NAMI Excited with New Opportunities to Improve Medicaid Mental Health Care (IMD)

Nov 13, 2018

Secretary Alex Azar, U.S. Health & Human Services, announced that the Administration will allow states to apply for Medicaid waivers to pay for mental health treatment in inpatient settings known as IMDs, or institutions of mental disease. Historically, Medicaid has not paid for treatment in these settings for most adults. While this policy was intended to reduce inhumane institutionalization, it also resulted in unequal coverage of mental health and, tragically, a lack of appropriate options for people with severe mental health conditions.  If we treated other chronic conditions this way, far more people would die from diabetes, epilepsy, hypertension and heart disease.

On September 12^th, NAMI and 11 of our colleagues on the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) sent a letter to Administrator Seema Verma of the Centers for Medicare & Medicaid Services, calling for Medicaid to cover care provided in inpatient settings, or IMDs and strengthen quality and continuity of care to community services. The ISMICC letter also asked for greater flexibility to pay for evidence-based outpatient services to reduce reliance on hospitalization, such as Coordinated Specialty Care in early psychosis programs and Assertive Community Treatment (ACT) teams. We are so pleased that our recommendations were well received and are being implemented. These changes will make a positive impact on people living with severe mental illness.

“This is a landmark day for people living with severe mental illness and their families,” according to Mary Giliberti, NAMI’s CEO. “ISMICC played a key role in changing the paradigm from neglect to one of care and compassion for the millions of children, youth and adults of all ages who live with severe mental illness in America. We’re grateful that the Administration listened and provided the flexibility and direction for states to improve access to continuity of care for millions of Americans and their families.”

NAMI applauds CMS for issuing a detailed letter to State Medicaid Directors that not only allows greater flexibility for inpatient treatment in IMDs, it also takes heartening steps to encourage states to improve outpatient services, including crisis stabilization programs. Today’s guidance could provide a shot in the arm to mental health care. NAMI strongly urges states to step up to the plate and use this flexibility from CMS to improve care for people with mental health conditions.