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Washington, D.C. - Today, Congressman Tom Emmer (MN-06) introduced the Expanding Access to Inpatient Mental Health Act, which will eliminate an arbitrary cap on mental health services which has served as a barrier to individuals seeking treatment. 

“Every community throughout the country has been struggling with the same challenge: providing quality mental health care to individuals experiencing mental illness,” Emmer said. “The current public health crisis has only exacerbated the need for mental health care. The federal government has instituted a limitation to care that has no regard for a doctor’s recommendation for proper care. As a result, many individuals are left out in the cold, and often face law enforcement or end up in emergency rooms when we could be addressing their mental health challenges. This legislation would be an important step in addressing one of the many barriers to ensuring access to mental health care.”

Under current law, mental health care treatment is limited at some facilities due to the Institutions for Mental Disease (IMD) exclusion. Because of the IMD exclusion, caps are placed on the number of beds provided for patients, and the number of days a patient can receive care. Medicaid managed care, for instance, limits care for patients in an IMD to 15 days. This cap has harmed proper mental health care treatment and unnecessarily harmed the establishment of new mental health facilities.

Specifically, the Expanding Access to Inpatient Mental Health Act would eliminate the 15-day cap for Managed Care Organizations (MCOs) and Prepaid Inpatient Health Plan (PIHP) beneficiaries receiving care in an IMD. This would allow individuals to receive care for the appropriate amount of time required to treat their mental illness.


The IMD Exclusion was initially enacted in 1965 to ensure state responsibility for mental health treatment. While well-intentioned, this exclusion has severely limited individual’s access to proper mental health care. An IMD facility includes any facility with more than 16 beds, which are primarily established and utilized for the treatment of mental disease. Anoka Metro Regional Treatment Center is an IMD in the Sixth Congressional District of Minnesota.

In 2016, the Medicaid Managed Care rule permitted Medicaid beneficiaries receiving care under MCOs to receive up to 15 days of treatment in an IMD each month. While this was a great step in expanding access to a larger group of beneficiaries, 15 days is often not an adequate amount of time to provide the care needed. This interruption can mean the difference between a tragedy and the first step on the road to recovery.

This loophole also prevents individuals from seeking short-term care in mental health facilities with more than sixteen beds. In fact, some psychiatric facilities have decreased their number of beds, resulting in the treatment of fewer patients. 

Read the text of the Expanding Access to Inpatient Mental Health Act here