Representatives Ann McLane Kuster (D-NH), Brian Fitzpatrick (R-PA), Stephanie Murphy (D-FL), Tom MacArthur (R-NJ), and Donald Norcross (D-NJ) have introduced the Road to Recovery Act – bipartisan legislation that would eliminate the Medicaid Institutions for Mental Diseases (IMD) exclusion for substance use disorder and help states expand access to inpatient treatment for its enrollees.

The IMD exclusion is a long-standing policy that prohibits the federal Medicaid matching funds to states for services rendered to Medicaid-eligible individuals who are patients for SUD and mental health treatment. Some states – including Pennsylvania - have used an “in lieu of services” provision allowing for inpatient treatment, but with limitations on patient population, facility size, and length of stay.  These limitations disproportionately affect Medicaid beneficiaries.

“The opioid epidemic is devastating communities across New Hampshire and the country,” said Kuster, co-chair of the Bipartisan Heroin Task Force. “This is not a Republican or Democratic issue; it’s an American issue. I’m pleased to join my colleagues on both sides of the aisle to introduce this legislation, which will help the most vulnerable people struggling with substance use disorder get the treatment they need to begin the recovery process and move forward with their lives.”

“The ‘IMD exclusion’ blocks access to treatment for people who need inpatient treatment for addiction including some of society’s most vulnerable: veterans, pregnant addicted women, women with dependent children, and low-level drug offenders,” said Fitzpatrick, vice-chair of the Bipartisan Heroin Task Force. “This bipartisan bill will eliminate the IMD exclusion for substance use disorder and help states expand access to inpatient addiction services for Medicaid enrollees in a fiscally responsible manner while not intruding on a state’s flexibility to implement care.”

“Substance use disorder, especially opioid addiction, is a serious problem in central Florida, and I’m proud to work with my colleagues on both sides of the aisle to give more Americans access to life-saving treatment,” said Murphy. “Nearly 600 residents in Orange and Seminole counties died from drug overdoses in 2016 alone. Inpatient addiction services are an important tool for combatting the opioid epidemic, which is why allowing Medicaid to help us in this fight is so critical."

“New Jersey, especially South Jersey, has been devastated by opioid abuse, and a critical part of fighting this crisis is ensuring more Americans have access to life-saving treatment,” said MacArthur, co-chair of the Bipartisan Heroin Task Force.  “For the person struggling with addiction, it doesn't matter if a facility has 16 beds or 40 beds.  They need help and we should allow treatment at any available facility.  I’m grateful that my colleagues from both sides of the aisle have come together to help vulnerable Americans struggling with substance abuse. We must continue to fight for them and our communities.”

“We need our laws of yesterday to match the realities of today – and this simple, sensible bill will help us curb the current opioid epidemic,” said Norcross, vice-chair of the Bipartisan Heroin Task Force. “The soaring rise in deaths, fueled by heroin and prescription painkillers, now kills more Americans than car crashes, guns, terrorism or war. There is an outdated, unnecessary obstacle that prevents people from getting care when they need it and restarting their lives. We should take fast action, remove this barrier and help those suffering.”

Drug overdoses involving prescription opioids and heroin have nearly quadrupled since 1999 and are now the leading cause of accidental death. According to the US Department of Health and Human Services, substance abuse costs the country over $600 billion annually and based on conservative estimates, each dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When the return on investment is applied to healthcare costs, the total savings can exceed a ratio of 12:1.

