Repealing the IMD Exclusion Act
Sponsored By: Representative Torres (NY)
Introduced
Summary
Removes the age 65 exclusion that bars Medicaid coverage for care in institutions for mental diseases (IMDs). The bill would let Medicaid cover IMD-related items and services for people under 65 and would set national, evidence-based standards that IMDs must meet to receive Medicaid payments.
Show full summary
- Adults under 65 with mental illness or substance use disorders could receive Medicaid-covered services in hospitals, nursing facilities, or other IMDs.
- State Medicaid plans would begin applying the change 180 days after enactment, making IMD-related items and services available under state plans subject to plan rules.
- IMDs seeking Medicaid participation would need Secretary-approved, nationally recognized, evidence-based standards for mental health programs and for substance use disorder programs, for example standards from the American Society of Addiction Medicine.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Medicaid coverage for under-65 mental care
If enacted, Medicaid would be able to cover items and services provided in institutions for mental diseases (IMDs) for people under 65. The bill would remove age-based exclusions in several Medicaid rules and let States claim federal matching funds for those services. Medicaid would only cover IMD services if the facility meets national, evidence-based standards approved by the Secretary. Standards must include the types of services, hours of clinical care, and staffing credentials, and SUD programs must meet recognized standards such as those from the American Society of Addiction Medicine. These changes would take effect 180 days after enactment and apply to State Medicaid plans starting then. This would likely lower out-of-pocket costs for some patients but would also risk reducing the number of qualifying facilities or raising provider costs.
Sponsors & CoSponsors
Sponsor
Torres (NY)
NY • D
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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