[NYAPRS Enews] House Bill Would Allow States to Lift IMD Exclusion for SUD Inpatient Treatment

Fri Apr 24 10:26:48 EDT 2015

NYAPRS Note: Congressional members Ryan, Fudge and Kaptur have introduced ‘The Breaking Addiction Act’ that would allow the federal Health and Human Services Administration to accept state applications to waive the IMD exclusion as regards residential addiction treatment. Under that exclusion policy, inpatient facilities of over 16 beds have been considered institutions for mental diseases or IMDs and have not been eligible for federal Medicaid payments. The bill would specifically allow federal Medicaid reimbursements to states to treat a substance abuse condition in an IMD of not more than 60 beds.
This is significant in that unlike the vast majority of mental health services, many addiction recovery treatments are not Medicaid reimbursable.
On the other side, many advocacy groups like NYAPRS continue to oppose lifting the IMD exclusion for mental health intuitions since doing so would essentially bring Medicaid reimbursement into state psychiatric hospitals and private for profit hospitals for the first time.
Encouraging states to rebuild or expand state hospital facilities puts the incentives in the wrong place and is contrary to national efforts to adequately fund and deploy an adequate array of high response community based mental health recovery services. Private for profit psychiatric hospitals already take Medicaid managed care reimbursement, a funding stream that is growing exponentially as states move their behavioral health services into managed care designs.

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FOR IMMEDIATE RELEASE

Thursday April 23, 2015

Contact: Michael Zetts

202.225.5261<tel:202.225.5261>

Reps. Tim Ryan, Marcia Fudge, and Marcy Kaptur Announce Introduction of the Breaking Addiction Act of 2015

Washington, DC – Representative Tim Ryan (OH-13), Marcia L. Fudge (OH-11), and Marcy Kaptur (OH-9) today introduced H.R. 1988, the BREAKING ADDICTION ACT OF 2015. This legislation addresses a significant barrier to accessing inpatient treatment as our nation grapples with an epidemic of heroin and opiate related deaths.  Further, it increases states’ flexibility under their Medicaid programs to cover treatment for substance use disorders (SUDs) in expanded or additional community-based facilities.

Under current federal law, a section of the Medicaid statute, known as the institutions for mental diseases (IMD) exclusion, prohibits Medicaid matching payments for services provided in treatment facilities that have more than 16 beds.  The Breaking Addiction Act directs the Secretary of Health and Human Services (HHS) to accept applications to waive the IMD exclusion from states that seek to provide comprehensive addiction treatment in their jurisdictions.  The bill would specifically facilitate reimbursements to states that cover medical assistance to treat an SUD in an IMD of not more than 60 beds.

“Each day I turn on the news and hear another devastating story about a life taken too soon because of heroin or prescription drug abuse. As a country, we must do more to ensure these men and women get the access to the care that is desperately needed, and that means taking a hard look at our current treatment structure. That is why I am proud to join Congresswoman Fudge in introducing the Breaking Addiction Act, which addresses the growing drug crisis and increases access to addiction treatment. Not another day should go by that a person can’t find help due to this outdated system. As Democratic Co-Chair of the Addiction, Treatment and Recovery Caucus, I will continue to urge my congressional colleagues to move this legislation forward and help stem this harmful slide,” said Congressman Ryan.

“Only one out of nine Americans who suffers from substance abuse gets treated.  Many of these individuals sought care, but were turned away due to a lack of treatment beds.  In 2014, 252 heroin-related deaths occurred in Cuyahoga and Summit Counties.  This is unacceptable.  The Breaking Addiction Act provides the means to save lives in a responsible manner and it does so without adding to the federal deficit,” said Congresswoman Fudge.

“Drug addiction is a debilitating disease, and the people who suffer from it deserve the same standard of care available to anyone else who gets sick in this country,” said Congresswoman Kaptur. “This legislation is urgently needed as rates of heroin overdose, prescription drug abuse and other forms of addiction are rising at an alarming rate, especially in our region. This budget-neutral approach rises to meet that need by expanding access to mental health treatment and allowing mental health facilities to expand without losing federal support. Members of our community are suffering. This would help them break the cycle of addiction and make our health care system work better for everyone. Let’s get it done.”

The Breaking Addiction Act of 2015 replaces and updates legislation introduced by Reps. Fudge and Ryan in 2014.  By utilizing waivers that are required to be budget neutral to the federal government, this bill is not only cost efficient but is also expected to result in savings due to system wide reductions in the cost of untreated addiction.

See a list of frequently asked questions about the legislation here.<http://timryanforms.house.gov/Components/Redirect/r.aspx?ID=468884-40304374>

Click here to read the text<http://timryanforms.house.gov/Components/Redirect/r.aspx?ID=468885-40304374> of the bill.

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Michael Zetts
Press Secretary
Rep. Tim Ryan (OH-13)
Office: 202.225.5261<tel:202.225.5261>
Mobile: 330.398.2569<tel:330.398.2569>

NOTE: Please DO NOT respond to this email as this inbox is unattended. To contact my office please click here<http://timryanforms.house.gov/Components/Redirect/r.aspx?ID=468886-40304374>

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