really encourage you to give us feedback on the policies that we’re implementing.”

The behavioral health space is one where CMS sees significant opportunities for improvement. 

Tequila Terry, group director of state innovation and prevention and population health at the Center for Medicare & Medicaid Innovation (CMMI), part of CMS, said at the Behavioral Health Business event VALUE: “I think there is an opportunity to bring both the public sector and the private sector together to coordinate, align and to identify improvement opportunities.”

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