Bill to Expand Bed Limit of Residential SUD Treatment Reintroduced in the Senate
A new bill in the Senate would modify existing Medicaid payment prohibitions and expand the bed limit for residential treatment facilities serving persons with substance use disorders. Known as the “Institutes of Mental Disease (IMD)” exclusion, this payment exclusion prevents Medicaid from providing federal matching funds for services provided in residential substance use settings with more than 16 beds, hindering patients’ access to care. Similar legislation was introduced in the last Congress but was never voted on.
The Medicaid Coverage for Addiction Recovery Expansion (CARE) Act – introduced by Senators Dick Durbin (D-IL), Rob Portman (R-OH), Sherrod Brown (D-OH), Shelley Moore Capito (R-WV), Angus King (I-ME) and Susan Collins (R-ME) – would increase the bed limit in these settings from 16 to up to the first 40 beds in a facility, greatly expanding the number of facilities capable of servicing this population. The Medicaid CARE Act would allow facilities to offer treatment services for up to 60 consecutive days.
“The opioid epidemic impacts every community across Illinois and the U.S. – urban, suburban, and rural. And every day, 91 people die from an opioid overdose. But we can help. By offering treatment for people suffering from addiction – rather than simply arresting them or turning them away from help – we can reduce crime, improve health, and save lives,” said Senator Durbin. “Unfortunately, as the result of a decades-old Medicaid policy, I’ve seen patients wait for weeks on end to desperately access care. The Medicaid CARE Act is a vital piece of legislation that builds off gains made from the Affordable Care Act’s Medicaid expansion and would help save the lives of so many individuals currently in the throes of addiction.”
The bill allows individuals receiving addiction treatment in an IMD facility to maintain Medicaid coverage for other medical services, which are currently ineligible under the IMD Exclusion. In Illinois, the most recent data available indicates that the Medicaid CARE Act would expand access to more than 535 residential addiction treatment beds across 18 facilities that are larger than the 16 bed limit and therefore presently ineligible for Medicaid payments.
The legislation also establishes a new $50 million youth inpatient addiction treatment grant program to fund facilities that provide substance use disorder treatment services to underserved, at-risk Medicaid beneficiaries who are younger than age 21, with an emphasis on rural communities. In addition, the bill would increase flexibility for pregnant and postpartum women who are seeking treatment, and would allow them to access the services they need to ensure positive birth outcomes.
The National Council fully supports this legislation and is working closely with Senator Durbin’s office to see it through to passage.