[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9422 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 9422
To amend titles XIX and XXI of the Social Security Act to add a new
State plan amendment option to provide medical assistance for certain
individuals who are patients in certain institutions for mental
diseases.
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IN THE HOUSE OF REPRESENTATIVES
August 27, 2024
Ms. Pettersen introduced the following bill; which was referred to the
Committee on Energy and Commerce
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A BILL
To amend titles XIX and XXI of the Social Security Act to add a new
State plan amendment option to provide medical assistance for certain
individuals who are patients in certain 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 ``Recovery Act''.
SEC. 2. ADDING MEDICAID AND CHIP STATE PLAN AMENDMENT OPTIONS.
(a) Additional Medicaid State Plan Amendment Option.--Section 1915
of the Social Security Act (42 U.S.C. 1396n) is amended by adding at
the end the following new subsection:
``(m) Additional State Plan Amendment Option To Provide Medical
Assistance for Certain Individuals Who Are Patients in Certain
Institutions for Mental Diseases.--
``(1) In general.--Subject to the succeeding paragraphs of
this subsection, with respect to calendar quarters beginning on
or after January 1, 2025, a State may elect, through a State
plan amendment, to provide medical assistance for items and
services furnished to an eligible individual who is a patient
in an eligible institution for mental diseases in accordance
with the requirements described in paragraphs (3) through (7)
of subsection (l).
``(2) Payments.--
``(A) In general.--Subject to paragraphs (3) and
(4) of subsection (l) as applied to a State plan
amendment under paragraph (1), amounts expended under
such a State plan amendment for services described in
such paragraph furnished, with respect to a 12-month
period, to an eligible individual who is a patient in
an eligible 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 the period of
medical necessity determined under subparagraph (B)
with respect to such eligible individual during such
12-month period.
``(B) Period of medical necessity.--For purposes of
subparagraph (A), with respect to an eligible
individual, the period of medical necessity--
``(i) is the number of days (both
consecutive and nonconsecutive) that treatment
in an eligible institution for mental diseases
is determined, in a manner specified by the
Secretary, to be in accordance with the most
recent evidence-based criteria developed by a
nonprofit medical association with expertise in
substance use disorder treatment, such as the
American Society of Addiction Medicine; and
``(ii) shall be redetermined at a frequency
specified by the Secretary, but in no case less
frequently than every 30 consecutive days
during which such eligible individual is a
patient in an eligible institution for mental
diseases.
``(3) Temporary enhanced fmap.--Notwithstanding section
1905(b), for each fiscal quarter during the first 5 years that
a State plan amendment elected under this subsection is in
effect, the Federal medical assistance percentage applicable to
payments under this subsection shall be equal to 90 percent.
``(4) Clarification with respect to inpatient and
residential services.--For purposes of a State plan amendment
elected under this subsection, paragraph (4)(C)(ii) of
subsection (l) shall be applied by substituting the following
for subclause (IV):
```(IV) Medically managed, high-
intensity residential services for
adolescents, and medically managed,
intensive residential services
(including withdrawal management) for
adults, that provide 24-hour nursing
care, make physicians available for
significant problems in Dimensions 1,
2, or 3, and provide comprehensive
psychosocial services.'.
``(5) Planning grants.--
``(A) In general.--Beginning January 1, 2025, the
Secretary may award planning grants to States for
purposes of developing and implementing a State plan
amendment under this subsection, including through the
funding of appropriate tools and training. A planning
grant awarded to a State under this paragraph shall
remain available until expended.
``(B) Application.--To be eligible to receive a
planning grant under this paragraph, a State shall
submit to the Secretary an application in such form and
manner as the Secretary shall specify.
``(C) Limitation.--The total amount of payments to
States under this paragraph shall not exceed
$25,000,000.
``(6) Eligible individual defined.--In this subsection, the
term `eligible individual' means an individual who--
``(A) with respect to a State, is enrolled for
medical assistance under the State plan or a waiver of
such plan;
``(B) has not attained 65 years of age; and
``(C) has at least 1 substance use disorder.''.
(b) Children's Health Insurance Program.--Section 2107(e)(1) of the
Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended by adding at
the end the following new subparagraph:
``(V) Section 1915(m) (relating to the State option
to provide medical assistance for individuals who are
patients in an eligible institution for mental
diseases).''.
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