Pennsylvania Attorney General Josh Shapiro and New Jersey Attorney General Christopher Porrino are teaming with attorneys general from 37 other states to urge Congress to quickly pass legislation to eliminate a decades-old restriction that prevents larger drug treatment centers from billing Medicaid.
The AGs made their case in a letter sent Monday to House Speaker Paul Ryan, Minority Leader Nancy Pelosi and other congressional leaders, expressing support for legislation known as the “Road to Recovery Act” that would lift the Medicaid Institutions for Mental Diseases exclusion.
The rule prevents drug treatment centers with more than 16 beds from billing Medicaid for residential treatment services. It was created in 1965 to prevent Medicaid funding from going to private mental health institutions accused of warehousing patients. But it has been cited by lawmakers and advocates as a major obstacle for people suffering from substance abuse disorders to receive inpatient treatment.
Lifting it, the attorneys argue, would greatly expand access to treatment during the current opioid addiction epidemic.
“If we truly want to end this crisis, we need to focus on its root causes, including the lack of treatment for those suffering from addiction,” the attorneys said in the letter, which was spearheaded by Shapiro and Ohio Attorney General Mike DeWine.
The group cited a recent study that found that over 65,000 Americans may have died last year from drug overdoses.
“If we have any hope of reversing this terrible trend, we need every treatment option at our disposal,” the attorneys said.
The legislation was introduced in June by U.S. Rep. Brian Fitzpatrick, R-8 of Middletown, and is pending in the House Energy and Commerce Committee.
The attorneys general are the latest to support the bill, which would retain the limit for mental health institutions. The House Bipartisan Heroin Task Force has also called for the measure’s passage as part of its proposed legislative agenda for the current Congress.
The task force is co-chaired by New Jersey Rep. Tom MacArthur, who is co-sponsor of the bill, along with fellow New Jersey Rep. Donald Norcross, D-1st of Camden.
Fitzpatrick and Norcross are vice chairmen of the House task force.
The Gov. Chris Christie-led White House Commission on Combating Drug Addiction and the Opioid Crisis also recommended action to lift or waive the IMD exclusion, describing the move as "the single fastest way to increase drug treatment availability across the nation."
Christie, who has made ending the stigma surrounding addiction and devising ways to combat the crisis a top priority in his final year as governor, first raised the issue during his January State of the State address, describing the restriction as one of the "outdated barriers to substance abuse care" and an example of "ridiculous and antiquated thinking."
"Eligibility for drug abuse treatment should not be determined by how many beds are in the facility where you seek treatment," he said.
New Jersey applied for a waiver from the restriction in January but continues to wait for approval from the federal government, which is developing "standardized language" setting the terms and conditions for IMD waivers, officials said.
"We have every reason to believe that waiver will be granted very soon," Christie said recently.
MacArthur has said he expects the Trump administration will be able to move quickly on IMD waivers once it formally declares the opioid epidemic a national public health emergency.
President Donald Trump announced his intention to issue a declaration over a month ago, saying on Aug. 10 that the opioid crisis was "a serious problem, the likes of which we have never had" and that "officially right now it is an emergency. It’s a national emergency." However, he has yet to take formal action on the declaration.