[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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            August 27, 2024

Ms. Pettersen introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 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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