Institutions for Mental Diseases Exclusion


We must prevent laws that promote over-reliance on institutional care for treatment.

In April 2018, the Health Subcommittee of the House Energy and Commerce Committee considered a bill to lift long-standing restrictions on using Medicaid funds for inpatient services in psychiatric institutions called Institutions for Mental Diseases (IMDs).  Although the bill was aimed at combating substance use disorders, it requires states to fund unnecessary institutional care at the expense of expanding critical community-based mental health services. CPR sent a letter opposing the bill. We were particularly concerned about the bill’s requirement that states keep at least the same number of IMD inpatient beds and institutional funding regardless of need. The bill did not include the same requirement to invest in funding community services.  The current bill, H.R. 5797, does not include all of the same provisions, but still expands coverage for institutional services without addressing gaps in community services. The Senate Finance Committee also considered, has not yet not voted on, a proposal to alter the IMD payment exclusion.

We will keep you updated on what you can do to stop these bills from allowing institutional bias in Medicaid services to be adopted as part of the fight against opioid abuse.  

Additional Resources

House Bill Partially Repealing “IMD Exclusion” Would Do More Harm Than Good, Center on Budget and Policy Priorities (6/20/18)

Congress Needs a Broader Approach to Address Opioid Epidemic, OpEd, The Hill (6/10/18)

Consortium for Citizens with Disabilities (CCD) Letter Opposing the Bill

Repealing Medicaid Exclusion for Institutional Care Risks Worsening Services for People With Substance Use Disorders, Center on Budget and Policy Priorities

Policy Implications of Repealing the IMD Exclusion, National Health Law Program

Bazelon Center for Mental Health Law Letter Opposing the Bill (4/19/18)


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