Repealing the IMD Exclusion Act
Sponsored By: Representative Torres, Ritchie [D-NY-15]
Introduced
Summary
Allows Medicaid to pay for care in institutions for mental diseases for adults under 65. The bill would end the age-based ban and create national, evidence-based standards for those institutions, with rules taking effect 180 days after enactment.
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- Adults with serious mental illness and people needing addiction treatment: Could gain Medicaid-covered access to inpatient mental health and substance use services that were previously excluded for those under 65.
- State Medicaid programs: Would be able to claim federal payments for IMD services and must apply the new qualifying standards. The changes apply to State plans beginning 180 days after enactment.
- Hospitals, nursing facilities, and other IMDs: Must meet nationally recognized, evidence-based standards approved by the Secretary. Standards must cover services offered, hours of clinical care, staffing credentials, and any other required elements. Substance use programs must meet standards such as those from the American Society of Addiction Medicine.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
More Medicaid coverage for IMD care
If enacted, Medicaid would be able to pay for services provided in institutions for mental diseases (IMDs). Adults under 65 on Medicaid would become eligible for IMD coverage because age-based bans would be removed. The statutory exclusion for IMD payments would be deleted. The amendments would start 180 days after enactment and apply to State plans on that date.
New quality rules for mental health facilities
If enacted, the bill would redefine an institution for mental diseases to include hospitals, nursing facilities, or other institutions primarily engaged in treating mental illness. IMDs would have to meet nationally recognized, evidence-based mental health standards approved by the Secretary. If an IMD treats substance use disorders, it would need nationally recognized SUD standards such as those from the American Society of Addiction Medicine. Standards would cover services offered, hours of clinical care, and staff credentials. These rules would take effect 180 days after enactment.
Sponsors & CoSponsors
Sponsor
Torres, Ritchie [D-NY-15]
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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