Reentry Services for Incarcerated Individuals
Formerly incarcerated individuals with physical and mental health conditions and substance use disorders (SUDs) typically have difficulty succeeding upon reentry because of obstacles present immediately at release, such as high rates of poverty and/or high risk of poor health outcomes. Without access to affordable health care services post-release, individuals who were formerly incarcerated often do not seek outpatient medical care, including needed SUD or mental health treatment and are at significantly increased risk for emergency department (ED) use and hospitalization. Individuals reentering the community from correctional facilities are also at a greater risk of overdose death as compared to the general population, especially in the first two weeks post-release.
Incarceration status does not render an individual ineligible for Medicaid, as it is not a factor of eligibility. Individuals who are held involuntarily in a public institution may be eligible for and enrolled in Medicaid, but federal Medicaid funds may not be used to pay for services for such individuals while they are incarcerated, except when they are inpatients in a medical institution as provided in paragraph (A) following the last paragraph of section 1905(a) of the Act, often referred to as the inmate payment exclusion.
The Centers for Medicare & Medicaid Services (CMS) has been engaged in several Congressionally mandated actions aimed at improving care transitions for certain individuals who are soon-to-be former inmates of a public institution and who are otherwise eligible for Medicaid and the Children’s Health Insurance Program (CHIP). CMS believes that provision of pre-release services to eligible individuals who are incarcerated may not only improve the health and reentry outcomes of individuals who are leaving carceral facilities but may also benefit the Medicaid program and society at large through potential reduced drug-related deaths, decreased use of EDs and hospitalizations, and reductions in health disparities experienced by people of color.
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