Senators argue changes to outdated Medicaid rules necessary in response to worsening opioid addiction epidemic

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WASHINGTON – U.S. Senators Dick Durbin (D-IL) and Susan Collins (R-ME) today led a bipartisan group of 29 senators urging the Centers for Medicare and Medicaid Services (CMS) to improve access to substance abuse treatment by amending the Institutions for Mental Disease (IMD) Exclusion. In a letter to CMS Acting Administrator Andy Slavitt, the senators asked the agency to further expand covered services to include substance abuse treatment in all medically necessary care settings in response to America’s worsening opioid addiction crisis. Under existing CMS policy, Medicaid prohibits reimbursement to states for services provided by IMDs, including residential addiction treatment facilities with over 16 beds, dramatically limiting options for patients seeking substance abuse treatment.  

“America is in the grip of a heroin and prescription opioid epidemic that has revealed barriers that patients face when trying to access life-saving care.  Improved understanding of addiction pathologies has also informed novel therapies, and patients with SUDs can now manage addiction and reach recovery using mediation-assisted treatments,” said Durbin. “There are numerous Congressional efforts underway seeking to address this issue, but we strongly urge CMS to use existing authorities to broaden treatment opportunities, such as by removing SUD treatment and facilities from the IMD Exclusion.”

The letter was also signed by Senators Patty Murray (D-WA), Lisa Murkowski (R-AK), Barbara Mikulski (D-MD), Shelley Moore Capito (R-WV), Sherrod Brown (D-OH), Kelly Ayotte (R-NH), Angus King (I-ME), Rob Portman (R-OH), Chris Murphy (D-CT), Mark Kirk (R-IL), Maria Cantwell (D-WA), Barbara Boxer (D-CA), Ben Cardin (D-MD), Bob Casey (D-PA), Bob Menendez (D-NJ), Diane Feinstein (D-CA), Jeanne Shaheen (D-NH), Richard Blumenthal (D-CT), Ed Markey (D-MA), Jeff Merkley (D-OR), Elizabeth Warren (D-MA), Kirsten Gillibrand (D-NY), Heidi Heitkamp (D-ND), Amy Klobuchar (D-MN), Claire McCaskill (D-MO), Al Franken (D-MN), and Cory Booker (D-NJ).

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