In October, President Trump signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) to address the ongoing opioid epidemic. For state Medicaid programs, one key impact is the availability of substance use disorder treatments through Institutions of Mental Disease (IMD) facilities where Medicaid recipients have been historically unable to receive care that qualifies for federal matching funds. The SUPPORT Act provides a simpler way for states to include IMD facilities in their fee-for-service and managed care delivery models—a state plan amendment.