fah hospital policy blog

Perspectives on health policy affecting America’s hospitals and the patients we serve.

Coalition Asks Key Committee to Support Limited Repeal of IMD Exclusion

May 16, 2018 | FAH Policy Blog Team

Category: General, Medicaid

FAH joined a coalition of other care providers in asking leaders of the House Energy and Commerce Committee to include in their legislative effort to combat the opioid epidemic a bill entitled “The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries with Substance Use Disorder Act.”

This bill would improve access to needed substance use disorder (SUD) treatment services for millions of Americans.

Since 1965, the Institutions for Mental Diseases (IMD) exclusion has prohibited federal payments to states for services for adult Medicaid beneficiaries between the ages of 21 and 64 who are treated in facilities that have more than 16 beds, and that provide inpatient or residential behavioral health – SUD and mental illness – treatment. The discriminatory IMD policy was established at a time when SUDs were not considered medical conditions on the same level as physical health conditions. Today, we know that SUD is a brain disease and that successful treatment requires access to the full continuum of care – namely, inpatient care, partial hospitalization, residential treatment and outpatient services.

The coalition sent a letter to E&C leaders that states, “Different types of patients require different clinical services from across the care continuum. The IMD exclusion currently excludes critical elements of that care continuum…Investing only in outpatient care and failing to provide states with relief from the IMD exclusion would continue to deny many of these patients access to the most clinically appropriate care.”

The letter, which can be found here, was signed by FAH, AHA, America’s Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States, National Association for Behavioral Healthcare, Premier healthcare alliance and Vizient, Inc.