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States Are Leveraging Medicaid Waivers to Transform Their Behavioral Health Systems

A Case for Repeal of the IMD Exclusion

As the nation experiences unprecedented levels of behavioral health needs—even further exacerbated by the COVID-19 pandemic—state Medicaid programs have increasingly looked for flexibility to craft services and payment models that support improved access and outcomes. As the single largest payer for behavioral health services nationwide, Medicaid is in a unique position to impact millions of Americans’ access to quality behavioral health care. To engender this effort, the Centers for Medicare & Medicaid Services (CMS) has waived historical restrictions on inpatient substance use and mental health services and permitted states to leverage Section 1115 demonstrations to support broad-based reform.

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