DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
  
 
DATE:  March 15, 2012 
 
FROM:  Cindy Mann, Director 
  Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:  Medicaid and CHIP Updates 
 
This bulletin provides information on the following topics: 
  5010 Implementation Moratorium Period Extension 
  Approval of Nations First Balancing Incentive Program Grant Award 
  Award of Medicaid Emergency Psychiatric Demonstrations 
 
5010 Implementation Moratorium Period Extension 
 
This is a follow up to the announcement the Centers for Medicare & Medicaid Services (CMS) 
made on November 17, 2011, about enforcement discretion regarding compliance with new 
HIPAA standards for electronic health transactions. The prior informational bulletin on this topic 
is available at http://www.cms.gov/CMCSbulletins/downloads/CIB-HIPAA-11-17-11.pdf   
 
Today CMS  has announced a three month extension of the 90-day moratorium period allowing 
HIPAA covered entities (including State Medicaid programs) to exercise discretion in accepting 
and submitting both Version 4010 and Version 5010 electronic health transactions, as well as 
NCPDP Telecom 5.1 and D.0 for pharmacy transactions.  The compliance date for use of 
Version 5010, NCPDP D.0 and 3.0 by HIPAA covered entities remains January 1, 2012.  With 
this extension, the three month moratorium period now will begin on April 1, 2012 and will end 
on June 30, 2012.   
 
The announcement can be found at http://www.cms.gov/ICD10, under Latest News link.  
 
Approval of Nations First Balancing Incentive Program Grant Award 
 
On March 1, 2012, CMS approved the nations first Balancing Incentive Program grant award. The 
Balancing Incentive Program is authorized under section 10202 of the Affordable Care Act. This 
program offers $3 billion enhanced Federal matching dollars to support States in further developing 
community-based services and supports for people who need long-term care so those people can 
continue to live in the community instead of living in an institutional setting, like a nursing home.  CMCS Informational Bulletin  Page 2 
 
The New Hampshire DHHS Balancing Incentive Program, in partnership with community 
organizations throughout the state, plans to further develop the systems of community-based care 
that serve individuals with behavioral health needs, physical and/or intellectual disabilities. The 
goal of the New Hampshire Balancing Incentive Program is to increase the percentage of 
expenditures for LTSS that are provided in community settings to equal or exceed the 
expenditures for facility-based LTSS. We anticipate New Hampshire will spend approximately 
$26 million over the 3-year grant period. 
The press release for this award is located at: 
http://www.cms.gov/apps/media/press/release.asp?Counter=4296  
For more information about the Balancing Incentives Program, please refer to the letter issued to 
State Medicaid Directors on September 12, 2011, available at http://medicaid.gov/Federal-
Policy-Guidance/Federal-Policy-Guidance.html  
 
Award of Medicaid Emergency Psychiatric Demonstrations 
 
On March 13, 2012, CMS announced that 11 States and the District of Columbia will participate 
in the Medicaid Emergency Psychiatric Demonstration, established under the Affordable Care 
Act to help people who are experiencing a psychiatric emergency get immediate, appropriate 
care.   
 
This demonstration will provide up to $75 million in federal Medicaid matching funds over three 
years to 11 StatesAlabama, California, Connecticut, Illinois, Maine, Maryland, Missouri, 
North Carolina, Rhode Island, Washington, and West Virginia and the District of Columbia, to 
enable institutions for mental diseases (IMDs) to receive Medicaid reimbursement for emergency 
care provided to Medicaid enrollees aged 21 to 64 who have an acute need for treatment.   
 
The Demonstration will be administered by the Center for Medicare and Medicaid Innovation, which 
was created by the Affordable Care Act to test innovative payment and service delivery models that 
have the potential to reduce program expenditures while preserving or enhancing the quality of care. 
 
Additional information can be found here: innovations.cms.gov/initiatives/medicaid-emergency-
psychiatric-demo 
 
To read the full CMS Press Release issued: 
http://www.cms.gov/apps/media/press/release.asp?Counter=4300 
 
Also, the CMS Fact Sheet Additional information: 
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4301