This bill permanently allows state Medicaid programs to receive federal payment for substance-use disorder services that are provided at institutions for mental diseases (IMDs) for individuals aged 21 to 64. The bill also extends the maximum length of stay over a 12-month period from 30 days to 45 days.
In addition, the bill provides statutory authority for a 2018 letter from the Centers for Medicare & Medicaid Services that provided for Medicaid demonstration programs for IMD mental health services for adults and children; the bill similarly increases the average length of stay under such programs to 45 days.
To amend title XIX of the Social Security Act to make permanent the 
 State plan amendment option to provide medical assistance for certain 
    individuals who are patients in certain institutions for mental 
                   diseases, 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. LIFTING THE IMD EXCLUSION FOR SUBSTANCE USE DISORDER AND 
              SERIOUS MENTAL ILLNESS.

    (a) Making Permanent State Plan Amendment Option To Provide Medical 
Assistance for Certain Individuals Who Are Patients in Certain 
Institutions for Mental Diseases.--Section 1915(l)(1) of the Social 
Security Act (42 U.S.C. 1396n(l)(1)) is amended by striking ``With 
respect to calendar quarters beginning during the period beginning 
October 1, 2019, and ending September 30, 2023,'' and inserting ``With 
respect to calendar quarters beginning on or after October 1, 2019,''.
    (b) Lengths of Stay.--Section 1915(l)(2) of the Social Security Act 
(42 U.S.C. 1396n(l)(2)) is amended--
            (1) by striking ``30 days'' and inserting ``45 days''; and
            (2) by adding at the end the following new sentence: 
        ``Nothing in this paragraph shall be construed as precluding a 
        State from using other authorities, including section 1115, 
        that apply with respect to medical assistance under the State 
        plan under this title, or waiver of such plan, for delivering 
        care in certain institutions for mental diseases with more than 
        16 beds concurrently with this paragraph and allowing for stays 
        in such institutions for mental diseases equal to the combined 
        total lengths of stays permitted under the respective 
        authorities so long as all requirements for such authorities 
        are met.''.
    (c) Codification of State Medicaid Director Letter #18-011.--
Beginning on the date of the enactment of this Act, the State Medicaid 
Director Letter #18-011 shall have the force and effect of law, except 
that in applying such letter, with respect to a State, the State mental 
health director (or such other similar actor) may allow for up to 45 
days for the Statewide average length of stay described in such letter.
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To amend title XIX of the Social Security Act to make permanent the State plan amendment option to provide medical assistance for certain individuals who are patients in certain institutions for mental diseases, and for other purposes.
To amend title XIX of the Social Security Act to make permanent the State plan amendment option to provide medical assistance for certain individuals who are patients in certain institutions for mental diseases, and for other purposes.
Official Titles - House of Representatives
Official Title as Introduced
To amend title XIX of the Social Security Act to make permanent the State plan amendment option to provide medical assistance for certain individuals who are patients in certain institutions for mental diseases, and for other purposes.
Rep. Burgess, Michael C.