[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5797 Reported in House (RH)]
<DOC>
Union Calendar No. 558
115th CONGRESS
2d Session
H. R. 5797
[Report No. 115-723]
To amend title XIX of the Social Security Act to allow States to
provide under Medicaid services for certain individuals with opioid use
disorders in institutions for mental diseases.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 15, 2018
Mrs. Mimi Walters of California (for herself, Mr. Knight, and Mr.
Guthrie) introduced the following bill; which was referred to the
Committee on Energy and Commerce
June 12, 2018
Additional sponsors: Mrs. Blackburn, Mr. Walden, and Mr. Hill
June 12, 2018
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed
in italic]
[For text of introduced bill, see copy of bill as introduced on May 15,
2018]
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to allow States to
provide under Medicaid services for certain individuals with opioid use
disorders in institutions for mental diseases.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Individuals in Medicaid Deserve Care
that is Appropriate and Responsible in its Execution Act'' or the ``IMD
CARE Act''.
SEC. 2. MEDICAID STATE PLAN OPTION TO PROVIDE SERVICES FOR CERTAIN
INDIVIDUALS WITH OPIOID USE DISORDERS IN INSTITUTIONS FOR
MENTAL DISEASES.
Section 1915 of the Social Security Act (42 U.S.C. 1396n) is
amended by adding at the end the following new subsection:
``(l) State Plan Option To Provide Services for Certain Individuals
in Institutions for Mental Diseases.--
``(1) In general.--With respect to calendar quarters
beginning during the period beginning January 1, 2019, and
ending December 31, 2023, a State may elect, through a State
plan amendment, to, notwithstanding section 1905(a), provide
medical assistance for services furnished in institutions for
mental diseases and for other medically necessary services
furnished to eligible individuals with opioid use disorders, in
accordance with the requirements of this subsection.
``(2) Payments.--
``(A) In general.--Amounts expended under a State
plan amendment under paragraph (1) for services
described in such paragraph furnished, with respect to
a 12-month period, to an eligible individual with an
opioid use disorder who is a patient in an institution
for mental diseases shall be treated as medical
assistance for which payment is made under section
1903(a) but only to the extent that such services are
furnished for not more than a period of 30 days
(whether or not consecutive) during such 12-month
period.
``(B) Clarification.--Payment made under this
paragraph for expenditures under a State plan amendment
under this subsection with respect to services
described in paragraph (1) furnished to an eligible
individual with an opioid use disorder shall not affect
payment that would otherwise be made under section
1903(a) for expenditures under the State plan (or
waiver of such plan) for medical assistance for such
individual.
``(3) Information required in state plan amendment.--
``(A) In general.--A State electing to provide
medical assistance pursuant to this subsection shall
include with the submission of the State plan amendment
under paragraph (1) to the Secretary--
``(i) a plan on how the State will improve
access to outpatient care during the period of
the State plan amendment, including a
description of--
``(I) the process by which eligible
individuals with opioid use disorders
will make the transition from receiving
inpatient services in an institution
for mental diseases to appropriate
outpatient care; and
``(II) the process the State will
undertake to ensure individuals with
opioid use disorder are provided care
in the most integrated setting
appropriate to the needs of the
individuals; and
``(ii) a description of how the State plan
amendment ensures an appropriate clinical
screening of eligible individuals with an
opioid use disorder, including assessments to
determine level of care and length of stay
recommendations based upon the multidimensional
assessment criteria of the American Society of
Addiction Medicine.
``(B) Report.--Not later than the sooner of
December 31, 2024, or one year after the date of the
termination of a State plan amendment under this
subsection, the State shall submit to the Secretary a
report that includes at least--
``(i) the number of eligible individuals
with opioid use disorders who received services
pursuant to such State plan amendment;
``(ii) the length of the stay of each such
individual in an institution for mental
diseases; and
``(iii) the type of outpatient treatment,
including medication-assisted treatment, each
such individual received after being discharged
from such institution.
``(4) Definitions.--In this subsection:
``(A) Eligible individual with an opioid use
disorder.--The term `eligible individual with an opioid
use disorder' means an individual who--
``(i) with respect to a State, is enrolled
for medical assistance under the State plan (or
a waiver of such plan);
``(ii) is at least 21 years of age;
``(iii) has not attained 65 years of age;
and
``(iv) has been diagnosed with at least one
opioid use disorder.
``(B) Institution for mental diseases.--The term
`institution for mental diseases' has the meaning given
such term in section 1905(i).
``(C) Opioid prescription pain reliever.--The term
`opioid prescription pain reliever' includes
hydrocodone products, oxycodone products, tramadol
products, codeine products, morphine products, fentanyl
products, buprenorphine products, oxymorphone products,
meperidine products, hydromorphone products, methadone,
and any other prescription pain reliever identified by
the Assistant Secretary for Mental Health and Substance
Use.
``(D) Opioid use disorder.--The term `opioid use
disorder' means a disorder that meets the criteria of
the Diagnostic and Statistical Manual of Mental
Disorders, 4th Edition (or a successor edition), for
heroin use disorder or pain reliever use disorder
(including with respect to opioid prescription pain
relievers).
``(E) Other medically necessary services.--The term
`other medically necessary services' means, with
respect to an eligible individual with an opioid use
disorder who is a patient in an institution for mental
diseases, items and services that are provided to such
individual outside of such institution to the extent
that such items and services would be treated as
medical assistance for such individual if such
individual were not a patient in such institution.''.
Union Calendar No. 558
115th CONGRESS
2d Session
H. R. 5797
[Report No. 115-723]
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to allow States to
provide under Medicaid services for certain individuals with opioid use
disorders in institutions for mental diseases.
_______________________________________________________________________
June 12, 2018
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed