Bipartisan legislation was introduced in the House by U.S. Representatives Brian Fitzpatrick (R-PA), Stephanie Murphy (D-FL), Tom MacArthur (R-NJ), Ann McLane Kuster (D-NH) and Donald Norcross (D-NJ) to address IMD exclusion.
Medical Institutions for Mental Disease (IMD) exclusion is a serious barrier for individuals who are in need of mental health and substance use disorder treatment. Under the current policy, IMD exclusion prohibits Medicaid from covering patients 22-64 years old in residential mental health or substance use disorder treatment facilities that have more than 16 beds.
The Road to Recovery Act [H.R. 2938] will enable states to expand access to inpatient treatment for individuals with substance use disorders, while removing the barriers set forth by the Medicaid Institutions for Mental Disease (IMD) exclusion policy. This bill will remove the 16-bed limit for all accredited treatment facilities, regardless of their size and will allow Medicaid to cover individuals under the age of 65.
In addition, this bill requires periodic reviews, no less than every 60 days, to ensure individuals needs and services are met. This provision ensures there is no limit to length of time in which an individual can stay in treatment and allows patients to receive a treatment plans that best meets their needs. The bill also allows states to set standards on how to implement care based on the needs of their constituents.
“The ‘IMD exclusion’ blocks access to treatment for people who need inpatient treatment for addiction including some of society’s most vulnerable: veterans, pregnant addicted women, women with dependent children, and low-level drug offenders,” said Representative Fitzpatrick, vice-chair of the Bipartisan Heroin Task Force. “This bipartisan bill will eliminate the IMD exclusion for substance use disorder and help states expand access to inpatient addiction services for Medicaid enrollees in a fiscally responsible manner while not intruding on a state’s flexibility to implement care.”
Read the full bill here.
Read the press release here.
Watch Rep. Fitzpatrick discuss the bill here.
Thank these Members of Congress for introducing such important legislation!