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Medicaid limits on support of institutional psychiatric care

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This article summarizes a Report to Congress concerning Medicaid limits on assistance for patients in institutions for mental diseases (IMDs). There is little or no basis for changing this policy. Court judgments have found that the policy's application has been reasonable and consistent with congressional intent. Also, the general trend in the alcohol, drug abuse, and mental health (ADM) service system has been in outpatient or partial care, not institutional care. Research supports the conclusion that alternatives to IMD treatment are the most cost-effective. Finally, eliminating the IMD policy would be expensive, and simply substitute federal for state funding.

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Author information

Correspondence to Jeffrey A. Buck Ph.D..

Additional information

Richard Frank and David Salkever of Johns Hopkins University provided cost estimates and expenditure information.

The views presented in this paper are those of the Department of Health and Human Services and not necessarily those of the authors.

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Buck, J.A., Kiesler, C.A., Ashman, T.D. et al. Medicaid limits on support of institutional psychiatric care. Adm Policy Ment Health 22, 573–580 (1995). https://doi.org/10.1007/BF02254821

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  • Public Health
  • Alcohol
  • Mental Health
  • Drug Abuse
  • Mental Disease