Bill text available HERE

WHAT THEY’RE SAYING:

·         American Society of Addiction Medicine (ASAM): “On behalf of the American Society of Addiction Medicine (ASAM), the nation’s oldest and largest medical specialty society representing more than 4,300 physicians and allied health professionals who specialize in the treatment of addiction, I am writing to offer our support for your bill, the Road to Recovery Act, which would lift the Medicaid Institutions for Mental Diseases (IMD) exclusion for mental health and substance use disorder residential treatment facilities… ASAM thanks you for your leadership on this important issue. Repealing the IMD exclusion is critical to improving access to addiction treatment and we are pleased to endorse your legislation.” – Kelly Clark, MD, MBA, DFASAM, President

·         National Association of County and City Health Officials (NACCHO): “Local health departments are key players in connecting those seeking treatment with appropriate services. Removing barriers to treatment covered by Medicaid and CHIP will increase inpatient treatment access for substance use. Local health departments are on the frontlines of the opioid epidemic and support solutions along the prevention-treatment continuum. The focus here is treatment and ensuring there is access to treatment for the most vulnerable in our communities.” - Laura Hanen, Interim Executive Director

·         Addiction Policy Forum (APF): “At Addiction Policy Forum, we recognize that our country has a treatment gap, and we need to take significant steps to increase access. Representative Fitzpatrick's legislation addressing the IMD exclusion is the perfect example of an important, bipartisan effort that will do a great deal of good in the fight to treat those with substance use and mental health disorders. The removal of this barrier to treatment will, quite simply, save lives, fixing a decades old, arbitrary rule that limits patient access to treatment. We applaud Rep. Fitzpatrick, and all who support this bill for their effort to expand addiction treatment nationwide.” – Jessica Nickel, President and CEO

·         Partnership for Drug-Free Kids: “With 144 people dying from drug overdoses each day in our country, it is imperative that we remove every possible barrier to getting people the treatment that they need, including addressing the IMD exclusion, an antiquated law which makes it impossible for many institutions to provide substance use disorder treatment to Medicaid patients.  The fix for this problem is long overdue and is a necessary step to increase access to treatment services.” – Marcia Lee Taylor, President and CEO

·         American Academy of Emergency Medicine (AAEM): “Emergency physicians are on the front lines of the opioid epidemic and encounter patients every day dealing with substance use disorder. We are very concerned about the current misuse of prescription pain medications and the subsequent adverse health consequences. Our goal is to provide the most appropriate, highest quality medical care to our patients. By expanding access to inpatient treatment for substance use disorder we will increase our capacity to serve all patients in the emergency department” – Kevin Rodgers, MD FAAEM, President

·         NAADAC – the Association for Addiction Professionals: “The Road to Recovery Act is an important and long overdue piece of legislation that NAADAC fully supports. Removing the 16-bed limit on treatment facilities and the cap on length of stay are imperative steps for expanding access to and the effectiveness of impatient treatment for those living with substance use disorder and co-occurring disorders. The proposed legislation will allow residential treatment facilities to have increased funding available for all types of treatment, become more self-sustainable, increase the quality of their work, and ultimately save more lives.” – Cynthia Moreno Tuohy, Executive Director

·         Treatment Communities of America: "The IMD Exclusion is an antiquated policy that unjustly bars access to community based treatment for those in greatest need of care. TCA is pleased to support this bill to end this inequity and restore appropriate access to the full continuum of care." - Dr. Kathy Icenhower, President

·         Pennsylvania Attorney General Josh Shapiro: "Heroin and opioids are the number one public health and safety threat in Pennsylvania and we can’t arrest our way out of this epidemic – we need more access to treatment. I commend Representative Fitzpatrick, who worked with Pennsylvania law enforcement to craft this legislation, for being a leader in fighting this crisis. This bill will remove bureaucratic barriers to treatment so everyday Americans can get the help they need.”  

Other organizations supporting the Road to Recovery Act include:

·         Community Anti-Drug Coalition (CADCA)

·         American Medical Association (AMA)

·         America’s Health Insurance Plans (AHIP)

·         Healthcare Leadership Council (HLC)

·         Anthem

·         American College of Emergency Physicians (ACEP)

·         National Council on Alcoholism and Drug Dependence (NCADD)

·         Medicaid Health Plans of America (MHPA)

·         Association for Behavioral Health & Wellness (ABHW)

·         Association for Community Affiliated Plans

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