New Bill Seeks Increased Access to Medicaid Addiction Treatment

June 2017 ~

A new bill has been introduced to the Senate that seeks to increase Medicaid addiction treatment access by modifying existing laws to allow more substance abuse treatment centers to receive Medicaid payments.

The new bill, titled Medicaid Coverage for Addiction Recovery Expansion (CARE) Act [S.1169], would modify existing the Medicaid payment prohibitions, known as the Institutes of Mental Disease (IMD) exclusion, and expand the bed limit for residential treatment facilities serving persons with substance use disorders.

Enacted in 1965, the IMD exclusion was implemented as a means to discourage the long-term institutionalization of those with mental illness. Presently, the IMD exclusion prevents Medicaid from providing federal matching funds for services provided in residential substance use settings with more than 16 beds, which often leads to delayed or blocked access to care. Supporters of the CARE Act say the IMD exclusion is now outdated and has proven to be a barrier to treatment and advocate that the new bill will remove these barriers and boost addiction treatment services to help fight the heroin and prescription opioid epidemic.

If passed, the CARE Act would increase the bed limit for residential treatment facilities serving persons with substance use disorders from 16 to no more than 40, and would also allow facilities to offer treatment services for up to 60 consecutive days.

The CARE ACT would also establishes a new $50 million youth inpatient addiction treatment grant program to fund facilities that provide substance use disorder treatment services to underserved, at-risk Medicaid beneficiaries who are younger than age 21, with an emphasis on rural communities. The bill also seeks to increase flexibility for pregnant and postpartum women who are seeking treatment, and would allow them to access the services they need to ensure positive birth outcomes.

The bill is currently co-sponsered by nine U.S Senators (Sen. Portman, Rob-OH, Sen. Brown, Sherrod-OH, Sen. Capito, Shelley Moore-WV, Sen. King, Angus S., Jr.-ME, Sen. Collins, Susan M.-ME, Sen. Manchin, Joe, III-WV, Sen. Booker, Cory A.-NJ, Sen. Warren, Elizabeth-MA, Sen. Hassan, Margaret Wood-NH) and has received full endorsement from the National Council for Behavioral Health, Treatment Communities for America and Mental Health America.

Source(s): Leavitt Partners; Modern Healthcare; Congress.gov; National Council for Behavioral Health; U.S. News;