On July 31, 2017, the Federal Commission on Combating Drug Addiction and the Opioid Crisis recommended in its interim report that the federal Medicaid program end the exclusion on reimbursing for services provided in an “Institution of Mental Disease” (IMD). The exclusion has been in place since Medicaid was created; under the exclusion the federal Medicaid program will not pay for services provided in a facility that provides psychiatric or addiction treatment if the facility has 16 or more beds. The exclusion was intended to encourage states to provide community-based mental health services, rather than to rely on inpatient . . .