The Medicaid Institution for Mental Diseases (IMD) exclusion, which has been part of Medicaid since its enactment, is one of the few instances where Medicaid cannot pay for otherwise covered services for a specific Medicaid-covered population in a specific setting.
This presentation discusses how the IMD exclusion came to be, how it has changed over time, and concerns that have been raised about its impact on the delivery of behavioral health services. It concludes with brief discussion of proposals to modify the exclusion.