Breaking:Another Win for Murphy Mental Health Effort

Press Release

Congressman Tim Murphy (R-PA), author of the Helping Families in Mental Health Crisis Act, commented on the Medicaid managed care final rule released by the Centers for Medicare & Medicaid Services which includes a provision on expanding psychiatric bed capacity. The rule makes changes to the Institutions of Mental Disease exclusion by allowing greater access to inpatient psychiatric care for individuals with serious mental illness and opioid addiction.

"We've all known for years that the flawed IMD exclusion policy has been an obstacle to delivering life-saving care for those in psychiatric and addiction crisis, but Congress has ignored it and the Administration followed suit," said Murphy. "With this step, after many hard fought years on my end to change this cruel barrier, patients will no longer languish in emergency departments as their families watch them strapped to a gurney waiting to see if a psychiatric bed opens up."

Congressman Murphy conducted numerous Oversight hearings on the lack of psychiatric beds resulting from the antiquated billing relic from the Johnson administration known as the Institutions for Mental Disease (IMD) exclusion. Part of the original Medicaid program enacted in 1965, the definition of an IMD is "a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment or care for persons with mental disease, including medical attention, nursing care, and related services." The IMD exclusion prohibits Medicaid federal matching payments for inpatient psychiatric care to Medicaid patients between the ages of 21-64 when those services are provided in freestanding psychiatric hospitals.

"For more than a half century, the United States has denied psychiatric care by prohibiting access to inpatient mental health care and substance use disorder treatment. Yet, we wonder why those with the most serious conditions are no longer in hospitals but can be found in bus stations, homeless shelters, jails, prisons, and early graves. The Institutions of Mental Disease exclusion has failed those with serious mental illness and opioid addiction. Finally we are moving in the right direction."

"I have been fighting for nearly a decade to make mental health and substance use disorder parity a reality and stopping insurance companies from limiting care for those most in need. So I'm disappointed that in 1,400 pages, CMS still left out half of those on Medicaid because this rule will only reach those in managed care and still keeps an arbitrary, non-clinical based cap of 15 days per month. This is why I'm going to keep pushing my Helping Families in Mental Health Crisis Act."

This latest move by the Administration reflects another provision of the Helping Families in Mental Health Crisis Act to be implemented, such as: SAMSHA has including Assisted Outpatient Treatment (AOT) as an evidence-based practice with an accompanying budget request for funding; dedicated a portion of the block grant to the most promising early intervention for psychosis, the Recovery After Initial Schizophrenia Episode (RAISE) program; and clarifying the application of HIPAA for patients with serious mental and their caregivers.

"These are groundbreaking steps for families and patients who have been ignored and relegated to the shadows. But we still have more work to be done and I will continue building our 187-member strong bipartisan coalition to get the all the provisions of the Helping Families in Mental Health Crisis Act over the finish line."

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