Requests President and Congress take action to permit federal Medicaid funding for certain substance use disorder programs.

SCR81

SENATE CONCURRENT RESOLUTION No. 81

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED FEBRUARY 5, 2026

Sponsored by:

Senator� SHIRLEY K. TURNER

District 15 (Hunterdon and Mercer)

SYNOPSIS

���� Requests President and Congress take action to permit
federal Medicaid funding for certain substance use disorder programs.

CURRENT VERSION OF TEXT

���� As introduced.

��

A
Concurrent Resolution
respectfully
requesting the President and Congress of the United States take action to
permit federal Medicaid funding for certain substance use disorder programs.

Whereas,

The Medicaid program is a federally supported health benefits program
established in 1965 as Title XIX of the Social Security Act; and

Whereas,

The federal government provides the authority and broad requirements under
which each state creates and administers an individual Medicaid program which
best meets the needs of that particular state. The federal and state government
share the financing of Medicaid benefits through formulas established by the
federal government; and

Whereas,

In certain instances, the federal government prohibits certain benefits or
services from being reimbursed by the federal Medicaid program and thus, if
these benefits or services are provided by a state, the associated costs are
entirely borne by that state; and

Whereas,

Since the inception of Medicaid in 1965, the federal law has excluded financing
for most care delivered in Institutions for Mental Diseases (IMD), commonly
referred to as the IMD exclusion, which prohibits payments for the majority of
Medicaid individuals, between the ages of 21 and 64, who are patients in an
IMD; and�

Whereas,

Specifically, the law defines an IMD as a �hospital, nursing facility, or other
institution of more than 16 beds� that, by its overall character, is a facility
established and maintained primarily for the care and treatment of individuals
with mental diseases; and

Whereas,

The purpose of the IMD exclusion was to ensure that states, rather than the
federal government, would be primarily responsible for funding inpatient
psychiatric services; and

Whereas,

Certain in-patient and out-patient rehabilitation and treatment programs for
individuals afflicted with a substance use disorder are classified as IMDs
because substance use disorder is recognized as a mental disease and is
included as such in the International Classification of Diseases; and

Whereas,

The federal Medicaid program has taken certain steps to permit states to be
reimbursed for services provided to individuals who are afflicted with
substance use disorder and receiving treatment in an IMD.� For example, the
federal Medicaid program adopted rules in July 2016 which allow certain
Medicaid clients to receive certain substance use disorder treatment services
in an IMD for up to 15 inpatient days; and

Whereas,

The federal Medicaid program has also permitted states to apply for a waiver
from the traditional Medicaid program requesting permission to expand services
available for substance use disorder treatment and rehabilitation.� In October
2017, the federal government approved New Jersey�s requested expansion of
reimbursable substance use disorder services in its waiver submission, the NJ
FamilyCare 1115 Comprehensive Demonstration Application for Renewal; and

Whereas,

The waiver review process can be quite lengthy and, once approved,
waivers are limited in duration. While the process requires a level of
bureaucratic oversight that is important, it can result in the continued delay
of needed substance use disorder rehabilitation and treatment programs for
individuals who are desperately in need of such programs and who will continue
to suffer and even die from their substance use disorders; and

Whereas,

The President and Congress of the United States should take action to ensure
that individuals with substance use disorders can access the needed in-patient
and out-patient rehabilitation and treatment programs to assist these
individuals in recovery from substance use disorder; and

Whereas,

The actions the President and Congress of the United States could take include,
but are not limited to: repealing the IMD exclusion; excluding substance use
disorder from the definition of mental disease for the purposes of determining
if a treatment facility is an IMD; and increasing the bed limit of the IMDs;
now, therefore,

����
Be It
Resolved
by the Senate of the State of New
Jersey (the General Assembly concurring):

���� 1.��� The President and
Congress of the United States are respectfully requested to take actions
amending the provisions in the Medicaid program which prohibit federal
reimbursement for certain in-patient and out-patient rehabilitation and
treatment programs for individuals who are afflicted with substance use
disorder.

���� 2.��� Copies of this
resolution, as filed with the Secretary of State, shall be transmitted by the
Clerk of the General Assembly or the Secretary of the Senate to the President
and the Vice-President of the United States, the Majority and Minority Leaders
of the United States Senate, the Speaker and Minority Leader of the United
States House of Representatives, every member of Congress elected from this
State, and the Secretary of the United States Department of Health and Human
Services.

STATEMENT

���� This concurrent resolution
respectfully requests the President and Congress of the United States to take
action amending the provisions in the Medicaid program which prohibit federal
reimbursement for certain in-patient and out-patient rehabilitation and
treatment programs for individuals who are afflicted with substance use
disorder.

���� Since the inception of the
Medicaid program in 1965, prohibitions have existed on the federal funding of
services which are provided in an Institution for Mental Diseases (IMD),
referred to as the IMD exclusion.� As substance use disorder is classified as a
mental disease, certain programs that provide in-patient and out-patient
rehabilitation and treatment services for individuals who are afflicted with
substance use disorder are not eligible for federal Medicaid reimbursement.

���� The federal Medicaid program
has taken certain steps to permit states to be reimbursed for services provided
to individuals who are afflicted with substance use disorder and receiving
treatment in an IMD, such as permitting states to apply for a waiver from the
traditional Medicaid program requesting permission to expand services available
for substance use disorder treatment and rehabilitation.� However, the waiver
review process can be quite lengthy and, once approved, waivers are limited in
duration.��

���� The President and Congress of
the United States could take certain actions to ameliorate these problems by
modifying certain Medicaid provisions. Examples of these potential actions
include, repealing the IMD exclusion, excluding substance use disorder from the
definition of mental disease for the purposes of determining if a treatment
facility is an IMD, and increasing the bed limit of the IMDs.