May 19A group of senators, including Shelley Moore Capito, R-W.Va., introduced legislation Wednesday to expand access to substance abuse treatment for tens of thousands of Medicaid beneficiaries across the country.
The Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act would increase addiction treatment services to help combat the heroin and prescription opioid epidemic by modifying the Medicaid Institutions for Mental Disease (IMD) Exclusion a policy created in 1965 limiting Medicaid coverage for substance abuse treatment to facilities with less than 16 beds.
This policy was created to discourage the mass warehousing of those with mental illness, but as understanding and treatment options for addiction have improved, this rule proves to be outdated and poses barriers to treatment.
The Medicaid CARE Act would expand Medicaid coverage to pay for up to 40 treatment beds at larger substance abuse treatment facilities.
"West Virginia has been hit hard by the opioid epidemic," Capito said in a release. "It's a crisis that affects families and communities across our state, and we need to make sure all West Virginians have access to critical treatment and rehabilitation resources."
She said the Medicaid CARE Act will help ensure individuals struggling with addiction have the care they need to fight and overcome it.
A release from Capito's office said the IMD Exclusion violates substance use disorder treatment parity requirements by unfairly discriminating against Medicaid beneficiaries. This policy is no longer justified, and stakeholders, such as the Surgeon General and National Governors Association, agree that this policy poses a burden to care.
Under the bill, the IMD Exclusion would be modified to allow Medicaid coverage for up to 40 beds in appropriately accredited "residential addiction treatment facilities" for up to 60 consecutive days for adults with substance use disorders.
The bill allows individuals receiving addiction treatment in such a facility to maintain Medicaid coverage for other medical services, which are currently ineligible under the IMD Exclusion.
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 bill is also sponsored by Dick Durbin, D-Ill.; Rob Portman, R-Ohio; Sherrod Brown, D-Ohio; Angus King, I-Maine; and Susan Collins, R-Maine.
U.S. Rep. Bill Foster, D-Ill., will be introducing the House companion version of this bill. It is endorsed by the National Council for Behavioral Health, Treatment Communities for America, Mental Health America, National Association of City and County Health Officials, Commission on Accreditation for Residential Facilities and Joint Commission.
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