H.R. 5462: Michelle Alyssa Go Act

This bill, known as the Michelle Alyssa Go Act, aims to make changes to the definition of "institution for mental diseases" within the Medicaid program. Currently, institutions that provide treatment for mental health issues, including hospitals and nursing facilities, are classified under this term, which impacts how Medicaid funding is allocated. The bill proposes to exclude facilities with 36 beds or fewer from this definition, provided they meet certain criteria.

Key Provisions of the Bill

• The bill amends Section 1905(i) of the Social Security Act regarding what constitutes an "institution for mental diseases."
• Institutions with 36 beds or fewer can be exempt from the designation if they fulfill specific standards related to mental health care.
• These standards must be nationally recognized and evidence-based, including criteria set by recognized bodies such as the American Society of Addiction Medicine (ASAM) for facilities treating substance use disorders.
• Facilities must adhere to established guidelines regarding services offered, clinical care durations, and qualifications for staffing.

Effective Date

If enacted, the changes would take effect 180 days after the bill becomes law, impacting state Medicaid plans starting from that date.

Impact on Medicaid

This legislation is designed to potentially increase access to Medicaid funding for smaller mental health facilities that may provide critical services but do not qualify under the current definition due to their size. By allowing these smaller institutions to operate without the limitations imposed by the current classification, the bill aims to promote a more nuanced approach to mental health treatment within the Medicaid framework.

Relevant Companies

None found.