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Medicaid Emergency Psychiatric Demonstrations
Background
News

In November 2015, Congress approved and sent to the President legislation to extend and expand the “Medicaid Emergency Psychiatric Care Demonstration,” which is a top NAPHS priority. On December 11, 2015, President Obama signed into law S.599, which became  P.L.114-97 extending the Medicaid Emergency Psychiatric Demonstration Project

 

The original three-year demonstration began in July 2012, when 11 states and the District of Columbia began implementing the NAPHS-backed Medicaid Emergency Psychiatric Demonstration. The demonstration allowed states selected in March 2012 to cover patients in freestanding psychiatric hospitals and to receive federal Medicaid matching payments for patients ages 21 through 64. The goal of the demonstration is to expand the number of emergency inpatient psychiatric care beds available in communities.
 
The Medicaid Emergency Psychiatric Demonstration has had widespread support (from groups ranging from NAMI to the Emergency Nurses Association) as a way to address a pressing need. The Medicaid program is a vital source of support for people with mental disorders, funding more than 50% of state and local spending on mental health services.  Non-governmental community-based psychiatric hospitals could help relieve this access problem; however, due to a Medicaid statutory provision called the Institution for Mental Disease (IMD) exclusion, patients receiving care in these hospitals are not covered for their care if the patients are between the ages of 21-64 and the hospitals cannot get Medicaid federal matching payments for these services.
 
This demonstration presents a solution. In a June 1, 2009, Government Accountability Office (GAO) report (GAO-09-347) on hospital emergency departments, it was reported that difficulties in transferring, admitting, or discharging psychiatric patients from the emergency department were a factor contributing to emergency department overcrowding.
 
The demonstration is creating positive change, and it can save money. 

9/30/2016

CMS: "Medicaid Emergency Psychiatric Services Demonstration Evaluation: Final Report. August 18, 2016." Also see appendices.

9/23/2016

Letter from Senate authors of P.L.114-97 to CMS urging reconsideration of cost-neutrality findings on Medicaid Emergency Psychiatric Demonstration

9/22/2016

NAPHS statement on Medicaid Emergency Psychiatric Demonstration

5/11/2016

Fact sheet: "Comprehensive Mental Health Reform Requires Action on the Medicaid Institutions for Mental Disease (IMD) Exclusion; The Medicaid Managed Care Final Rule Is Only One Step Toward Fixing the Problem"

4/12/2016

NAPHS ad as seen in Politico and Roll Call titled "OVERDUE: Mental Health Reform:  It's time to fix the Institutions for Mental Disease (IMD) exclusion that prohibits adult Medicaid beneficiaries (21-64) from accessing short-term, acute care in psychiatric hospitals"

11/20/2015

NAPHS release: "NAPHS Applauds Final Passage of Bipartisan Legislation To Extend and Expand the Medicaid Emergency Psychiatric Demonstration Project; Bill Next Goes to President for Signature."  [NOTE: Signed into law 12.11.15 as P.L.114-97.]

10/2/2015

House bill (H.R.3681) introduced to extend and expand the Medicaid Emergency Psychiatric Demonstration Project

9/29/2015

NAPHS release: "NAPHS Applauds Passage of Senate Legislation (S.599) To Extend and Expand the Medicaid Emergency Psychiatric Demonstration Project"

6/23/2015

NAPHS letter of support to Sens. Hatch and Wyden (Senate Finance Committee) on S.599, the Improving Access to Emergency Psychiatric Care Act

2/26/2015

S.599, the Improving Access to Emergency Psychiatric Care Act introduced by Sens. Ben Cardin (D-MD), Patrick Toomey (R-PA), and Susan Collins (R-ME) to extend and expand the Medicaid Emergency Psychiatric Demonstration. See Congressional Record statement on S.599 by Sen. Cardin (scroll down to pages S1168-S1170).

2/2/2015

NAPHS release: "President’s FY16 Budget Tackles Lingering Discrimination; NAPHS Applauds Proposal to Eliminate the Medicare 190-Day Lifetime Limit, Urges Action to Address Discrimination in Medicaid"

1/29/2015

MACPAC presentation at 1.29.15 meeting: "Medicaid’s Role in Behavioral Health: Background and Policy Issues"

3/26/2014

NAPHS release: "Millions of Disabled and Poor Americans Encounter Discrimination When They Face Mental or Addictive Disorders, Says NAPHS; NAPHS Applauds House Oversight Hearing on Challenges Facing Families in Mental Health Crisis."

3/26/2014

NAPHS letter submitted to House Energy and Commerce Oversight Committee hearing on “Where Have All the Patients Gone? Examining the Psychiatric Bed Shortage.”

3/10/2014

2014 Advocacy Priorities: 1) End discrimination (modify the Medicaid IMD exclusion); 2) Fix gaps (support H.R.3717); 3) Support Medicare/Medicaid funding for health information technology.

2/4/2014

Senate Finance Committee "Summary and Overview of Mental Health Recommendations" received in response to their 8.1.13 Open Letter seeking input on how to improve the US mental health system.

12/6/2013

CMS notice: "Type of Information Collection Request: New Collection (Request for a new OMB control number); Title of Information Collection: Medicaid Emergency Psychiatric Demonstration (MEPD) Evaluation"

9/30/2013

Mental Health Liaison Group (MHLG) comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system

9/20/2013

NAPHS comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system

4/18/2013

National Association of Medicaid Directors letter to Senate HELP Committee:  Includes a call for elimination of the IMD exclusion

3/13/2012

CMS release: "Affordable Care Act Demonstration to Expand Access to Emergency Psychiatric Care; New Demonstration Program to Help States Improve the Quality of Care for Patients with Psychiatric Emergency." Also see additional information.

3/23/2010

NAPHS statement: Reform law includes provisions important to Americans facing mental and addictive disorders. Includes IMD/EMTALA demonstration on emergency psychiatric care. [View]

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