[Congressional Record Volume 163, Number 85 (Wednesday, May 17, 2017)]
[Senate]
[Pages S3017-S3018]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself, Mr. Portman, Mr. Brown, Mrs. Capito, 
        Mr. King, Ms. Collins, Mr. Manchin, and Mr. Booker):
  S. 1169. A bill to amend title XIX of the Social Security Act to 
provide States with an option to provide medical assistance to 
individuals between

[[Page S3018]]

the ages of 22 and 64 for inpatient services to treat substance use 
disorders at certain facilities, and for other purposes; to the 
Committee on Finance.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1169

       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, 2019, 
     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, 2019.

     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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