Medicaid

Click here for more information on the "Protecting the Medicaid Safety Net Act of 2008"

Ensuring Coverage for Drug and Alcohol Treatment Under Medicaid

The Legal Action Center supports policy changes to require Medicaid to finance drug and alcohol treatment.  Currently, because the service is optional, only about 25 states have opted to cover drug and alcohol treatment services under their Medicaid benefit.  The advantage of this policy change is that it would establish a more stable source of funding for treatment that is not discretionary and subject to the annual appropriations process.  Such stability would increase access to treatment for low-income individuals and families who presently rely on limited Substance Abuse Prevention and Treatment Block Grant and scarce discretionary funds to support treatment services.   

Repealing the IMD Exclusion

Additionally, LAC supports repealing the exclusion of Medicaid coverage for individuals with substance use disorders in community-based residential treatment facilities that are larger than 16 beds.  The IMD exclusion is a statutory provision that prohibits Medicaid from paying for institutional treatment for individuals between 22 and 64 who are diagnosed with mental diseases and receiving treatment in programs with more than 16 treatment beds.  While the purpose of the IMD exclusion - to prevent Medicaid funds from going to expensive mental hospitals - is wholly unrelated to cost-effective, community-based alcohol and drug residential programs, nonetheless the federal government has applied it to deny those programs access to Medicaid funding.  Therefore, in order for drug and alcohol treatment programs to receive Medicaid reimbursement, they must keep their residential programs at 16 beds or less.

Click here for more information on the IMD Exclusion. 

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