Institutions for Mental Diseases Exclusion


On April 25, 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 is aimed at combating substance use disorders, it also would require 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. It does not have the same requirement to invest in funding community services.  The bill could result in over-reliance on institutional care for treatment and undermine state efforts to expand community-based services that prevent people from needing inpatient care in the first place and helps them transition back to the community.  The bill passed the Subcommittee by a vote of 16-10.  We will keep you updated on what you can do to stop these bill from allowing institutional bias in Medicaid services to be adopted as part of the fight against opioid abuse.

Additional Resources

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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