Study Medicaid payment rates for MH/SUD services

Medicaid beneficiaries are disproportionately more likely to experience a MH/SUD than those with private insurance.[2] However, Medicaid beneficiaries access MH/SUD services at lower rates than those with other insurance types.[3] One reason for the disparate access to care may be inadequate reimbursement within state Medicaid programs that disincentivizes providers to accept Medicaid patients.[4] Research shows Medicaid reimbursement rates for MH/SUD remain extraordinarily low, with some providers not having seen increases in rates in 30 years, causing experienced providers to be less likely to accept it and compounding an existing shortage of providers.[4][5] To sufficiently understand this problem and how to address it, Congress should direct the GAO to conduct a study examining Medicaid payment rates for both MH/SUD and physical health services across a sample of states to determine whether MH/SUD services are being reimbursed adequately. In late 2022, a bipartisan group of Senate Finance Committee members supported requiring such a report.[1]