This bill removes a long-standing rule that prevents Medicaid from paying for mental health and substance abuse treatment at certain types of facilities. Currently, Medicaid won't cover care at institutions that primarily focus on mental health treatment—a restriction known as the IMD (Institution for Mental Diseases) exclusion. This bill eliminates that blanket ban, allowing Medicaid to pay for mental health and addiction treatment services at these facilities, just like it does for other medical care.

The bill does include new requirements to make sure these mental health facilities meet quality standards. Institutions would need to follow nationally recognized, evidence-based standards for mental health programs and substance abuse treatment (like standards from the American Society of Addiction Medicine). They'd also need to meet requirements about the types of services offered, how many hours of clinical care they provide, and what qualifications their staff must have.

This change could significantly expand access to mental health and addiction treatment for Medicaid patients, since more facilities could now receive federal funding for this care. The bill also removes age restrictions that previously limited certain mental health services to people under 65. The changes would take effect 180 days after the bill becomes law.

Repealing the IMD Exclusion Act

Torres, Ritchie

Repealing the IMD Exclusion ActThis bill removes certain limitations relating to Medicaid coverage of services provided in institutions for mental diseases (IMDs).Current law generally prohibits federal payment under Medicaid for services provided in IMDs with more than 16 beds for individuals under the age of 65 (although states may receive payment through certain mechanisms, such as through a Medicaid demonstration waiver).The bill removes the age limitation and allows any institution to qualify as an IMD, regardless of the number of beds, if it primarily treats individuals with mental diseases and meets nationally recognized standards for mental health or substance use disorder programs, as approved by the Centers for Medicare &amp; Medicaid Services.