Medicaid Substance Abuse Treatment Act of 1991

Medicaid Substance Abuse Treatment Act of 1991 - Amends title XIX (Medicaid) of the Social Security Act to provide federally reimbursed Medicaid coverage of alcoholism and drug dependency residential treatment services for pregnant women whose family income is below 185 percent of the Federal poverty level and for their Medicaid-eligible children and spouses. Lists the required services included in such coverage as: (1) individual, group, and family counseling and addiction education and treatment provided pursuant to individualized treatment plans; (2) room and board in a structured environment with on-site supervision 24 hours a day; (3) therapeutic child care or counseling for children of individuals in treatment; (4) parental assistance in obtaining developmental assistance for their preschool children and public education for themselves and their school-age children; (5) easier access to prenatal, postpartum, pediatric, and other appropriate health, social, and child care services; (6) planning and assistance in reentering society; and (7) continuing specialized training of residential treatment facility staff members in the most recent and effective treatment techniques.

Requires that such coverage continue for at least 12 months, except that the coverage of pregnant women must continue for one year following the end of pregnancy.

Limits the size of a residential treatment facility to no more than 40 beds beginning in calendar year 1994. Allows a State agency to grant exceptions to such limit for one or more facilities subject to review by the Secretary of Health and Human Services. Prescribes the conditions for granting such exceptions. Caps the number of nationwide beds for which Federal assistance may be provided under such residential treatment programs. Increases such annual bed cap from 1,080 to 6,000 beds nationwide for calendar years 1992 through 1996.

Addresses treatment needs of pregnant addicted Indian and Alaska Native women in the Indian Health Service areas by: (1) allocating additional beds nationwide for such areas; (2) providing 100 percent Federal matching funds to States to create residential treatment programs in such areas; and (3) requiring the Secretary to conduct training in such areas for appropriate parties regarding the availability and nature of residential treatment services in such areas under this Act.