American Society of Addiciton Medicine

ASAM Sends Letters of Support for Bills to Repeal the IMD Exclusion

Removing Barriers to Medicaid and CHIP Addiction Treatment Act

Medicaid Coverage for Addiction Recovery Treatment Act

 

ASAM sent letters of support for the Removing Barriers to Medicaid and CHIP Addiction Treatment Act, introduced by Rep. Brian Fitzpatrick (PA-08), and the Medicaid Coverage for Addiction Recovery Treatment Act, introduced by Senators Durbin (IL), Portman (OH), Brown (OH), Collins (ME), Capito (WV), Manchin (WV), King (ME), and Booker (NJ) . 

These bills would work to repeal the Medicaid Institutions for Mental Diseases (IMD) exclusion for mental health and substance use disorder residential treatment facilities. The IMD exclusion is a statutory provision enacted in 1965 at the creation of Medicaid. The exclusion was created in an effort to avoid burdening Medicaid with financing care in large non-federal facilities and to avoid having federal dollars pay for long-term treatment or “warehousing” of patients with mental disorders in state hospitals or nursing homes.

At its inception, the IMD exclusion was well intended, but as evidence-based treatment for addiction has progressed and become available, the provision now serves as a major obstacle for patients by denying coverage for treatment except in hospitals with fewer than 16 psychiatric beds.