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1 1 (August 3, 2023)

handle is hein.crs/govemkz0001 and id is 1 raw text is: S Congressional ____ ~ Research Service Expiration of 1915(1) Medicaid State Plan Option August 3, 2023 Background Medicaid is a joint federal-state program that finances the delivery of primary and acute medical services, as well as long-term services and supports, for a diverse low-income population, including children, pregnant women, adults, individuals with disabilities, and people aged 65 and older. Medicaid's institutions for mental diseases (IMD) exclusion limits the circumstances under which federal Medicaid funding to states is available for inpatient behavioral health care. Policymakers have concerns about the effects of this exclusion on access to behavioral health care, and recent enacted laws and federal guidance have amended the IMD exclusion. One of the amendments to the IMD exclusion is a provision in the Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act; P.L. 115-271), which added a Medicaid state plan option to allow for federal Medicaid funds to be used for patients at IMDs with substance use disorder (SUD). This Medicaid state plan option is set to expire on September 30, 2023. What Is the IMD Exclusion? The IMD exclusion is a long-standing policy under Medicaid that prohibits the federal government from providing federal Medicaid funds to states for services rendered to Medicaid-eligible individuals aged 21- 64 who are patients in IMDs. IMD is defined as a hospital, nursing facility, or other institution of more than 16 beds, that is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services. For the definition of IMDs, the term mental disease includes SUD. Congressional Research Service https://crsreports.congress.gov IN12212 CRS INSIGHT Prepared for Members and Committees of Congress

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