[Congressional Record Volume 155, Number 79 (Thursday, May 21, 2009)]
[Senate]
[Page S5829]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for herself, Mr. Conrad, Mr. Wyden, and Ms. 
        Collins):
  S. 1130. A bill to provide for a demonstration project regarding 
Medicaid reimbursements for stabilization of emergency medical 
conditions by non-publicly owned or operated institutions for mental 
diseases; to the Committee on Finance.
  Ms. SNOWE. Mr. President, today, I rise to introduce the Medicaid 
Emergency Psychiatric Care Demonstration Project Act. I am pleased to 
be joined by Senators Conrad, Wyden and Collins in this effort. We are 
introducing this legislation to address an unfair conflict in two 
Federal laws--the Institution for Mental Diseases, IMD, Exclusion and 
The Emergency Medical and Labor Treatment Act, EMTALA.
  EMTALA requires all hospitals, including freestanding psychiatric 
hospitals, to stabilize patients who come in with an emergency medical 
condition. At the same time, under an outdated Medicaid provision 
called the IMD exclusion, adult Medicaid patients, 21-64, are not 
covered for inpatient psychiatric care in a freestanding psychiatric 
hospital, but are covered in a general hospital psychiatric unit. Yet 
both types of hospitals are required to stabilize any patient--which 
may require hospitalization--who comes to them for emergency care 
regardless of ability to pay.
  In order to correct this inequity, we have introduced the Medicaid 
Emergency Psychiatric Care Demonstration Project Act. This legislation 
would establish a 3-year, demonstration program capped at $75 million, 
which would allow states to apply for federal Medicaid matching funds 
to demonstrate that covering Medicaid patients in freestanding, non-
governmental psychiatric hospitals will improve timely access to 
emergency psychiatric care, reduce the burden on overcrowded emergency 
rooms, and improve the efficiency and cost-effectiveness of inpatient 
psychiatric care. Our legislation helps alleviate a problem where 
patients with significant mental health needs are often forced to 
endure prolonged stays in emergency rooms and hospitals without the 
psychiatric attention they require.
  The measure is supported by 27 national healthcare organizations, 
including the National Alliance for the Mentally Ill--the country's 
largest advocacy organization for the mentally ill, the National 
Association of Psychiatric Health Systems, the American Hospital 
Association, the Federation of American Hospitals, the American 
Psychiatric Association, the National Association of County Behavioral 
Healthcare Directors, the American College of Emergency Physicians, and 
the Emergency Nurses Association.
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