Addiction treatment center in Billings still has waiting list — and empty beds | Local

The waiting list for Medicaid patients to receive treatment at Rimrock is 160 names long. And yet on any given day, 16 to 20 beds at the addiction center’s main facility sit empty. 

That’s due to an obscure federal law that limits Medicaid dollars from paying for treatment at any mental health or substance abuse center with more than 16 beds. Rimrock’s main center has 42.

And while providers like Rimrock were recently assured that state applications for exemption from the rule would be fast-tracked, no one is holding their breath.

Filling empty beds

The 16-bed limit was enacted in 1965. According to Rimrock CEO Lenette Kosovich, it was aimed at cutting down on the type of harsh and ineffective mental health care depicted in Ken Kesey’s 1962 novel “One Flew Over the Cuckoo’s Nest,” in which patients were forced into submission using harsh measures like electroshock therapy as punishment. By keeping facilities small enough, officials had hoped to steer away from mass institutionalization.


Rimrock Foundation CEO Lenette Kosovich, seen here Friday, says all segments of society are affected by drug addiction.

Instead, the law has forced organizations like Rimrock to turn away people paid for by Medicaid, who make up the majority of the center’s patients.


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