Repealing the IMD Exclusion Act in plain language
1: Short title
This section would let the Act be referred to by the name the Repealing the IMD Exclusion Act.
Show official text
1. Short title This Act may be cited as the Repealing the IMD Exclusion Act .
2: Removal of age exclusion from medical assistance of items and services for patients in an institution for mental diseases
This section would change the Medicaid law's definition of medical assistance in Section 1905(a) of the Social Security Act. Right now that definition excludes certain care from Medicaid coverage through two listed exclusions, marked (A) and (B), joined by the word or. This section would delete the second exclusion, marked (B), completely, and would fold the wording that introduced the first exclusion into the main sentence so the definition no longer needs subparagraph letters, ending that sentence with a period instead of the word or. The section's own heading describes the eliminated exclusion as the age exclusion for patients in an institution for mental diseases (an IMD). The section would also delete the phrase 65 years of age or older, or in one instance 65 years of age or over, from five other Medicaid provisions: the introductory wording and subparagraph (C) of Section 1902(a)(20), Section 1902(a)(21), Section 1905(a)(14), and Section 1919(e)(7)(B)(i)(I). Deleting that age phrase means each of those provisions would apply no matter whether a patient is 65 years of age or older. Taken together, and as the section's own heading states, the changes are meant to let Medicaid pay for care and services given to patients in an institution for mental diseases without regard to whether the patient is under 65 years of age.
Show official text
2. Removal of age exclusion from medical assistance of items and services for patients in an institution for mental diseases (a) In general Section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) ) is amended, in the first sentence, in the matter following paragraph (32)— (1) by striking such term does not include— and all that follows through (A) any and inserting such term does not include any ; (2) by striking ; or and inserting a period; and (3) by striking subparagraph (B). (b) Conforming amendments To permit medical assistance for IMD patients under 65 years of age Title XIX of the Social Security Act ( 42 U.S.C. 1396a et seq. ) is amended— (1) in section 1902(a)— (A) in paragraph (20)— (i) in the matter preceding subparagraph (A), by striking 65 years of age or older ; and (ii) in subparagraph (C), by striking 65 years of age or older ; and (B) in paragraph (21) by striking 65 years of age or older ; (2) in section 1905(a)(14), by striking 65 years of age or over ; and (3) in section 1919(e)(7)(B)(i)(I), by striking 65 years of age or older .
3: Required standards for IMDs
This section would replace the definition of institution for mental diseases in Section 1905(i) of the Social Security Act with a new definition. Under the new definition, an institution for mental diseases would mean a hospital, nursing facility, or other institution that meets two requirements. First, it must be primarily engaged in providing diagnosis, treatment, or care for people with mental diseases, including medical attention, nursing care, and related services. Second, it must meet nationally recognized, evidence-based standards for mental health programs, approved by the Secretary; if the institution also provides treatment for substance use disorders, it must separately meet nationally recognized, evidence-based standards for substance use disorder programs, such as the latest standards set by the American Society of Addiction Medicine. The standards approved by the Secretary must include standards on the types of services the institution offers, its hours of clinical care, and the staffing credentials required, and the Secretary may require any other standards as well.
Show official text
3. Required standards for IMDs Section 1905(i) of the Social Security Act ( 42 U.S.C. 1396d(i) ) is amended to read as follows: (i) Institution for mental diseases The term institution for mental diseases means a hospital, nursing facility, or other institution that— (1) is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services; and (2) meets nationally recognized, evidence-based standards for mental health programs (and, in the case of an institution for mental diseases that provides treatment for substance use disorders, meets nationally recognized, evidence-based standards for substance use disorder programs, such as the latest standards set forth by the American Society of Addiction Medicine), approved by the Secretary, including standards that establish the types of services offered, hours of clinical care, and staffing credentials for such an institution, and any other standards as the Secretary may require. .
4: Effective date
This section would make the changes made by this Act take effect 180 days after the date the Act becomes law, and states that they would apply to state Medicaid plans starting on that same date.
Show official text
4. Effective date The amendments made by this Act shall take effect 180 days after the date of enactment of this Act and shall apply to State plans beginning on such date.