[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7156 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 7156
To amend title XIX of the Social Security Act to provide States with an
option to provide medical assistance to individuals between the ages of
22 and 64 for inpatient services to treat substance use disorders at
certain facilities, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 18, 2022
Mr. Foster (for himself, Mr. Fitzpatrick, Ms. Jackson Lee, Ms. Moore of
Wisconsin, Mrs. Beatty, and Mr. Van Drew) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to provide States with an
option to provide medical assistance to individuals between the ages of
22 and 64 for inpatient services to treat substance use disorders at
certain facilities, and for other purposes.
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 ``Medicaid Coverage for Addiction
Recovery Expansion Act''.
SEC. 2. STATE OPTION TO PROVIDE MEDICAL ASSISTANCE FOR RESIDENTIAL
ADDICTION TREATMENT FACILITY SERVICES; MODIFICATION OF
THE IMD EXCLUSION.
(a) In General.--Section 1905 of the Social Security Act (42 U.S.C.
1396d) is amended--
(1) in subsection (a)(16)--
(A) by striking ``and, (B)'' and inserting ``,
(B)''; and
(B) by inserting ``, and (C) effective January 1,
2023, residential addiction treatment facility services
(as defined in subsection (h)(3)) for individuals over
21 years of age and under 65 years of age, if offered
as part of a full continuum of evidence-based treatment
services provided under the State plan, including
residential, outpatient, and community-based care, for
individuals with substance use disorders'' before the
semicolon; and
(2) in subsection (h)--
(A) in paragraph (1), by striking ``paragraph (16)
of subsection (a)'' and inserting ``subsection
(a)(16)(A)''; and
(B) by adding at the end the following new
paragraph:
``(3)(A) For purposes of subsection (a)(16)(C), the term
`residential addiction treatment facility services' means, subject to
subparagraph (B), inpatient services provided--
``(i) to an individual for the purpose of treating a
substance use disorder that are furnished to an individual for
not more than 2 consecutive periods of 30 consecutive days,
provided that upon completion of the first 30-day period, the
individual is assessed and determined to have progressed
through the clinical continuum of care, in accordance with
criteria established by the Secretary, in consultation with the
American Society of Addiction Medicine, and requires continued
medically necessary treatment and social support services to
promote recovery, stable transition to ongoing treatment, and
discharge; and
``(ii) in a facility that is accredited for the treatment
of substance use disorders by the Joint Commission on
Accreditation of Healthcare Organizations, the Commission on
Accreditation of Rehabilitation Facilities, the Council on
Accreditation, or any other accrediting agency that the
Secretary deems appropriate as necessary to ensure nationwide
applicability, including qualified national organizations and
State-level accrediting agencies.
``(B) The State agency responsible for administering the State plan
under this title shall establish procedures to ensure that, with
respect to any facility providing residential addiction treatment
facility services in a fiscal year, the average monthly number of beds
used by the facility to provide such services during such year is not
more than 40.
``(C) The provision of medical assistance for residential addiction
treatment facility services to an individual shall not prohibit Federal
financial participation for medical assistance for items or services
that are provided to the individual in or away from the residential
addiction treatment facility during any 30-day period in which the
individual is receiving residential addiction treatment facility
services.
``(D) A woman who is eligible for medical assistance on the basis
of being pregnant and who is furnished residential addiction treatment
facility services during any 30-day period may remain eligible for, and
continue to be furnished with, such services for additional 30-day
periods without regard to any eligibility limit that would otherwise
apply to the woman as a result of her pregnancy ending, subject to
assessment by the facility and a determination based on medical
necessity related to substance use disorder and the impact of substance
use disorder on birth outcomes.''.
(b) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 2023.
SEC. 3. GRANT PROGRAM TO EXPAND YOUTH ADDICTION TREATMENT FACILITIES
UNDER MEDICAID AND CHIP.
(a) Establishment.--
(1) In general.--The Secretary shall establish a program
under which the Secretary shall award grants to States for the
purpose of expanding the infrastructure and treatment
capabilities, including augmenting equipment and bed capacity,
of eligible youth addiction treatment facilities that provide
addiction treatment services to Medicaid or CHIP beneficiaries
who have not attained the age of 21 and are in communities with
high numbers of medically underserved populations of at-risk
youth.
(2) Use of funds.--Grant funds awarded under this section
may be used to expand the infrastructure and treatment
capabilities of an existing facility (including through
construction) but shall not be used for the construction of any
new facility or for the provision of medical assistance or
child health assistance under Medicaid or CHIP.
(3) Timetable for implementation; duration.--
(A) Implementation.--Not later than 1 year after
the date of the enactment of this Act, the Secretary
shall award grants under the grant program.
(B) Duration.--The Secretary shall award grants
under the grant program for a period not to exceed 5
years.
(b) Application.--A State seeking to participate in the grant
program shall submit to the Secretary, at such time and in such manner
as the Secretary shall require, an application that includes--
(1) detailed information on the types of additional
infrastructure and treatment capacity of eligible youth
addiction treatment facilities that the State proposes to fund
under the grant program;
(2) a description of the communities in which the eligible
youth addiction treatment facilities funded under the grant
program operate;
(3) an assurance that the eligible youth addiction
treatment facilities that the State proposes to fund under the
grant program shall give priority to providing addiction
treatment services to Medicaid or CHIP beneficiaries who have
not attained the age of 21 and are in communities with high
numbers of medically underserved populations of at-risk youth;
and
(4) such additional information and assurances as the
Secretary shall require.
(c) Rural Areas.--Not less than 15 percent of the amount of a grant
awarded to a State under this section shall be used for making payments
to eligible youth addiction treatment facilities that are located in
rural areas or that target the provision of addiction treatment
services to Medicaid or CHIP beneficiaries who have not attained the
age of 21 and reside in rural areas.
(d) Definitions.--For purposes of this section:
(1) Addiction treatment services.--The term ``addiction
treatment services'' means services provided to an individual
for the purpose of treating a substance use disorder.
(2) CHIP.--The term ``CHIP'' means the State children's
health insurance program established under title XXI of the
Social Security Act (42 U.S.C. 1397aa et seq.).
(3) Eligible youth addiction treatment facility.--The term
``eligible youth addiction treatment facility'' means a
facility that is a participating provider under the State
Medicaid or CHIP programs for purposes of providing medical
assistance or child health assistance to Medicaid or CHIP
beneficiaries for youth addiction treatment services on an
inpatient or outpatient basis (or both).
(4) Medicaid.--The term ``Medicaid'' means the medical
assistance program established under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.).
(5) Medicaid or chip beneficiary.--The term ``Medicaid or
CHIP beneficiary'' means an individual who is enrolled in the
State Medicaid plan, the State child health plan under CHIP, or
under a waiver of either such plan.
(6) Medically underserved populations.--The term
``medically underserved populations'' has the meaning given
that term in section 330(b)(3) of the Public Health Service Act
(42 U.S.C. 254b(b)(3)).
(7) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(e) Authorization of Appropriations.--There are authorized to be
appropriated $50,000,000 to carry out the provisions of this section.
Funds appropriated under this subsection shall remain available until
expended.
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