Bill Text: NJ ACR139 | 2018-2019 | Regular Session | Introduced
Bill Title: Requests President and Congress to take action to permit federal Medicaid funding for certain substance use disorder programs.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2018-02-08 - Introduced, Referred to Assembly Health and Senior Services Committee [ACR139 Detail]
Download: New_Jersey-2018-ACR139-Introduced.html
ASSEMBLY CONCURRENT RESOLUTION No. 139
STATE OF NEW JERSEY
218th LEGISLATURE
INTRODUCED FEBRUARY 8, 2018
Sponsored by:
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
SYNOPSIS
Requests President and Congress take action to permit federal Medicaid funding for certain substance use disorder programs.
CURRENT VERSION OF TEXT
As introduced.
A Concurrent Resolution respectfully requesting the President and Congress of the United States take action to permit federal Medicaid funding for certain substance use disorder programs.
Whereas, The Medicaid program is a federally supported health benefits program established in 1965 as Title XIX of the Social Security Act; and
Whereas, The federal government provides the authority and broad requirements under which each state creates and administers an individual Medicaid program which best meets the needs of that particular state. The federal and state government share the financing of Medicaid benefits through formulas established by the federal government; and
Whereas, In certain instances, the federal government prohibits certain benefits or services from being reimbursed by the federal Medicaid program and thus, if these benefits or services are provided by a state, the associated costs are entirely borne by that state; and
Whereas, Since the inception of Medicaid in 1965, the federal law has excluded financing for most care delivered in Institutions for Mental Diseases (IMD), commonly referred to as the IMD exclusion, which prohibits payments for the majority of Medicaid individuals, between the ages of 21 and 64, who are patients in an IMD; and
Whereas, Specifically, the law defines an IMD as a "hospital, nursing facility, or other institution of more than 16 beds" that, by its overall character, is a facility established and maintained primarily for the care and treatment of individuals with mental diseases; and
Whereas, The purpose of the IMD exclusion was to ensure that states, rather than the federal government, would be primarily responsible for funding inpatient psychiatric services; and
Whereas, Certain in-patient and out-patient rehabilitation and treatment programs for individuals afflicted with a substance use disorder are classified as IMDs because substance use disorder is recognized as a mental disease and is included as such in the International Classification of Diseases; and
Whereas, The federal Medicaid program has taken certain steps to permit states to be reimbursed for services provided to individuals who are afflicted with substance use disorder and receiving treatment in an IMD. For example, the federal Medicaid program adopted rules in July 2016 which allow certain Medicaid clients to receive certain substance use disorder treatment services in an IMD for up to 15 inpatient days; and
Whereas, The federal Medicaid program has also permitted states to apply for a waiver from the traditional Medicaid program requesting permission to expand services available for substance use disorder treatment and rehabilitation. New Jersey has requested expansion of reimbursable substance use disorder services in its waiver submission, the NJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal, which was submitted to the federal Department of Health and Human Services on January 6, 2017; and
Whereas, The waiver review process can be quite lengthy and requires a level of bureaucratic oversight that is important, but will result in the continued delay of needed substance use disorder rehabilitation and treatment programs for individuals who are desperately in need of such programs and who will continue to suffer and even die from their substance use disorders; and
Whereas, The President and Congress of the United States should take action to ensure that individuals with substance use disorders can access the needed in-patient and out-patient rehabilitation and treatment programs to assist these individuals in recovery from substance use disorder; and
Whereas, The actions the President and Congress of the United States could take include, but are not limited to: repealing the IMD exclusion; excluding substance use disorder from the definition of mental disease for the purposes of determining if a treatment facility is an IMD; and increasing the bed limit of the IMDs; now, therefore,
Be It Resolved by the General Assembly of the State of New Jersey (the Senate concurring):
1. The President and Congress of the United States are respectfully requested to take actions amending the provisions in the Medicaid program which prohibit federal reimbursement for certain in-patient and out-patient rehabilitation and treatment programs for individuals who are afflicted with substance use disorder.
2. Copies of this resolution, as filed with the Secretary of State, shall be transmitted by the Clerk of the General Assembly or the Secretary of the Senate to the President and the Vice-President of the United States, the Majority and Minority Leaders of the United States Senate, the Speaker and Minority Leader of the United States House of Representatives, every member of Congress elected from this State, and the Secretary of the United States Department of Health and Human Services.
STATEMENT
This concurrent resolution respectfully requests the President and Congress of the United States to take action amending the provisions in the Medicaid program which prohibit federal reimbursement for certain in-patient and out-patient rehabilitation and treatment programs for individuals who are afflicted with substance use disorder.
Since the inception of the Medicaid program in 1965, prohibitions have existed on the federal funding of services which are provided in an Institution for Mental Diseases (IMD), referred to as the IMD exclusion. As substance use disorder is classified as a mental disease, certain programs that provide in-patient and out-patient rehabilitation and treatment services for individuals who are afflicted with substance use disorder are not eligible for federal Medicaid reimbursement.
This has led to decreased access to these programs and is contributing to the substance use disorder epidemic that is gripping the nation and the State. The President and Congress of the United States could take certain actions to ameliorate these problems by modifying certain Medicaid provisions. Examples of these potential actions include, repealing the IMD exclusion, excluding substance use disorder from the definition of mental disease for the purposes of determining if a treatment facility is an IMD, and increasing the bed limit of the IMDs.
